Pain sensitivity in recovered anorexics, restrained and unrestrained eaters

The heat pain threshold and local skin temperature were assessed in 23 former anorexic in-patients with an 'intermediate' (N = 9) or 'good' outcome (N = 14) and in 21 restrained and 20 unrestrained eaters. All subjects were female. The group means of the pain thresholds did not differ significantly from each other, suggesting that the homogeneous increase in pain thresholds we had previously observed in acutely ill eating disorder patients is state dependent. However, a sizeable percentage of the restrained eaters (29%) had pain thresholds clearly above the normal range. Thus it may well be that restrained eating carries a risk of reducing pain sensitivity. Pain threshold and skin temperature correlated significantly (r = -0.63) only in the group of patients with an intermediate outcome, a finding resembling that obtained in acute anorexics. This suggests that peripheral thermoregulation and pain sensitivity are linked in the acute and moderately improved phases of anorexia nervosa.