A direct measure of satiety disturbance in patients with bulimia nervosa

To determine whether patients with bulimia nervosa (BN) experience the development of satiety during a meal differently than control subjects, a novel laboratory meal procedure was employed. Eleven women with BN and 11 women without eating disorders consumed a yogurt shake meal after being instructed to binge. After each 75-g increment consumed, the subjects were signaled by a tone to fill out a questionnaire on which they were asked to rate various sensations on visual analog scales. The sensations included "Fullness", "Hunger", "Desire" for a favorite food, "Pleasantness" of consuming the shake, "Sickness", and having "Enough" to consume. Although patients, before purging, consumed significantly more food than the controls, who did not purge (1597 +/- 626.5 g vs. 1004 +/- 362.5 g, mean +/- SD), their final questionnaire ratings were not significantly different from the controls' ratings. Patients ate significantly more than the controls before reaching 50% of their range of "Hunger" rating and 75% of their "Full", "Desire", "Sick", and "Enough" rating ranges. The patients also ate significantly more than the controls between 75% and 100% of their "Hunger" rating range. These data suggest that one possible mechanism for overeating in patients with BN may be their failure to perceive or respond as normal subjects do to the range of sensations associated with satiety. Collecting ratings as a function of intake may provide a method for assessing and studying eating disturbances in clinical populations.