The importance of eating behavior in eating disorders

Abstract

A disturbance in eating behavior is the defining characteristic of the clinical eating disorders, Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Surprisingly little research has been devoted to assessing objectively the nature of the eating disturbances in these disorders, to elucidating what factors contribute to the development and persistence of these disturbances, or to describing how they change with treatment. This review, which is based on a Mars lecture delivered at the 2010 meeting of the Society for the Study of Ingestive Behavior, reviews objective information about the nature of the disturbances of eating behavior in eating disorders. These data suggest that more detailed knowledge of eating behavior is an essential component of a full understanding of eating disorders and may provide a foundation for studies of pathophysiology and for the development of new treatment methods.

Figure 1

Kilocalorie content (1A) and macronutrient composition (1B) of binge meals of patients with Bulimia Nervosa. In 1A, filled circles are from patient meals and open circles are from control meals. In 1B, filled columns indicate means of patient meals and open columns indicate means of control meals. Adapted from [2].

Figure 2

Kilocalorie content of non-binge meals of patients with Bulimia Nervosa. Filled circles are from patient meals and open circles are from control meals. Adapted from [2].

Figure 3

Average kilocalorie content of binge meals of patients with Binge Eating Disorder (BED) and controls (NC) from three studies. Filled columns indicate means of patient meals and open columns indicate means of control meals.

Figure 4

Average kilocalorie content of non-binge meals of patients with Binge Eating Disorder (BED) and controls (NC) from two studies. Filled columns indicate means of patient meals and open columns indicate means of control meals.

Figure 5

Average kilocalorie and macronutrient composition of observed meals of patients with Anorexia Nervosa (AN) and controls (NC). Data from [17].

Figure 6

Kilocalorie intake of 12 patients with Anorexia Nervosa from a single-item lunch meal before and after weight gain. Dashed line indicates average intake of control group. Data from [18].

Figure 7

Pre-meal anxiety and kilocalorie intake across three laboratory test meals in individuals with Anorexia Nervosa. Pre-meal anxiety was measured by Spielberger State-Trait Inventory, State version (STAI-S).From [23].