ABSTRACT
This study investigates the subjective estimation of weight gain in patients with anorexia nervosa (AN) when being confronted with food cues both in a general (self-unrelated) and in an intent-to-eat (self-related) condition. Looking at the presentation of different snack pictures with different nutrition values (high-low calories), AN patients (N = 24) and age-matched healthy women (N = 27) estimated the weight gain when they imagined eating the presented portions of snack pictures once a day in addition to the normal daily nutrition in the following two conditions: 1) a general condition without specific additional instruction, 2) an intent-to-eat condition, in which they were instructed to imagine that they would eat the snack themselves. Compared to healthy women, patients with AN estimated a higher weight gain only in the intent-to-eat condition, i.e. when they imagined eating the snacks themselves, but not in the general, not self-related condition. In the patient group, mean estimations of weight gain were associated with the "drive for thinness". This study suggests cognitive abnormalities related to the effects of food intake on the weight gain in AN, and that these cognitive anomalies could be related to the fear of gaining weight, one central symptom of AN. It appears that the self-reflective disturbed cognition, rather than the general cognition, could be the main driver underlying anorexia and that the overestimation of the energetic content of food is related to the drive for thinness.
Subject(s)
Anorexia Nervosa/physiopathology , Anxiety/etiology , Cognitive Dissonance , Energy Intake , Health Knowledge, Attitudes, Practice , Models, Psychological , Overweight/prevention & control , Adolescent , Adult , Anorexia Nervosa/psychology , Anorexia Nervosa/therapy , Anxiety/psychology , Body Mass Index , Combined Modality Therapy , Cues , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Overweight/psychology , Pilot Projects , Psychiatric Status Rating Scales , Serving Size , Snacks/psychology , Switzerland , Thinness/etiology , Thinness/prevention & control , Thinness/psychology , Weight Gain , Young AdultABSTRACT
Pathological concern regarding one's weight and weight gain is a crucial feature of anorexia nervosa. Consequently, anorexia nervosa patients often claim that they are uncertain regarding the amount of food they should eat. The present study investigated whether individuals with anorexia nervosa show an altered estimation of meal portion sizes and whether this estimation is modulated by an intent-to-eat instruction (where patients are asked to imagine having to eat the presented meal), meal type and meal portion size. Twenty-four women with anorexia nervosa and 27 healthy women estimated, using a visual analogue scale, the size of six different portions of three different meals, with and without intent-to-eat instructions. Subjects with anorexia nervosa estimated the size of small and medium meal portions (but not large meal servings) as being significantly larger, compared to estimates of healthy controls. The overestimation of small meal portions by anorexia nervosa subjects was significantly greater in the intent-to-eat, compared to general, condition. These findings suggest that disturbed perceptions associated with anorexia nervosa not only include interoceptive awareness (i.e., body weight and shape), but also extend to external disorder-related objects such as meal portion size. Specific therapeutic interventions, such as training regarding meal portion evaluation, could address these difficulties.
