Food intake in anorexia nervosa: patterns reported over a 25-year period, 1967-1992

Abstract

INTRODUCTION Measurements of food intake, of people with anorexia nervosa and described in the literature, usually derive from expert carefully elicited self-reports concerning periods of time in the immediate or more remote past. The validity of such measures is questionable. They could reflect inaccuracies due to poor or distorted memory (in fact, as we know, people with anorexia nervosa are often exceptionally knowledgeable and informed about their food intake) or, more likely, the patients’ desire to present themselves as ‘normal’. The person with anorexia nervosa, seeking to achieve and thereafter maintain a pathologically low body weight, strives to restrict absorption of calories. This aim to slim by such means, albeit less drastically, is common amongst teenage females who, nevertheless, usually remain significantly heavier/ fatter than they would wish (Crisp et al., 1998). The anorectic ‘succeeds’. If she is not to be compelled to fall back on her last defence (of vomiting and high laxative dosage in the face of bulimia), her task has been effectively to identify and severely restrict her calorie intake in the first instance and thereafter. The present author and his colleagues had long claimed that this selective dietary calorie restriction is the unique hallmark of the classical restricting type of anorexia nervosa and fundamental to some of its biological expressions such as early onset of amenorrhoea (e.g. see Crisp, 1967).