Changes in perceptions and emotions before and after refeeding in anorexia nervosa: a pilot study

Abstract

AbstractObjective: Physiological and psychological distortions associated with eating are recognised within the syndrome of anorexia nervosa. The purpose of this study was to compare subgroups of restricting and bulimic anorexic patients (AN-R and AN-B) with control subjects, and with themselves after six weeks of refeeding and weight gain, on a series of indices before and after a standard meal. Method: Nineteen consecutively admitted female AN patients completed visual analogue ratings of hunger, satiety, depression, urge to binge, urge to vomit and food craving during the first week and sixth week of hospitalisation. A female control group of seven subjects completed similar ratings for one week. The patient ratings were compared to those of the control subjects at baseline before and after a meal. Further comparisons between the two patient groups were also carried out six weeks after treatment. Results: As expected, AN patients reported significantly higher ratings of depression, urges to vomit, urges to binge and higher satiety levels when compared to controls. Comparisons between the patient subgroups revealed that at baseline AN-B patients had significantly higher urges to vomit that AN-R patients after meals, and reported significantly less satiety both before and after eating. Also, an increase in depression after the meal, at baseline, was reported by both groups although after six weeks higher levels of depression were recorded before rather than after the meal. There was also a significant decrease in food cravings after six weeks compared to baseline for both patient groups.Conclusions: The findings in this study provide further evidence that clinically significant differences exist between subtypes of patients suffering from anorexia nervosa, and highlight the differential, change in various symptoms during intense hospital treatment.