Standardized test meals in assessment of eating behavior in bulimia nervosa: Consumption of feared foods when vomiting is prevented

Abstract

This study contrasted the amount of food eaten in the absence of vomiting by normal-weight bulimia nervosa patients and matched normal controls. Subjects were instructed to eat as much food as they comfortably could without vomiting afterwards in three standardized test meals: a complete dinner eaten in a laboratory situation, and spaghetti and candy eaten at home. Bulimia nervosa subjects ate a very small amount of food in each test meal when compared with control subjects. Bulimia nervosa subjects also reported greater anxiety and urge to vomit after eating. A content analysis of tape-recorded thoughts showed that bulimia nervosa subjects were more preoccupied with eating and expressed more negative food-related thoughts. The results support the hypothesis that women with bulimia nervosa are unable to eat normal amounts of “frightening” foods when they do not plan to vomit. This behavioral test of eating behavior appears to be useful for the assessment of bulimia nervosa.