Fat aversion in eating disorders

Abstract

Patients with eating disorders are reported to show an irrational dislike of starchy foods, sometimes described as a "carbohydrate phobia". In the present study, food-related attitudes and self-reported food preferences of women patients with anorexia nervosa (N = 13), anorexia with bulimia (N = 16) and bulimia (N = 14) were mapped using multidimensional scaling (MDS) procedures and compared to those of normal-weight controls (N = 49). Sixteen common food names were rated along 9-point category scales for their nutritional similarity, perceived macronutrient content, caloric density and overall nutritional value. MDS (SINDSCAL) and property fitting (PROFIT) procedures revealed that eating disorder patients associated calories with fat content to a greater extent than did controls, and tended to dislike high-fat foods. In contrast, no differences in perceptions or preferences for carbohydrate foods were observed. Anorectic restrictor patients showed the most rigid attitude structure, expressing preferences only for the lowest calorie and the most nutritious foods. The present multivariate techniques of mapping perceptual space may help to distinguish between diagnostic subgroups in studies of eating disorders.