Associations between mealtime anxiety and food intake in anorexia nervosa
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Objective: A salient disturbance in anorexia nervosa (AN) is the persistent restriction of food intake. Eating behavior in AN is thought to be influenced by anxiety. The current study probed associations between mealtime anxiety and food intake among individuals with AN and healthy comparison individuals (HC). Method: Data were combined across three studies (total of 92 AN and 78 HC) for secondary data analysis. Participants completed a multiitem laboratory buffet meal and visual analogue scale assessments of pre‐meal and post‐meal anxiety. Linear regression models assessed the association between mealtime anxiety and calorie and fat intake at the meal, and whether associations differed by diagnostic group. Results: Among individuals with AN, pre‐meal anxiety was significantly associated with reduced calorie intake and reduced consumption of calories from fat at the meal; these associations were not observed among HC. There was no evidence for an association between calorie/fat intake at the meal and post‐meal anxiety in either group. Discussion: Treatments that target mealtime anxiety may improve eating and nourishment among individuals with AN. Interventions like exposure therapy that provide skills in overcoming mealtime anxiety might be enhanced by informing patients that post‐meal anxiety is not related to intake.
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Only few experimental studies have examined anorectic fears in the laboratory.
“To date, only few experimental studies have examined anorectic fears in the laboratory (e.g. [48–50], although experimental research may be helpful in gathering more precise knowledge about the factors of maintenance and change that should be targeted in an effective eating disorder treatment [51, 52].”
From Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa (2024) · cites this paper as [48]
More pre-meal anxiety predicts less actual food intake in patients with anorexia nervosa.
“So far, previous laboratory studies on food related fears in anorexia nervosa have shown that as fear about eating increases, the maximum tolerated food portion size decreases in patients with anorexia nervosa [50] and that more pre-meal anxiety predicts less actual food intake [48].”
From Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa (2024) · cites this paper as [48]
The finding that patients with AN displayed more pre- and post-meal anxiety and consumed less calories than healthy controls when exposed to food is consistent with previous research.
“Similarly, patients with anorexia nervosa displayed more pre- and post-meal anxiety, and consumed less calories than healthy controls when exposed to food, which is consistent with previous research [48, 49].”
From Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa (2024) · cites this paper as [48]
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Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa
Melles, H., & Jansen, A. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01094-w · Cited by 5 · see citing works
“Similarly, patients with anorexia nervosa displayed more pre-and post-meal anxiety, and consumed less calories than healthy controls when exposed to food, which is consistent with previous research [48, 49].”
BackgroundResult
- Authors
- Lloyd, E. C., Powell, C., Schebendach, J., Walsh, B. T., Posner, J., & Steinglass, J. E.
- Affiliations
- Columbia University Irving Medical Center (US)
- Corresponding author
- Lloyd, E. Caitlin
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2021-07-29
- Volume
- 54
- Issue
- 9
- Pages
- 1711-1716
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC8434846
- OpenAlex
- W3183762154
- Cited by
- 36
- References
- 38
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 14 · 2023: 3 · 2022: 5 · 2021: 2
- FWCI
- 4.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Global Foundation for Eating Disorders
- National Institute of Mental Health (MH105452 (R01), MH113737 (K24), MH11445 (R01))
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- anorexia nervosa, dietary intake, energy intake, dietary fat intake, dietary habits, exposure therapy, buffet meals
- MeSH terms
- Anorexia Nervosa, Anxiety, Energy Intake, Eating, Humans, Meals
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