Pre-meal anxiety and food intake in anorexia nervosa
Open accessAbstract
Anorexia nervosa (AN) is a serious mental illness characterized by reduced caloric intake that often persists after acute weight restoration. This preliminary study assesses the relationship between pre-meal anxiety and food intake in recently weight-restored individuals with AN. We hypothesized that pre-meal anxiety is inversely related to caloric intake in AN. Caloric intake and pre-meal anxiety were measured in three laboratory-based assessments (yogurt snack, multi-item lunch, macaroni and cheese lunch). Anxiety was measured by Spielberger State-Trait Anxiety Inventory (STAI-S) administered prior to the meal. Acutely weight-restored patients with AN were compared with healthy controls (HCs). Associations between anxiety and intake were analyzed first within each meal type separately and then using a model to combine the sample. In the multi-item lunch and the macaroni and cheese lunch, AN ate significantly less than HC (p=0.01, p<0.001). Pre-meal anxiety was significantly correlated with intake among AN, but not HC. In the yogurt snack, there was no significant association between anxiety and intake among patients or controls, and the groups did not differ in caloric intake. The association between pre-meal anxiety and intake among weight-restored individuals with AN suggests a potential target for relapse prevention treatment.
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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 [49]
The Results (‘Average caloric intake and anxiety’; page not provided) report higher pre-meal anxiety in patients with anorexia nervosa than in healthy controls and significantly lower intake at two lunches. Intake did not differ significantly for the yogurt snack. The paper measures anxiety before meals, so it does not support the claim about post-meal anxiety. (LLM, conf=0.90)
Experimental — accuracy not yet measuredOnly 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 [49]
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- Authors
- Steinglass, J. E., Sysko, R., Mayer, L., Berner, L. A., Schebendach, J., Wang, Y., Chen, H., Albano, A. M., Simpson, H. B., & Walsh, B. T.
- Affiliations
- New York State Psychiatric Institute (US)
- Columbia University (US)
- Corresponding author
- Steinglass, Joanna E.
- ORCID
- Venue
- Appetite
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 55
- Issue
- 2
- Pages
- 214-218
- ISSN
- 0195-6663 (ISSN-L)
- PMC
- PMC2939314
- OpenAlex
- W1972949801
- Cited by
- 153
- References
- 27
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 17 · 2023: 5 · 2022: 5 · 2021: 9 · 2020: 15 · 2019: 9 · 2018: 14 · 2017: 10 · 2016: 11 · 2015: 15 · 2014: 9 · 2013: 13 · 2012: 1
- FWCI
- 6.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Appetite (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R03AG031113)
- National Institute of Mental Health (R01 MH08273602, K24MH091555, K23MH076195, R01MH082736, T32MH015144)
- 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, weight restoration, relapse prevention, dietary habits, state anxiety
- MeSH terms
- Adolescent, Adult, Anorexia Nervosa, Anxiety, Energy Intake, Eating, Female, Humans, Interviews as Topic, Weight Gain, Case-Control Studies, Young Adult
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