Computerized measurement of anticipated anxiety from eating increasing portions of food in adolescents with and without anorexia nervosa: Pilot studies
Open accessAbstract
Dieting and excessive fear of eating coexist in vulnerable individuals, which may progress to anorexia nervosa [AN], but there is no objective measure of this fear. Therefore, we adapted a computer program that was previously developed to measure the satiating effects of foods in order to explore the potential of food to induce anxiety and fear of eating in adolescent girls. Twenty four adolescents (AN) and ten healthy controls without eating disorders rated pictures of different types of foods in varying sized portions as too large or too small and rated the expected anxiety of five different portions (20-320 kcal). Two low energy dense (potatoes and rice) and two high energy dense (pizza and M&Ms) foods were used. The regression coefficient of line lengths (0-100 mm) marked from "No anxiety" to "this would give me a panic attack", regressed from portions shown, was the measure of "expected anxiety" for a given food. The maximum tolerated portion size [kcal] (MTPS), computed by method of constant stimulus from portions shown, was significantly smaller for high energy dense foods, whereas the expected anxiety response was greater, for all foods, for patients compared to controls. For both groups, expected anxiety responses were steeper, and maximum tolerated portion sizes were larger, for low, than high, energy dense foods. Both maximum tolerated portion size and expected anxiety response were significantly predicted by severity of illness for the patients. Those who had larger maximum tolerated portion sizes had smaller anticipated anxiety to increasing portion sizes. Visual size had a greater influence than energy content for these responses. This method could be used to quantify the anxiety inducing potential of foods and for studies with neuro-imaging and phenotypic clarifications.
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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 [50]
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.
“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 [50]
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“Indeed, emerging evidence points towards divergent responses to food cues in those with AN, purely as a function of intent to eat (Kissileff et al., 2016; Milos et al., 2013).”
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
- Authors
- Kissileff, H. R., Brunstrom, J. M., Tesser, R., Bellace, D., Berthod, S., Thornton, J. C., & Halmi, K.
- Affiliations
- St. Luke's-Roosevelt Hospital Center (US)
- University of Bristol (GB)
- Weill Cornell Medicine (US)
- Corresponding author
- Kissileff, H.R.
- Venue
- Appetite
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 97
- Pages
- 160-168
- ISSN
- 0195-6663 (ISSN-L)
- PMC
- PMC7001782
- OpenAlex
- W2181037577
- Cited by
- 23
- References
- 23
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 2 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 1
- FWCI
- 2.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Appetite (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion, other-oa)
- PubMed Central (acceptedVersion)
- Bristol Research (University of Bristol) (submittedVersion, other-oa)
- Funders
- NIH (NIH/NIDDK DK26687)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anorexia nervosa, fear of eating, portion size, energy density, adolescents, computer-aided measurement, dieting, eating disorders
- MeSH terms
- Adolescent, Anorexia Nervosa, Anxiety, Energy Intake, Child, Computer Simulation, Eating, Female, Humans, Male, Pilot Projects, Satiation, Linear Models, Case-Control Studies, Portion Size
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