The development of satiation in bulimia nervosa

Bulimia nervosa (BN) is characterized by the recurrent consumption of excessive amounts of food (binge eating) followed by inappropriate compensatory behaviors. A leading hypothesis is that the persistence of BN may be due, in part, to a disturbance in the development of satiation. Because patients with BN consume larger meals than controls, previous studies have not been able to directly compare the development of satiation. In order to address this problem, subjects consumed large meals of predetermined size without knowing when they would be stopped. Twenty-one women with BN and 13 control women participated in a study in which they rated hunger and fullness during the course of a 975 g liquid meal eaten from an opaque reservoir. Subjects' ratings were obtained after each 75 g increment of consumption. There were no statistically significant differences between the two groups in the mean ratings of hunger or of fullness before, after, or during the meal. Individuals with BN consumed the meal more rapidly than control participants. These results suggest that, when individuals with BN are not instructed to binge eat and do not control meal size, they do not manifest a disturbance in reported satiation over the course of a large liquid meal.