A standard test meal to assess treatment response in anorexia nervosa patients

This report describes a clinical experience of quantitative and qualitative observations of eating behavior in 19 anorexia nervosa patients before and after a standardized meal prior to treatment, compared to a similar observation at the end of a comprehensive, integrative treatment program. Prior to treatment, patients demonstrated a consistent low intake of food energy, especially fats, with report via analog scale of low hunger and high fullness, as well as distress in mood overall. After treatment, patients more than doubled their food intake, doubled their fat intake, and significantly increased the rate of calories per minute ingested. They reported more robust hunger and less inappropriate fullness before a meal. While still symptomatic, they showed overall significant decreases in anxiety, guilt, depression, and fear of fatness at the time of discharge. This report suggests that clinical observation and documentation of eating behavior, hunger, satiety, and mood prior to treatment is simple, cost-effective, and a powerful means of documenting the effect of treatment when repeated prior to discharge.