Bulimia Nervosa: An Examination of the Anxiety-Inhibiting Properties of the Prospect of Vomiting

Abstract

The anxiety-inhibiting properties of the prospect of vomiting were assessed and contrasted in 12 women with bulimia nervosa and an equal number of non-bulimic women. Subjects were exposed to a pleasant control scene and six food-related scenes in which they imagined eating standardized test meals with the knowledge that vomiting could or could not occur afterwards. The level of anxiety evoked by the scenes was assessed using subjective, behavioural and physiological measures. As predicted, bulimics reported that they would consume more of the meal when vomiting could occur after. No such difference was found for control subjects. However, the groups did not differ on subjective and physiological measures of anxiety. The results of the present study suggest that bulimics may utilize a hierarchy of control strategies to mediate the anxiety evoked by eating that may be amenable to cognitive-behavioural interventions.