Macronutrient analysis of binge eating in bulimia.

In a laboratory study of binge eating behavior 21 normal-weight women who met DSM-IIIR criteria for bulimia identified and rank-ordered items on a Foods Attribution Rating Scale as either "safe" or "forbidden." Macronutrient compositional analyses of foods in each attribution category found the most marked difference in the higher fat content of forbidden food items (p less than 0.000). Forbidden foods were also found to have a higher caloric density (p less than 0.000). Analyses of 11 days of 24-hour food intake records found that 69% of binge eating episodes consisted of forbidden foods, compared to 15% of episodes classified by subjects as nonbinge intervals. These results are consistent with previous studies describing nutrient content of alternating bouts of overconsumption and dietary restraint. They also point to a strong association between dichotomous attitudes about specific foods and the content of binge and nonbinge episodes, thus providing support for such cognitive models of eating behavior in bulimia as the abstinence violation effect.