Stress and eating disorder behavior in anorexia nervosa as a function of menstrual cycle status

Int J Eat Disord. 2014 Mar;47(2):181-8. doi: 10.1002/eat.22211. Epub 2013 Nov 12.

Abstract

Objective: Fluctuations in ovarian hormones during the menstrual cycle and psychosocial stress contribute to eating disorder (ED) behavior.

Method: Using ecological momentary assessment techniques, this study examined relationships between stress and binge eating, self-induced vomiting, and dietary restriction based on menstrual cycle status in anorexia nervosa (AN). One hundred nine females with full and subthreshold AN (17-45 years old) recorded ED behavior and stress ratings over 2 weeks. Using hierarchical linear modeling, individuals with eumenorrhea and those with amenorrhea or oligomenorrhea were compared.

Results: Following episodes of meal skipping, momentary stress decreased in individuals with normal menstrual cycles and increased in those with irregular menstrual cycles.

Discussion: Results suggest that changes in stress severity in response to food restriction may differ based on ovarian hormonal status and may be a mechanism by which AN is maintained in individuals without menstrual disturbance.

Keywords: anorexia nervosa; ecological momentary assessment; menstrual cycle; stress.

MeSH terms

  • Adolescent
  • Adult
  • Amenorrhea / psychology
  • Anorexia Nervosa / physiopathology
  • Anorexia Nervosa / psychology*
  • Feeding Behavior / psychology*
  • Female
  • Humans
  • Menstrual Cycle / psychology*
  • Middle Aged
  • Stress, Psychological*
  • Young Adult