Accuracy of self-reported energy intake in weight-restored patients with anorexia nervosa compared with obese and normal weight individuals.

Objective: To compare self-reported and measured energy intake in weight-restored patients with anorexia nervosa (AN), weight-stable obese individuals (OB), and normal weight controls (NC).

Method: Forty participants (18 AN, 10 OB, and 12 NC) in a laboratory meal study simultaneously completed a prospective food record.

Results: AN patients significantly (p = .018) over-reported energy intake (16%, 50 kcal) and Bland-Altman (B-A) analysis indicated bias toward over-reporting at increasing levels of intake. OB participants significantly (p = .016) under-reported intake (19%, 160 kcal) and B-A analysis indicated bias toward under-reporting at increasing levels of intake. In NC participants, NS (p = .752) difference between reported and measured intake was found and B-A analysis indicated good agreement between methods at all intake levels.

Discussion: Self-reported intake should be cautiously interpreted in AN and OB. Future studies are warranted to determine if over-reporting is related to poor outcome and relapse in AN, or under-reporting interferes with weight loss efforts in OB.