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

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.