The variability of phenomenology in anorexia nervosa.

OBJECTIVE

To study the variability of phenomenology in Chinese patients with anorexia nervosa in Hong Kong.

METHOD

Longitudinal case studies of four patients.

RESULTS

The anorexic illness was not uniformly about the fear of fatness. Rather, patients' explanations for food refusal could change over time. A typology of anorexic phenomenology emerged; namely, fat phobic type I (fat phobia consistently present), fat phobic type II (fat phobia changing to non-fat phobic presentation), non-fat phobic type I (consistently non-fat phobic) and non-fat phobic type II (non-fat phobic initially, but fat phobic later).

CONCLUSION

The variability of anorexic phenomenology challenges the current fat phobia paradigm and has implications on the diagnosis, treatment and psychometric assessment of eating disorders.