Gwirtsman H E, Kaye W H, Obarzanek E, George D T, Jimerson D C, Ebert M H
Section on Biomedical Psychiatry, National Institutes of Mental Health, Bethesda, MD.
Am J Clin Nutr. 1989 Jan;49(1):86-92. doi: 10.1093/ajcn/49.1.86.
Patients with bulimia (binge-purge syndrome) frequently complain that they consume a very restrictive diet to avoid gaining weight. To investigate this claim, 23 hospitalized bulimic patients were assessed daily for body weight, caloric intake, macronutrient diet content, activity measures, and body composition estimates during weight-stable periods. Bulimic patients ate fewer kilocalories per kilogram body weight (22.1 +/- 4.6 kcal/kg) than did age-matched normal women (29.7 +/- 6.5 kcal/kg) but had similar activity levels and body composition. Clinical variables, such as history of laxative abuse, anorexia, or obesity, and physiological characteristics, such as body weight, activity level, or dietary content, could not account for this difference in caloric consumption. Bulimic patients tended to eat a diet lower in fat and higher in protein than did control subjects. These results agree with observations of increased efficiency of caloric utilization in obese patients and support patient complaints of a tendency to gain weight easily.
患有贪食症（暴饮暴食-清除综合征）的患者经常抱怨，为了避免体重增加，他们采用了非常严格的饮食方式。为了调查这一说法，对23名住院的贪食症患者在体重稳定期每天进行体重、热量摄入、宏量营养素饮食含量、活动量测量以及身体成分评估。贪食症患者每千克体重摄入的热量（22.1±4.6千卡/千克）低于年龄匹配的正常女性（29.7±6.5千卡/千克），但活动水平和身体成分相似。诸如泻药滥用史、厌食症或肥胖症等临床变量，以及诸如体重、活动水平或饮食内容等生理特征，都无法解释热量消耗的这种差异。与对照组相比，贪食症患者倾向于食用脂肪含量较低、蛋白质含量较高的饮食。这些结果与肥胖患者热量利用效率提高的观察结果一致，并支持患者关于容易体重增加倾向的抱怨。
