When energy in does not equal energy out: disordered energy control.


OBJECTIVE To explore women's fear of loss of control and excessive inappropriate control of eating, exercise or their body in relation to patient/nonpatient status. To examine the utility of a concept of Disordered Energy Control (DEC). METHODS Comparison of the features of DEC of 169 female eating disorder, first admission inpatients, 61 previous inpatients ('recovering') and 225 female students who completed computer questions including the Quality of Life Eating Disorder (QOL ED). RESULTS Fear of loss of control was reported by 89% of inpatients, 36% of 'recovering' patients and 34% of students. Fear of loss of control or excessive controlling behaviour (defined as BMI <15.5, vomiting >7 days/month) was reported by 96% of inpatients (97% anorexia nervosa, 100% bulimia nervosa, 89% EDNOS), 51% of 'recovering' patients and 35% of students. There was significantly more impact on QOL ED psychological aspects, daily living, and acute medical health for student and patient groups reporting control issues compared to those who did not. DEC was present in 13% of students, 94% of inpatients and 28% of recovering patients. DISCUSSION The concept of disordered energy control warrants further investigation particularly in overweight and obese groups. A biological measure of inappropriate energy control associated with medical and psychological problems would be useful.


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