How do patients with eating disorders perceive and evaluate food portion sizes? A systematic review

OBJECTIVE: The selection of adequate portion sizes plays a key role in the nutritional treatment of eating disorders (EDs). There is limited knowledge concerning the estimation of portion sizes in individuals with EDs. METHOD: We performed a systematic review according to the PRISMA statement to synthesise current evidence in this field. Of N = 584 hits, four full-texts were included in the qualitative synthesis. RESULTS: While patients with anorexia nervosa (AN) tend to overestimate the size of energy-dense food items and small to medium sized meal portions, they do not show a different estimation compared to healthy controls when judging the amount of food pieces. Large portion sizes were associated with increased anxiety in patients with AN. DISCUSSION: The overestimation of food portion sizes seems to be driven by attitudinal and/or higher cognitive factors associated with AN. Differences between the studies are discussed and suggestions for future studies are given.