Walging als de motor achter voedselrestrictie in anorexia nervosa

In this article we present a theoretical framework that points to disgust-induced
avoidance as a mechanism that can help explain the persistent and excessive food restriction in individuals with anorexia nervosa (AN). Disgust is characterized by intense negative feelings of revulsion and an overwhelming and irresistible urge towards avoidance. When eating food triggers disgust, this can explain the strong urge to avoid food intake that is characteristic of individuals with AN. Recently, more attention has been given to the phenomenon that not only external objects, but also the self can lead to disgust. Potentially, in individuals with AN not so much food or eating itself elicits disgust, but the potential impact of food on the self. We argue that limiting food intake may reflect a means to avoid self-disgust that is elicited by perceiving the own future) body as ‘too fat’. This implies that when self-disgust remains unchanged following treatment of AN, the motor keeps running and small changes in (perceived) body shape and weight may reactivate the urge to avoid food intake thereby paving the way for relapse. We discuss several options that may be helpful in decreasing self-disgust in individuals with AN.