The variability of phenomenology in anorexia nervosa


Dr Sing Lee, Director, Hong Kong Eating Disorders Center, Department of Psychiatry, 11/F, Prince of Wales Hospital, Shatin, Hong Kong


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.