Exploring the Clinical Utility of the Eating Pathology Symptoms Inventory in a Sample of Female Inpatients With Anorexia Nervosa

OBJECTIVE: The current study assessed whether Eating Pathology Symptoms Inventory (EPSI) scores among hospitalized patients with anorexia nervosa (AN) were associated with actual eating behavior and whether scores change with inpatient weight restoration treatment. Exploratory analyses compared outcomes between patients with restricting (AN-R) and binge-eating/purging (AN-BP) subtypes of AN. METHOD: Participants included 136 females with a DSM-5 diagnosis of AN who completed the EPSI at admission and discharge. Bivariate Pearson correlations tested associations between subscale scores and calories and fat consumed during an ad-libitum meal following admission among a subsample of participants (n = 59). Change in scores from admission to discharge was tested using paired samples t-tests and linear mixed models. RESULTS: The EPSI Restricting and Cognitive Restraint subscale scores at admission were significantly correlated with total calories consumed during the meal (ps ≤ 0.0001). From admission to discharge, most subscale scores showed significant improvement (Cognitive Restraint, Excessive Exercise, Purging, and Restricting), and Binge Eating showed significant worsening. Exploratory analyses identified subtype differences, with significantly greater correlations between subscale scores and eating behavior among patients with AN-R. CONCLUSIONS: Findings suggest the EPSI is related to the pathological restrictive eating behavior that is central to AN and captures symptom change during treatment of AN. Differences between AN subtypes warrant further consideration.