Altered pain perception, dietary restraint and drive for thinness in bulimia nervosa

Several studies have investigated pain processing in patients with bulimia nervosa (BN). In particular, BN patients showed higher pain thresholds than community women (CW). However, few studies have considered the role of the “drive for thinness” in relation to pain perception and tolerance.

Fifty-five participants were interviewed individually with the Eating Disorder Examination and the Structured Clinical Interview for DSM-5 (SCID-5); Twenty-four women with BN according to DSM-5 criteria and age, and Body Mass Index (BMI), matched healthy CW. All participants were given these tests: Dietary restraint subscale of the Three Factor Eating Questionnaire, Drive for Thinness subscale of the Eating Disorder Inventory 3. Subsequently pain tolerance and sensitivity were assessed by the cold pressor test in a single session.

Women with BN and CW showed significant differences in pain sensitivity, pain tolerance, drive for thinness, dietary restraint, and desired BMI. Also, pain sensitivity and tolerance was significantly correlated with drive for thinness and dietary restraint in BN women, while no such correlation was found in CW.

The main finding of this study is that high levels of drive for thinness and dietary restraint are associated with a lower pain sensitivity and a higher pain tolerance in BN patients.