Cognitive Restraint versus Restriction: An Investigation of Daily Eating Patterns Among Women with Restrictive Eating Disorders

Research has found only small-to-moderate correlations between cognitive restraint (efforts to reduce food intake) and dietary restriction (actual reduction in food intake). How scores on retrospective self-report measures of cognitive restraint and restriction relate to restrictive eating in daily life among women with eating disorders characterized by restrictive eating is unknown. In the current study, the Eating Pathology Symptoms Inventory Cognitive Restraint (EPSI-CR) and Restriction (EPSI-R) subscale scores were: 1) compared across women with anorexia nervosa (AN; n = 58), bulimia nervosa (BN; n = 56), avoidant/restrictive food intake disorder (ARFID; n = 31), and non-eating disorder controls (NED; n = 53), and 2) correlated with frequency of daily restrictive eating reported via two-weeks of ecological momentary assessment. EPSI-CR scores were significantly higher in the AN group than all other groups, and people with BN scored significantly higher than ARFID and NED groups, whose scores did not significantly differ. EPSI-R scores did not significantly vary between AN and ARFID, and these groups both scored higher than BN, who scored higher than NEDs. EPSI-CR scores were not significantly correlated with frequency of restrictive eating in daily life in any diagnostic group, suggesting that past-month cognitive restraint was not associated with dietary restriction in daily life. EPSI-R scores were strongly correlated with frequency of dietary restriction in women with BN and ARFID, but not women with AN, demonstrating a discrepancy between EMA and retrospective responses. Overall, results highlight the importance of differentiating cognitive restraint and restriction when assessing and treating eating disorders.