BackgroundStructural imaging studies demonstrate brain tissue abnormalities in eating disorders, yet a quantitative analysis has not been done.MethodsIn global and regional meta-analyses of 9 voxel-based morphometry (VBM) studies, with a total of 228 eating disorder participants (currently ill with anorexia nervosa), and 240 age-matched healthy controls, we compare brain volumes using global and regional analyses.ResultsAnorexia nervosa (AN) patients have global reductions in gray (effect size = −0.66) and white matter (effect size = −0.74) and increased cerebrospinal fluid (effect size = 0.98) and have regional decreases in left hypothalamus, left inferior parietal lobe, right lentiform nucleus and right caudate, and no significant increases. No significant difference in hemispheric lateralization was found.ConclusionsGlobal and regional meta-analyses suggest that excessive restrained eating as found in those with anorexia nervosa coincides with structural brain changes analogous to clinical symptoms.