The construct validity of Herman and Polivy's Restraint Scale (RS), the restraint factor of the Three Factor Eating Questionnaire (TFEQ-R), and the restraint scale of the Dutch Eating Behavior Questionnaire (DEBQ-R) were investigated by relating these scales to self-reported mean caloric intake per day and to other measures associated with disordered eating and figure consciousness. A factor analysis showed that the three restraint scales measure different components of the restraint construct. A high score on the RS was closely related to consequences of mostly unsuccessful dieting, such as disinhibited eating and weight fluctuations, but not to successful overall caloric restriction in everyday life. High scores on the TFEQ-R and the DEBQ-R represented the more successful dieting behavior component of restraint. The three scales have in common a motivational component of restrained eating, including concerns about shape and weight, and desire for thinness.

The doubly labeled water method was used to measure average daily total energy expenditure (EE) in 23 healthy normal-weight women classified as restrained or unrestrained eaters. Although the relative weight of restrained eaters was found to be higher (BMI 21.1 +/- 1.3 vs 20.0 +/- 1.3 kg/m2, p less than 0.03), the self-reported energy consumption of the restrained eaters, when adjusted for body composition and height, totaled approximately 410 kcal/d less energy than that of the unrestrained group (p less than 0.002). Correspondingly, the adjusted EE was found to be lower by 620 kcal/d in restrained eaters (p less than 0.005). In both groups metabolic indices of starvation (beta-hydroxybutyric acid and triiodothyronine) were in the normal range. Neither these nor weight changed from the beginning to the end of the 14-d observation period. Thus, the lower EE of the restrained group reflects diminished caloric requirements and is not an adaptive response to a temporary decrease in food intake.

By a standardized interview DSM‐III lifetime diagnoses were assessed in 91 eating disorders patients who were divided in four subgroups. Anorectic patients with bulimic symptoms and normal‐weight bulimic patients with and without a history of anorexia nervosa had a similar history of additional psychiatric diagnoses. In general, restricting anorexics showed lower lifetime rates of psychiatric disorders than patients with bulimic symptomatology. Minor affective disorders, however, were equally distributed across all four groups.

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