Dietary Fat and Carbohydrate Exposure During a Group-Based Nutritional Psychoeducational Program in Anorexia Nervosa

Background: Nutritional psychoeducation is a core component of multidisciplinary treatment for anorexia nervosa, yet evidence on its association with changes in eating behavior beyond weight outcomes remains limited. Methods: This pre–post observational study included 45 patients with anorexia nervosa attending a Day Hospital program who participated in a structured, group-based nutritional psychoeducational intervention as part of standard multidisciplinary care. Nutritional knowledge, dietary rules, eating behaviors, food group exposure assessed by a Food Frequency Questionnaire (FFQ), and body mass index (BMI) were evaluated before and after the intervention. Pre–post changes were examined using paired statistical tests with Holm correction. Associations between changes in cognitive–nutritional variables and eating behavior were explored using correlations and multiple linear regression models. Results: Significant pre–post improvements were observed in nutritional knowledge and reductions in rigid dietary rules. Eating behavior showed specific changes, with increased exposure to carbohydrate- and fat-containing foods, as well as improved meal adequacy. BMI increased during the observation period, consistent with expected outcomes of Day Hospital treatment. Changes in nutrient-related knowledge were positively associated with changes in dietary fat exposure, independent of baseline BMI and changes in dietary rules, whereas no comparable association was observed for carbohydrate exposure. Conclusions: In this Day Hospital sample, participation in a group-based nutritional psychoeducational program within a multidisciplinary treatment context was associated with specific changes in eating behavior alongside cognitive–nutritional changes and weight gain. The observed association between nutrient-related knowledge and dietary fat exposure may suggest the relevance of assessing food-specific behaviors and cognitive–nutritional processes as complementary outcomes during treatment for anorexia nervosa.