We appreciate Dr Macdonald's point that subnutrition may cause cognitive changes and other temporary conditions that may appear to affect personality. Data regarding personality in the context of adequate weight and nutrition are important for the accurate description of personality in eating disorders. It can be difficult, however, to ascertain whether shifts in personality functioning that take place through successful treatment or maturation precipitate positive nutritional changes or the reverse. Multiple studies do suggest that personality characteristics similar to those we describe in our report precede the development of eating disorders (Reference Anderluh, Tchanturia and Rabe-HeskethAnderluh et al, 2003) and persist following remission of symptoms (Reference Holtkamp, Muller and HeussenHoltkamp et al, 2005). Although we did not report the data in detail, only 6.9% of those in our sample had a weight 15% below ideal, and the number of days of fasting was not correlated with either measure of personality pathology, suggesting this issue may not have compromised our data regarding personality to a significant extent.