OBJECTIVE: The authors’ goal was to investigate the effect of imagining food on the regional cerebral blood flow (rCBF) of anorexia nervosa patients with and without habitual binge/purge behavior. METHOD: The subjects included seven female patients with purely restrictive anorexia, seven female patients with anorexia and habitual binge/purge behavior, and seven healthy women. Single photon emission computed tomography examination was performed before and after the subjects were asked to imagine food. Changes in rCBF count ratios (percent change) were then calculated and compared. The subjects were also asked to assess their degree of fear regarding their control of food intake. RESULTS: The anorexia nervosa patients with habitual binge/purge behavior had a significantly higher percent change in the inferior, superior, prefrontal, and parietal regions of the right brain than the patients with purely restrictive anorexia and the healthy volunteers. The patients with habitual binge/purge behavior also had the highest level of apprehension in regard to food intake. CONCLUSIONS: Specific activation in cortical regions suggests an association between habitual binge/purge behavior and the food recognition process linked to anxiety in patients with anorexia nervosa.