Karin Foerde1,2, Janet E Schebendach2, Lauren Davis1, Nathaniel Daw3, B Timothy Walsh1,2, Daphna Shohamy4, Joanna E Steinglass1,2. 1. Department of Psychiatry, New York State Psychiatric Institute, New York, USA. 2. Department of Psychiatry, Columbia University Irving Medical Center, New York, USA. 3. Department of Psychology, Princeton Neuroscience Institute, Princeton University, Princeton, USA. 4. Psychology Department and Zuckerman Mind Brain and Behavior Institute, Columbia University, New York, USA.
Abstract
BACKGROUND: Restriction of food intake is a central feature of anorexia nervosa (AN) and other eating disorders, yet also occurs in the absence of psychopathology. The neural mechanisms of restrictive eating in health and disease are unclear. METHODS: This study examined behavioral and neural mechanisms associated with restrictive eating among individuals with and without eating disorders. Dietary restriction was examined in four groups of women (n = 110): healthy controls, dieting healthy controls, patients with subthreshold (non-low weight) AN, and patients with AN. A Food Choice Task was administered during fMRI scanning to examine neural activation associated with food choices, and a laboratory meal was conducted. RESULTS: Behavioral findings distinguished between healthy and ill participants. Healthy individuals, both dieting and non-dieting, chose significantly more high-fat foods than patients with AN or subthreshold AN. Among healthy individuals, choice was primarily influenced by tastiness, whereas, among both patient groups, healthiness played a larger role. Dorsal striatal activation associated with choice was most pronounced among individuals with AN and was significantly associated with selecting fewer high-fat choices in the task and lower caloric intake in the meal the following day. CONCLUSIONS: A continuous spectrum of behavior was suggested by the increasing amount of weight loss across groups. Yet, data from this Food Choice Task with fMRI suggest there is a behavioral distinction between illness and health, and that the neural mechanisms underlying food choice in AN are distinct. These behavioral and neural mechanisms of restrictive eating may be useful targets for treatment development.
BACKGROUND: Restriction of food intake is a central feature of anorexia nervosa (AN) and other eating disorders, yet also occurs in the absence of psychopathology. The neural mechanisms of restrictive eating in health and disease are unclear. METHODS: This study examined behavioral and neural mechanisms associated with restrictive eating among individuals with and without eating disorders. Dietary restriction was examined in four groups of women (n = 110): healthy controls, dieting healthy controls, patients with subthreshold (non-low weight) AN, and patients with AN. A Food Choice Task was administered during fMRI scanning to examine neural activation associated with food choices, and a laboratory meal was conducted. RESULTS: Behavioral findings distinguished between healthy and ill participants. Healthy individuals, both dieting and non-dieting, chose significantly more high-fat foods than patients with AN or subthreshold AN. Among healthy individuals, choice was primarily influenced by tastiness, whereas, among both patient groups, healthiness played a larger role. Dorsal striatal activation associated with choice was most pronounced among individuals with AN and was significantly associated with selecting fewer high-fat choices in the task and lower caloric intake in the meal the following day. CONCLUSIONS: A continuous spectrum of behavior was suggested by the increasing amount of weight loss across groups. Yet, data from this Food Choice Task with fMRI suggest there is a behavioral distinction between illness and health, and that the neural mechanisms underlying food choice in AN are distinct. These behavioral and neural mechanisms of restrictive eating may be useful targets for treatment development.
Authors: Alexandra F Muratore; Mariya Bershad; Joanna E Steinglass; Karin E Foerde; Loren Gianini; Allegra Broft; Evelyn Attia Journal: Int J Eat Disord Date: 2021-08-20 Impact factor: 5.791
Authors: Alice M Xue; Karin Foerde; B Timothy Walsh; Joanna E Steinglass; Daphna Shohamy; Akram Bakkour Journal: J Neurosci Date: 2021-11-10 Impact factor: 6.709
Authors: Joanna E Steinglass; Evelyn Attia; Deborah R Glasofer; Yuanjia Wang; Julia Ruggiero; B Timothy Walsh; J Graham Thomas Journal: Int J Eat Disord Date: 2022-04-30 Impact factor: 5.791