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Restrictive eating across a spectrum from healthy to unhealthy: behavioral and neural mechanisms

Published online by Cambridge University Press:  13 October 2020

Karin Foerde Open the ORCID record for Karin Foerde [Opens in a new window] ,
Janet E. Schebendach ,
Lauren Davis ,
Nathaniel Daw ,
B. Timothy Walsh ,
Daphna Shohamy  and
Joanna E. Steinglass
Karin Foerde*
Affiliation:
Department of Psychiatry, New York State Psychiatric Institute, New York, USA Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
Janet E. Schebendach
Affiliation:
Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
Lauren Davis
Affiliation:
Department of Psychiatry, New York State Psychiatric Institute, New York, USA
Nathaniel Daw
Affiliation:
Department of Psychology, Princeton Neuroscience Institute, Princeton University, Princeton, USA
B. Timothy Walsh
Affiliation:
Department of Psychiatry, New York State Psychiatric Institute, New York, USA Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
Daphna Shohamy
Affiliation:
Psychology Department and Zuckerman Mind Brain and Behavior Institute, Columbia University, New York, USA
Joanna E. Steinglass
Affiliation:
Department of Psychiatry, New York State Psychiatric Institute, New York, USA Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
*
Author for correspondence: Karin Foerde, E-mail: kf2265@columbia.edu
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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.

Keywords

anorexia nervosacognitive neurosciencedecision-makingfood choicefMRIneuroimaging
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 9 , July 2022 , pp. 1755 - 1764
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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