Pleasure for visual and olfactory stimuli evoking energy-dense foods is decreased in anorexia nervosa (original) (raw)

Subjective experience of sensation in anorexia nervosa

Behaviour Research and Therapy, 2013

The nature of disturbance in body experience in anorexia nervosa (AN) remains poorly operationalized despite its prognostic significance. We examined the relationship of subjective reports of sensitivity to and behavioral avoidance of sensory experience (e.g., to touch, motion) to body image disturbance and temperament in adult women currently diagnosed with AN (n=20), women with a prior history of AN who were weight restored (n=15), and healthy controls with no eating disorder history (n=24). Levels of sensitivity to sensation and attempts to avoid sensory experience were significantly higher in both clinical groups relative to healthy controls. Sensory sensitivity was associated with body image disturbance (r(56) = .51, p < .0001), indicating that body image disturbance increased with increased global sensitivity to sensation. Sensory sensitivity was also negatively and significantly correlated with lowest BMI (r 2 = −.32, p < .001), but not current BMI (r 2 = .03, p = .18), and to the temperament feature of harm avoidance in both clinical groups. We discuss how intervention strategies that address sensitization and habituation to somatic experience via conditioning exercises may provide a new manner in which to address body image disturbance in AN.

Intact sensory function in anorexia nervosa

The American Journal of Clinical Nutrition, 2011

Background: In anorexia nervosa (AN), taste and smell are believed to be anhedonic, hunger and pain are muted, and body-image distortion obscures wasting, which together facilitate self-starvation. However, the emphasis on these deficits may be biased because other sensory systems have been sparsely investigated. Objectives: Objectives of the study were to clarify whether these dysfunctions are specific or part of a pattern of sensory-perceptual deficits in AN patients and to test the gustatory senses dissociated from ingestion to clarify whether any deficit is sensory or affective. Design: In 15 adolescent, first-episode, hospitalized, restrictive AN patients and 15 matched healthy controls who responded to gustatory stimuli (intensity and hedonics of 5 basic tastes and tastes and odors of foods and nonfoods), size estimation (manual and oral judgment of size and shape, kinesthesia, and body size and esthetics), cold pain, and auditory and visual processing were compared. Results: AN patients did not differ on most tests, were better at odor recognition, were less successful in central auditory processing and oral assessment of size and shape, and may have been more sensitive to cold. Body-image dissatisfaction in AN patients was not related to dysfunctional size estimation. Conclusions: There is no systematic sensory-perceptual deficit in AN patients, and specifically, not in gustatory function. The few differences shown might be due to fear of food-related stimuli or comorbidity.

Hedonic reactivity to visual and olfactory cues: Rapid facial electromyographic reactions are altered in anorexia nervosa

Biological Psychology, 2011

Though it has been suggested that hedonic processing is altered in anorexia nervosa (AN), few studies have used objective measures to assess affective processes in this eating disorder. Accordingly, we investigated facial electromyographic, autonomic and subjective reactivity to the smell and sight of food and non-food stimuli, and assessed more particularly rapid facial reactions reflecting automatic processing of pleasantness. AN and healthy control (HC) women were exposed, before and after a standardized lunch, to pictures and odorants of foods differing in energy density, as well as to non-food sensory cues. Whereas the temporal profile of zygomatic activity in AN patients was typified by a fast drop to sensory cues within the 1000 ms following stimulus onset, HC showed a larger EMG reactivity to pictures in a 800-1000 ms time window. In contrast, pleasantness ratings discriminated the two groups only for high energy density food cues suggesting a partial dissociation between objective and subjective measures of hedonic processes in AN patients. The findings suggest that the automatic processing of pleasantness might be altered in AN, with the sensitivity to reward being modulated by controlled processes.

Implicit and explicit affect toward food and weight stimuli in anorexia nervosa.

We know strikingly little about the core affective processes that drive the development and maintenance of, and recovery from anorexia nervosa (AN). To partially address this knowledge gap, we measured implicit and explicit affect toward pleasant, neutral, unpleasant, food-relevant, and weight-relevant images in three groups: in patients with acute AN, individuals recovered from AN, and healthy controls with no history of AN. Compared with the other two groups, acutely ill AN participants displayed significantly greater implicit positive affect toward pleasant images and significantly greater implicit negative affect toward unpleasant, high-calorie food, and overweight body type images. Recovered participants did not differ significantly from controls on any implicit affect measure. Explicit affective patterns were similar to implicit, but explicit measures yielded much smaller effect sizes and failed to detect certain group differences. Overall, negative implicit affect toward high-calorie foods and overweight body types may represent core affective processes that are operative during acute AN.

A comparison of clinical and psychological features in subgroups of patients with anorexia nervosa

European Eating Disorders Review, 2003

Background:In DSM-IV anorexics who purge without binging (AN-P) are considered together with the binge eating purging subgroup (AN-B). Few studies have investigated whether it is binge eating per se or the compensatory behaviours that provide the most relevant marker for subclassifying anorexia nervosa.In DSM-IV anorexics who purge without binging (AN-P) are considered together with the binge eating purging subgroup (AN-B). Few studies have investigated whether it is binge eating per se or the compensatory behaviours that provide the most relevant marker for subclassifying anorexia nervosa.Methods:We compared 40 restricting-type anorexics (AN-R), 40 AN-B and 38 AN-P subjects consecutively admitted to our inpatient treatment. We excluded patients who had not had a diagnosis of anorexia nervosa for at least 1.5 years duration.We compared 40 restricting-type anorexics (AN-R), 40 AN-B and 38 AN-P subjects consecutively admitted to our inpatient treatment. We excluded patients who had not had a diagnosis of anorexia nervosa for at least 1.5 years duration.Results:AN-B patients showed a slightly more severe eating disorder symptomatology, while in terms of body weight AN-R and AN-P present a higher degree of weight loss. Psychiatric symptoms were similar in the three groups. Sexual abuse, suicide attempts and dissociative symptoms were higher in AN-P and AN-B patients compared to AN-R.AN-B patients showed a slightly more severe eating disorder symptomatology, while in terms of body weight AN-R and AN-P present a higher degree of weight loss. Psychiatric symptoms were similar in the three groups. Sexual abuse, suicide attempts and dissociative symptoms were higher in AN-P and AN-B patients compared to AN-R.Discussion:Our results together with the fact that it is difficult to define binge eating in anorexic subjects and that purging behaviours are often associated with severe medical complications, support the subtyping system of anorexia nervosa based on the presence/absence of purging behaviours rather than of binge eating. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association.Our results together with the fact that it is difficult to define binge eating in anorexic subjects and that purging behaviours are often associated with severe medical complications, support the subtyping system of anorexia nervosa based on the presence/absence of purging behaviours rather than of binge eating. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association.

The psychobiology of eating behavior in anorexia nervosa

Psychiatry Research, 1996

Two models for conceptualizing eating behavior are presented and the development of the experimental methodology to examine eating behavior is described in historical context. Specific studies of eating behavior in eating disorder patients are described with emphasis on how these studies examine aspects of the two hypothetical models that are presented on eating behavior. The studies present and focus on hunger and satiety perceptions, cognitive sets, and the neurotransmitter associated with satiety, serotonin. Unfortunately, no single investigation can encompass all of the variables that need to be measured that affect eating behavior. The studies described of both acutely ill and short-term recovered eating disorder patients indicate there may be some perceptual and physiological traits that are present in anorexia nervosa and bulimia nervosa. Studies over a longer period of time are needed to substantiate this. An eventual integrative explanation of disturbed eating behavior that is documented in eating disorder patients will be possible only after extensive investigations of the components.

Nothing tastes as good as skinny feels: the neurobiology of anorexia nervosa

Trends in Neurosciences, 2013

Individuals with anorexia nervosa (AN) engage in relentless restrictive eating and often become severely emaciated. Because there are no proven treatments, AN has high rates of relapse, chronicity, and death. Those with AN tend to have childhood temperament and personality traits, such as anxiety, obsessions, and perfectionism, which may reflect neurobiological risk factors for developing AN. Restricted eating may be a means of reducing negative mood caused by skewed interactions between serotonin aversive or inhibitory and dopamine reward systems. Brain imaging studies suggest that altered eating is a consequence of dysregulated reward and/ or awareness of homeostatic needs, perhaps related to enhanced executive ability to inhibit incentive motivational drives. An understanding of the neurobiology of this disorder is likely to be important for developing more effective treatments.