The influence of homeostatic mechanisms on neural regulation of food craving in anorexia nervosa

Abstract Background Restrictive food intake in anorexia nervosa (AN) has been related to an overactive cognitive control network inhibiting intuitive motivational responses to food stimuli. However, the influence of short-term homeostatic signaling on the neural regulation of cue-induced food craving in AN is still unclear. Methods Twenty-five women with AN and 25 matched normal-weight women were examined on two occasions after receiving either glucose or water directly into their stomach using a nasogastric tube. Participants were blinded to the type of infusion. An event-related functional magnetic resonance imaging paradigm was used to investigate the effect of intestinal glucose load on neural processing during either simple viewing or distraction from food stimuli. Results Neural differences between patients with AN and normal-weight participants were found during the distraction from food stimuli, but not during the viewing condition. When compared to controls, patients with AN displayed increased activation during food distraction in the left parietal lobule/precuneus and fusiform gyrus after water infusion and decreased activation in ventromedial prefrontal and cingulate regions after intestinal glucose load. Conclusions Independent of the cephalic phase and the awareness of caloric intake, homeostatic influences trigger disorder-specific reactions in AN. Food distraction in patients with AN is associated with either excessive higher-order cognitive control during physiological hunger or decreased internally directed attention after intestinal glucose load. These findings suggest that food distraction plays an important role in the psychopathology of AN. This study was registered on clinicaltrials.gov with identifier: NCT03075371.

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The effect of intestinal glucose load on neural regulation of food craving

Nutritional Neuroscience ◽

10.1080/1028415x.2019.1600275 ◽

2019 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Marion A. Stopyra ◽

Hans-Christoph Friederich ◽

Sebastian Sailer ◽

Sabina Pauen ◽

Martin Bendszus ◽

...

Keyword(s):

Food Craving ◽

Glucose Load ◽

Neural Regulation

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Overcoming limitations of self-report: an assessment of fear of weight gain in anorexia nervosa and healthy controls using implicit association tests

Journal of Eating Disorders ◽

10.1186/s40337-021-00379-8 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Tiana Borgers ◽

Nathalie Krüger ◽

Silja Vocks ◽

Jennifer J. Thomas ◽

Franziska Plessow ◽

...

Keyword(s):

Anorexia Nervosa ◽

Weight Gain ◽

Normal Weight ◽

Self Report ◽

Healthy Controls ◽

Drive For Thinness ◽

Implicit Association ◽

Association Tests ◽

Implicit Assessment ◽

Fear Of Weight Gain

Abstract Background Fear of weight gain is a characteristic feature of anorexia nervosa (AN), and reducing this fear is often a main target of treatment. However, research shows that 20% of individuals with AN do not report fear of weight gain. Studies are needed that evaluate the centrality of fear of weight gain for AN with a method less susceptible to deception than self-report. Methods We approximated implicit fear of weight gain by measuring implicit drive for thinness using implicit association tests (IATs). We asked 64 participants (35 AN, 29 healthy controls [HCs]) to categorize statements as pro-dieting vs. non-dieting and true vs. false in a questionnaire-based IAT, and pictures of underweight vs. normal-weight models and positive vs. negative words in a picture-based IAT using two response keys. We tested for associations between implicit drive for thinness and explicitly reported psychopathology within AN as well as group differences between AN and HC groups. Results Correlation analyses within the AN group showed that higher implicit drive for thinness was associated with more pronounced eating disorder-specific psychopathology. Furthermore, the AN group showed a stronger implicit drive for thinness than HCs in both IATs. Conclusion The results highlight the relevance of considering fear of weight gain as a continuous construct. Our implicit assessment captures various degrees of fear of weight gain in AN, which might allow for more individually tailored interventions in the future.

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Caloric intake necessary for weight maintenance in anorexia nervosa: nonbulimics require greater caloric intake than bulimics

American Journal of Clinical Nutrition ◽

10.1093/ajcn/44.4.435 ◽

1986 ◽

Vol 44 (4) ◽

pp. 435-443 ◽

Cited By ~ 38

Author(s):

W H Kaye ◽

H E Gwirtsman ◽

E Obarzanek ◽

T George ◽

D C Jimerson ◽

...

Keyword(s):

Anorexia Nervosa ◽

Weight Maintenance ◽

Caloric Intake

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Clinical and Neurophysiological Correlates of Emotion and Food Craving Regulation in Patients with Anorexia Nervosa

Journal of Clinical Medicine ◽

10.3390/jcm9040960 ◽

2020 ◽

Vol 9 (4) ◽

pp. 960 ◽

Cited By ~ 4

Author(s):

Nuria Mallorquí-Bagué ◽

María Lozano-Madrid ◽

Giulia Testa ◽

Cristina Vintró-Alcaraz ◽

Isabel Sánchez ◽

...

Keyword(s):

Anorexia Nervosa ◽

Emotional Regulation ◽

Food Addiction ◽

Emotional Dysregulation ◽

Self Report ◽

Food Craving ◽

Task Condition ◽

Positive Potential ◽

Difficulties In Emotion Regulation ◽

Relevant Task

Background: Difficulties in emotion regulation and craving regulation have been linked to eating symptomatology in patients with anorexia nervosa (AN), contributing to the maintenance of their eating disorder. Methods: To investigate clinical and electrophysiological correlates of these processes, 20 patients with AN and 20 healthy controls (HC) completed a computerized task during EEG recording, where they were instructed to down-regulate negative emotions or food craving. Participants also completed self-report measures of emotional regulation and food addiction. The P300 and Late Positive Potential (LPP) ERPs were analysed. Results: LPP amplitudes were significantly smaller during down-regulation of food craving among both groups. Independent of task condition, individuals with AN showed smaller P300 amplitudes compared to HC. Among HC, the self-reported use of re-appraisal strategies positively correlated with LPP amplitudes during emotional regulation task, while suppressive strategies negatively correlated with LPP amplitudes. The AN group, in comparison to the HC group, exhibited greater food addiction, greater use of maladaptive strategies, and emotional dysregulation. Conclusions: Despite the enhanced self-reported psychopathology among AN, both groups indicated neurophysiological evidence of food craving regulation as evidenced by blunted LPP amplitudes in the relevant task condition. Further research is required to delineate the mechanisms associated with reduced overall P300 amplitudes among individuals with AN.

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Do Overweight People Have Worse Cognitive Flexibility? Cues-Triggered Food Craving May Have a Greater Impact

Nutrients ◽

10.3390/nu14020240 ◽

2022 ◽

Vol 14 (2) ◽

pp. 240

Author(s):

Shiqing Song ◽

Qingqing Li ◽

Yan Jiang ◽

Yong Liu ◽

Aidi Xu ◽

...

Keyword(s):

Cognitive Flexibility ◽

Performance Test ◽

Continuous Performance Test ◽

Brain Regions ◽

Normal Weight ◽

Food Craving ◽

Control Mechanisms ◽

Reactive Control ◽

Food Cravings ◽

Overweight People

Background: Overweight people have been revealed to have poor cognitive flexibility. Cognitive flexibility reflects proactive and reactive control abilities. However, the impairment had not been explicitly positioned at the cognitive stage. Therefore, this study provides increased support for impairment of cognitive flexibility due to overweight. Method: The study included 34 overweight and 35 normal-weight participants. They were required to complete the food and flower target AX-continuous performance test (AX–CPT), including the resting-state fMRI and cue-triggered food craving subscales. We compared the performance difference between the two tasks. Furthermore, we investigated whether the cue-triggered food cravings and the corresponding brain regions mediated the effect of overweight on the two control mechanisms. Result: Significant differences were found only in the food target AX-CPT task, where overweight participants performed worse. Cue-triggered food cravings mediated this relationship. Additionally, we found that the brain regions associated with cue-triggered food cravings (bilateral SFG) can completely mediate the relationship between BMI and the z-value of the fat mass index and sensitivity to proactive control. Conclusion: In the food target task, overweight participants performed worse in both control mechanisms. Moreover, we also revealed the potential mechanism by which being overweight might affect the two control mechanisms through cue-triggered food cravings.

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Keep your interoceptive stream under control: an active inference perspective on Anorexia Nervosa.

10.31219/osf.io/2s7qk ◽

2018 ◽

Cited By ~ 1

Author(s):

Laura Barca ◽

giovanni pezzulo

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Cognitive Control ◽

Western World ◽

Active Inference ◽

Extensive Body ◽

The Brain ◽

Computational Level

Eating disorders, and in particular anorexia nervosa (AN), are widespread in the western world. Despite an extensive body of research, the mechanisms underlying anorexia nervosa and its striking eating restriction are still elusive. Here we propose an innovative account of anorexia, which elaborates on recent theories of the brain as a predictive machine (Friston, 2010; Friston et al., 2017; Pezzulo, Barca, Friston, 2015). Here we use this (active) interoceptive inference account to explain the starvation behavior characterizing restrictive anorexia. This novel perspective aims at merging computational-level constructs of active inference and altered interoceptive processing to psychological-level theories of cognitive control and self-coherence.

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Deranged Secretion of Ghrelin and Obestatin in the Cephalic Phase of Vagal Stimulation in Women with Anorexia Nervosa

Biological Psychiatry ◽

10.1016/j.biopsych.2008.04.006 ◽

2008 ◽

Vol 64 (11) ◽

pp. 1005-1008 ◽

Cited By ~ 27

Author(s):

Palmiero Monteleone ◽

Cristina Serritella ◽

Vassilis Martiadis ◽

Mario Maj

Keyword(s):

Anorexia Nervosa ◽

Vagal Stimulation ◽

Cephalic Phase

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Setting the scene for eating disorders: childhood care, classification and course of illness

Psychological Medicine ◽

10.1017/s0033291700025447 ◽

1993 ◽

Vol 23 (3) ◽

pp. 663-672 ◽

Cited By ~ 49

Author(s):

Ulrike Schmidt ◽

Jane Tiller ◽

Janet Treasure

Keyword(s):

Anorexia Nervosa ◽

Bulimia Nervosa ◽

Family Environment ◽

Parental Control ◽

Childhood Adversity ◽

Normal Weight ◽

Semistructured Interview ◽

Childhood Experiences ◽

Course Of Illness ◽

Childhood Care

SynopsisThe aim of this study was to determine whether the childhood experiences of patients with anorexia nervosa and bulimia nervosa differ and affect the course of the illness. A semistructured interview developed by Harris et al. (1986) was used to assess the childhood family environment of 64 patients with restricting anorexia nervosa (RAN), 23 patients with bulimic anorexia nervosa (BAN), 37 bulimic patients with a history of anorexia nervosa (BN/HistAN) and 79 patients with normal weight bulimia nervosa (BN).There were no significant differences between groups in terms of parental mental disorder, low parental control or childhood sexual abuse. BN patients had had significantly more family arrangements and had experienced more parental indifference, excessive parental control, physical abuse, and violence against other family members than RAN patients with the BAN and BN/HistAN group being intermediate. There was a trend for BN-patients to have had more intra-familial discord than the other groups. Different aspects of adversity tended to cluster in the same patients and 65% of the bulimic group had experienced two or more types of childhood adversity. These results suggest that childhood experiences contribute to the form of eating disorder which later develops.

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