Food-related aversion in a female sample of people with anorexia nervosa: Cognitive-behavioural correlates, somatic and subjective anxiety, and early experiences

Persistent avoidance of virtual food in anorexia nervosa-restrictive type: Results from motion tracking in a virtual stopping task

OBJECTIVE

Food avoidance is central to patients with anorexia nervosa-restrictive type (AN-R). Competing accounts in experimental psychopathology research suggest that food avoidance may result from automatic, habitual responses or from elevated inhibitory control abilities. This study investigated behavioral trajectories of food avoidance in a novel virtual reality stopping task.

METHOD

Sixty patients with AN-R and 29 healthy controls with normal weight were investigated using a novel, kinematic task in virtual reality. We recorded spatial displacement in stop- and go-trials to virtual food and control objects. Inhibitory control abilities were operationalized by the VR task in stopping performance (i.e., interrupted movement in stop-trials), whereas we also measured habitual avoidance of virtual food across both go- and stop-trials (i.e., delayed movement relative to nonfood objects).

RESULTS

In patients with AN-R, hand displacements were shorter to food versus nonfood across stop- and go-trials, reflected in a Stimulus × Group interaction. Healthy controls showed no differences. Importantly, the food-specific effect in AN-R was identical across stop- and go-trials, indicating habitual food avoidance. Moreover, stop error rates (i.e., stop-trials with response) were lower in patients with AN-R.

DISCUSSION

The findings suggest food-specific habitual avoidance and heightened generalized inhibitory control in AN-R. The continuously delayed displacements during active hand movements across stop- and go-trials indicated the persistence of patients' avoidance of food.

PUBLIC SIGNIFICANCE

Experimental research investigates the mechanisms underlying mental disorders such as anorexia nervosa. In this study, we measured interrupted hand movements in response to food pictures or neutral pictures (shoes) in patients with anorexia nervosa and healthy controls. A virtual reality scenario was used. Findings indicated that patients were slower at approaching food, interrupted or not. Key mechanisms of food avoidance can be translated into habit-based treatment options in future research.

Negative and positive interpretations of emotionally neutral situations modulate the desire to eat personally craved foods

Emotions play an important role in modulating food craving. Previous studies demonstrated that exposure to negative or positive stimuli can subsequently influence the desire to eat. However, in many daily situations, individuals self-generate their emotions, for example, by interpreting emotionally-neutral situations as positive or negative. So far, no studies have examined if and how positive and negative interpretations of emotionally-neutral situations modulate food craving. In this study, 65 healthy participants were asked to interpret emotionally-neutral images negatively or positively or observe the images naturally. Subsequently, participants rated their state negative/positive affect and their desire to eat their personally craved foods. The results demonstrate a lower desire to eat craved foods after negative interpretations and a higher desire to eat after positive interpretations, compared to an observe-naturally condition. Additionally, the impact of emotional interpretations on the desire to eat was mediated by participants' state negative/positive affect. These findings suggest that self-generated emotion as a result of negative/positive interpretations plays a significant role in modulating food craving. The results highlight the potential of modifying affective interpretations for the treatment of disorders that are characterized by both dysregulated food craving and emotion.

Hunger modulates perceptions of food health but not taste in restricted eaters

Introduction

Food taste and health perceptions are of particular interest for their implications on food choice. Most in vivo food choice studies experimentally control for hunger via a set preload or fast.

Methods

To explore how hunger may interact with these perceptions to impact food decisions, we compared taste and health perceptions of sweet and savory obesogenic food items among hungry or satiated participants with varying restrained eating tendencies.

Results

In our sample of 232 adults (M BMI = 25.9; M age = 36.4 yrs), highly palatable foods were perceived as tasty but unhealthy. Tastiness ratings were high, consistent across restrained eating groups, and unassociated with hunger. Perceptions of health, however, were impacted by the interaction of restrained eating group and hunger. Amongst hungry participants only, a graded association between restrained eating group and perceptions of health emerged for both food types. Specifically, hungry and highly restrained eaters viewed sweet foods as 2.8x healthier and savory foods as 2.1x healthier than their satiated counterparts.

Discussion

Our data suggest that hunger predicts differential health perceptions, but not tastiness ratings, among restrained eaters. We argue that the generalization of food perception data-especially among different eater types-may be limited if the continuum of hunger level is experimentally constrained. Therefore, hunger is a critical dynamic to consider in explorations of food perceptions and eating behavior in restrained eaters.