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A comparison of food-based decision-making between restricting and binge-eating/purging subtypes of anorexia nervosa.

Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA. Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA. Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA. Department of Psychology, Columbia University, New York, NY, USA. Kavli Institute for Brain Science, Columbia University, New York, NY, USA.

The International journal of eating disorders. 2020;(10):1751-1756
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Abstract

OBJECTIVE By definition, restricting (ANR) and binge-eating/purging (ANBP) subtypes of anorexia nervosa (AN) differ in some manifestations of maladaptive eating behavior. This study aimed to determine whether the groups differ in the choices they make about what to eat, and whether there are differences in valuation related to food choice, using an experimental paradigm. METHOD Inpatients with ANR (n = 40) and ANBP (n = 46) participated in a Food Choice Task. During the task, participants rated 76 food images for healthiness and tastiness, and choice preferences. Groups were compared in percent selection of high-fat and low-fat foods, value ratings of foods, and engagement of self-control in food choice. RESULTS There were no differences between AN subtypes in healthiness or tastiness ratings, or in tendency to limit choice of high-fat foods. There was no difference between the groups in measures of self-control in food choice. DISCUSSION Individuals with ANR and ANBP similarly manifest reduced choices of high-fat foods, with similar tendencies to undervalue the tastiness of high-fat foods. These results suggest that while individuals with ANR and ANBP differ across a range of clinical characteristics, the decision-making process associated with the maladaptive restriction of high-fat foods characteristic of AN is shared by both subtypes.