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Restrictive food intake as a choice--a paradigm for study.

ABSTRACT: Inadequate intake and preference for low-calorie foods are salient behavioral features of Anorexia Nervosa (AN). The neurocognitive mechanisms underlying pathological food choice have not been characterized. This study aimed to develop a new paradigm for experimentally modeling maladaptive food choice in AN.Individuals with AN (n?=?22) and healthy controls (HC, n?=?20) participated in a computer-based Food Choice Task, adapted for individuals with eating disorders. Participants first rated 43 food images (including high-fat and low-fat items) for Healthiness and Tastiness; an item rated neutral on both blocks was then selected as the Reference item. On each of 42 subsequent trials participants were asked to choose between the food item presented and the Reference item.The AN group was less likely to choose high-fat foods relative to HC, as evidenced both in multilevel logistic regression (z?=?2.59, p?=?.009) and ANOVA (F(1,39)?=?7.80, p?=?.008) analyses. Health ratings influenced choice significantly more in AN relative to HC (z?=?2.7, p?=?.006), and were more related to Taste among AN (?(2)?=?4.10, p?=?.04). Additionally, taste ratings declined with duration of illness (r?=?-.50, p?=?.02).The Food Choice Task captures the preference for low-fat foods among individuals with AN. The findings suggest that the experience of tastiness changes over time and may contribute to perpetuation of illness. By providing an experimental quantitative measure of food restriction, this task opens the door to new experimental investigations into the cognitive, affective, and neural factors contributing to maladaptive food choices characteristic of AN.

SUBMITTER: Steinglass J

PROVIDER: S-EPMC4276488 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

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Restrictive food intake as a choice--a paradigm for study.

Steinglass Joanna J Foerde Karin K Kostro Katrina K Shohamy Daphna D Walsh B Timothy BT

The International journal of eating disorders 20140818 1

<h4>Objective</h4>Inadequate intake and preference for low-calorie foods are salient behavioral features of Anorexia Nervosa (AN). The neurocognitive mechanisms underlying pathological food choice have not been characterized. This study aimed to develop a new paradigm for experimentally modeling maladaptive food choice in AN.<h4>Method</h4>Individuals with AN (n = 22) and healthy controls (HC, n = 20) participated in a computer-based Food Choice Task, adapted for individuals with eating disorder ...[more]

PMID: 25130380

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Project description:BackgroundPrevious research has demonstrated that early weight gain in family-based treatment (FBT) is predictive of remission for adolescents with anorexia nervosa (AN). However, no published data has addressed if early weight gain is also predictive of reaching weight restoration (i.e., 95% EBW) in patients with avoidant/restrictive food intake disorder (ARFID). Furthermore, no studies have evaluated the performance of the statistical models used to predict weight restoration at the end of treatment. This study sought to examine whether early weight gain in ARFID is predictive of weight restoration at 20 weeks using ROC analysis. Additionally, this study assessed how accurately the model classified patients and what types of misclassifications occurred.MethodsParticipants (n = 130, 57.7% cisgender female 70.0% white) received virtual outpatient FBT. Receiver operating characteristics (ROC) were used to predict successful weight restoration at end of treatment, using early weight gain as the predictor. Twenty weeks was considered as the end of treatment, to align with the definition of end of treatment in FBT clinical trials. ROC analyses demonstrated that gaining at least 6.2 pounds by week 5 of treatment was the strongest predictor of achieving 95% EBW at 20 weeks (AUC = 0.72 [0.63, 0.81]). ROC analyses misclassified 35% of patients; the most common misclassification was predicting that a patient would not achieve 95% EBW when they actually did (61.6%). A logistical regression model, which included the patients' %EBW at admission in addition to early weight gain as a predictor, outperformed the ROC analyses (AUC = 0.90 [0.85, 0.95]) and provided additional context by showing the probability that a patient would succeed.ConclusionTaken together, research demonstrates that early weight gain is a useful predictor of 95% EBW at 20 weeks of treatment for patients with ARFID who require weight restoration. Furthermore, results suggest that statistical models need to take into account additional information, such as %EBW at admission, along with early weight gain in order to more accurately predict which patients will reach weight restoration at week 20.

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Restrictive food intake as a choice--a paradigm for study.

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Restrictive food intake as a choice--a paradigm for study.

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