Abstract: Background The Internet, particularly blogs have become an important tool for patients to disseminate and exchange information on a variety of health topics, including bariatric surgery. By virtue of its interactivity being free of judgement from health care providers, blogs expose gaps in patients’ knowledge and understanding. Purpose This study analyzes the main doubts expressed in blogs by patients in the postoperative period of bariatric surgery. Method This is a qualitative exploratory study of 11 blogs of patients, who underwent bariatric surgery, that were available on the Internet between October 2013 and May 2017. The data were collected through a structured instrument and analyzed according to Bardin’s suggestions. The sampling method used was intentional. Results Evolution of diet, weight loss, plateau effect, weight regain, physical exercises, physiological changes, complications, use of contraceptive and pregnancy were the main areas of concern. Conclusion More needs to be done to educate and prepare bariatric patients for the postoperative period. The content found in blogs serves towards building better links with patients, helps them make better decisions, and provides them an opportunity to be active participants in their own treatment. PubDate: 2019-12-01
Abstract: Purpose Parental invalidation and narcissism have been proposed to play an important role in understanding the etiology of eating disorders. The current research aimed to address two main gaps in the literature. The first aim was to determine the differential associations of grandiose and vulnerable narcissism with eating disorder pathology. The second aim was to find a common mediator between both maternal and paternal invalidation and eating disorder pathology. It was hypothesized that when controlling for vulnerable narcissism, grandiose narcissism would not predict eating disorder pathology. In addition, it was hypothesized that vulnerable narcissism would be a mediator of the relationship between parental invalidation and eating disorder pathology. Methods Participants were 352 women aged 18–30 years who were recruited from the general and tertiary student population, and as such constituted a community sample. Participants completed the Invalidating Childhood Environment Scale, Brief-Pathological Narcissism Inventory, Eating Disorder Examination Questionnaire, the Avoidance of Affect Subscale of the Distress Tolerance Scale, and the Emotional Expression as a Sign of Weakness Subscale of the Attitudes Towards Emotional Expression Scale in an online survey. Results Results showed that, when controlling for vulnerable narcissism, grandiose narcissism was no longer associated with eating disorder pathology. It was also found that parental invalidation had a positive indirect effect upon eating disorder pathology, via vulnerable narcissism. Conclusions The findings indicate that vulnerable narcissism is more strongly associated with eating disorder pathology as opposed to grandiose narcissism and help to further elucidate the mechanisms via which parental invalidation might exert its negative effect on eating disorder pathology. Level of evidence A cross-sectional survey (Level V). PubDate: 2019-12-01
Abstract: Purpose To investigate attentional and memorial biases towards body shape pictures among female patients with clinical eating disorders and healthy female controls. Methods A visual dot-probe task was used to assess attention towards pictures reflecting either a thin, normal, or obese female body shape. Pictures were presented in pairs; each pair depicted two different body shapes and were presented twice. Participant responses were compared across time and population. Results Overall, the eating disorder patients responded more slowly than controls, F(1,63) = 20.32, p < .001. Both groups showed an attentional bias towards the larger of two body shapes, F(1,63) = 4.30, p = .04, and responded more quickly the second time they viewed the picture pairs, F(1,63) = 33.80, p < .001. Upon second viewing of picture pairs, the eating disorder patients had a larger decrease in reaction time (86 ms) than the control sample (33 ms) only when both pictures included extreme body shapes (thin and obese); the decrease in reaction time when one of the pictures included a normal body shape was the same across groups upon second viewing (eating disorder: 37 ms; control: 32 ms), F(1,63) = 9.32, p = .003. Conclusions These findings suggest that individuals with eating disorders may be biased towards recall of dichotomous and/or extreme body shape images. While it remains unclear whether attentional and/or memorial bias is a risk, maintenance, or causal factor in eating disorders, future studies should employ longitudinal, prospective research designs to address these questions. Level of Evidence Level II, comparative study. PubDate: 2019-12-01
Abstract: Introduction Laparoscopic sleeve gastrectomy (SG) represents, at present, the most performed bariatric procedure worldwide with excellent long-term results on weight loss and comorbidities control. After the gastrectomy procedure, together with hormonal modification, several changes in taste and habits occur, including the potential modification in alcohol consumption. The aim of this prospective study was to determine the frequency and the amount of alcohol use before and after SG using a modified version of the Alcohol Use Disorder Identification Test (AUDIT) at 1-year follow-up and eventually to evaluate relationships between different ages and sexes. Materials and methods A total of 142 patients were prospectively enrolled and evaluated before and 1 year after SG with a modified AUDIT. The exclusion criteria were as follows: history of alcohol abuse, presence of psychopathology or cognitive impairments, diabetes mellitus type II decompensated, or previous gastrointestinal, liver, and pancreatic resective surgery. Subgroup analyses were performed between male and female and between under and over 40 years old. Results The median AUDIT score decreased from 2.70 (range 1–18) before surgery to 1.38 (range 1–7) after 1 year of SG, indicating a marked reduction in alcohol use. The most consumed alcoholic drink was beer (36.6%/n = 52) while after surgery the consumption of beer decreased considerably (21.1%/n = 30). The frequency of alcohol consumption also decreased: at baseline 45% of patients consumed alcoholic drinks “from 2 to 4 times per month”, whereas 26 and 39.4% consumed alcohol “never” and “less than once a month,” respectively. After surgery, nobody consumed more then six alcoholic drinks. No differences were found between the subgroups in terms of alcohol consumption and social behavior. Conclusions The alcohol preference is modified and decreased 1 year after SG and this could be related to the strict nutritional follow-up and to the hormonal changes. Studies with large samples and long-term follow-up are needed to confirm our data. Level of evidence IV. PubDate: 2019-12-01
Abstract: Purpose To determine the effectiveness of Family-Based Therapy (FBT) as a treatment for Anorexia Nervosa (AN) in adolescents in a Singaporean cohort. FBT has proven effective in studies in the West, but no such study has been done in Asia. Methods This is a retrospective analysis of a hospital-based cohort, which included all paediatric patients (≤ 18-years) with AN treated at a tertiary hospital in Singapore between 2011 and 2017 (n = 119). The patients either received manualised FBT (n = 42) or individualized adolescent focussed therapy (non-FBT) (n = 77). Patient characteristics and time to remission were abstracted from patient records. Survival analysis was used to determine median time to remission and remission-free survival rates. Hazard ratios for remission were obtained by cox regression. Results Patients in the non-FBT group had a significantly longer time to remission compared with the FBT group after adjustment for age, gender, BMI, psychiatric comorbidity, and ethnicity (p = 0.003, HR = 2.523, 95% CI 1.37–4.64). In the FBT group, the median time to remission was 5.0 months (95% CI 3.4–6.6 months); 11 months shorter than the non-FBT group (p < 0.001, 95% CI 7.9–14.1 months). FBT group remission rates were 69% and 90% at 1 and 2 years, respectively. Non-FBT group remission rates were 30% and 57% at 1 and 2 years, respectively. Conclusions This study confirms that FBT is an effective treatment strategy for AN in adolescents in the Asian context. FBT can shorten the illness duration, which reduces disruption to schooling and family life at this critical life stage. Level of evidence Level IV, evidence obtained from retrospective review of data before and after the introduction of new intervention. PubDate: 2019-12-01
Abstract: Purpose Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models. Methods Participants were 185 women aged 18–25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt. Results Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt. Conclusions Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change. Level of evidence Level I, evidence obtained from a properly designed randomized controlled trial. PubDate: 2019-12-01
Abstract: Background Industrialization has led to more varied and attractive high-calorie foods. Health problems such as obesity and diabetes are partially attributed to eating-related self-regulation difficulties that may be caused by increasingly frequent cues for highly palatable foods. Research studies aim at understanding the factors underlying responses to food cues. This has led to the development of food stimuli databases. However, they present some limitations. Objectives This study aimed at providing a controlled set of pictures, including 40 food pictures with high- and low-calorie stimuli, matched with 40 non-food pictures. The second objective was to provide a ready-to-use database with normative data regarding responses and associations between demographic, anthropometric and eating-related characteristics, and picture ratings. Participants A sample of 264 participants rated the total set of pictures. Measures Attractiveness, arousal and palatability were assessed for each picture, as well as participant’s current type of diet, BMI, hunger levels and eating behaviors (uncontrolled and emotional eating). Results Image characteristics (shape, colors, luminance) were comparable between food and matched non-food pictures. Positive correlations were found between hunger levels and attractiveness, arousal and palatability of food. Uncontrolled and emotional eating was positively correlated with high-calorie food palatability, and uncontrolled eating was positively correlated with high-calorie food attractiveness. Participants who did not report any specific diet rated high-calorie foods as more attractive and arousing, whereas vegan and vegetarian participants assessed low-calorie foods as more attractive and palatable. Conclusion The Food-Cal controlled set of picture database can be considered as a useful tool for experimental research. Level of evidence Level V, cross-sectional descriptive study. PubDate: 2019-12-01
Abstract: Purpose With the Internet becoming increasingly popular as a source of information, blogs offering healthy lifestyle techniques and knowledge have become popular and accessible. Despite their focus on health, these blogs portray content that may be negatively construed by viewers, especially those with or at risk for eating disorders. The present study investigated changes in affect and self-esteem after viewing a prototypic health blog. Personality traits, specifically neuroticism and conscientiousness, were also investigated. Methods A prototypic health blog was constructed after extensive review of existing blogs. A parallel format was then followed to create a home décor website for a control condition. Female undergraduate students were randomly assigned to one of two blog sites, and participants completed an earlier personality assessment and post-viewing study questionnaires. Results Contrary to the hypothesis that readers of the health blog will report more negative outcomes, no main effect of blog condition was found. However, individuals high in trait neuroticism experienced greater differences in negative affect, but not self-esteem, when viewing the health blog versus the control blog. Conclusions This study found that viewing health blogs did not have immediate effects on affect and self-esteem, but more neurotic individuals were more inclined to experience negative affect when viewing health promotion messages. Personality traits assessed prior to the experiment were more predictive of negative affect and self-esteem during the experiment than blog viewing conditions. No level of evidence, experimental study. PubDate: 2019-12-01
Abstract: Purpose Yoga has been increasingly used as a complementary therapy for eating disorders. However, it is still not clear whether yoga is effective in the prevention and treatment of eating disorders, as some studies suggest that yoga practitioners show elevated levels of disordered eating behaviours. The goal of this systematic review is, thus, to analyse the occurrence of disordered eating behaviours and correlates in yoga practitioners. Method PRISMA guidelines for systematic reviews were used. Search was conducted in several databases and specific journals. Results Twelve articles, all cross-sectional, were identified, following PRISMA guidelines. Results across studies were inconsistent. Yoga practice was usually associated with healthier eating behaviours, lower disordered eating symptoms, and higher positive body image and body satisfaction, suggesting that yoga practitioners may be at a lower risk of developing eating disorders. However, other studies suggested that a high dosage of yoga practice may be associated with a higher prevalence of disordered eating behaviours. Conclusions As yoga is increasingly used as therapy for eating disorders, understanding the relationship between yoga dosage and disordered eating behaviours is critical to guide treatment recommendations and establish yoga as a valuable complementary therapy. Level of evidence Level I, systematic review. PubDate: 2019-12-01
Abstract: Purpose This pilot study aimed to analyze the effects of an adapted dialectical behavior therapy (DBT) skills training group on problematic and adaptive eating behaviors in Brazilian obese individuals. Methods Thirty-one obese individuals were randomly assigned to 10 sessions of adapted DBT skills training (n = 14) or two months of a waiting list comparison condition (n = 17). Results Attrition rates were similar to what’s been found in comparable studies, with most dropouts happening at the beginning of the treatment. Results showed improvements in binge eating severity (d = 0.80) and depression (d = 0.82) compared to no treatment condition. After the intervention, adaptive eating and distress outcomes showed an improvement trend, reaching nonclinical levels for most participants in the intervention group. Large to moderate between-group effect sizes were observed, but none of those were statistically significant. Large within-group effect sizes were observed in the intervention group in binge eating severity (d = 1.34), intuitive eating (d = 1.33) and depression (d = 1.12). Medium effect sizes were observed in emotional eating (d = 0.73) and in emotion regulation (d = 0.72). Despite positive outcomes in other variables, mindful eating worsened after the intervention (d = 0.66). Conclusions These results are preliminary and require further replications with larger samples, yet they suggest that the intervention may be useful to improve distress outcomes and adaptive eating among obese people. Implications for clinical practice and recommendations for future research are discussed. Level of evidence Level I, randomized controlled trial. PubDate: 2019-12-01
Abstract: Background Eating disorders are characterized by high levels of anxiety, especially while eating. However, little is known about anxiety experienced during meals and specifically what other variables may impact such anxiety. Objective We sought to further quantify and understand the relationship between food anxiety, eating disorders, and related correlates (e.g., comorbid diagnoses, personality). Methods In the current study [N = 42 participants diagnosed with an eating disorder (n = 36 participants with anorexia nervosa)], we quantified anxiety before, during, and after a meal using data from a food exposure session in a partial hospital eating disorder center. We examined diagnostic, personality, and clinical factors as correlates of food anxiety. Results Participants were more likely to experience higher food anxiety if they had a current diagnosis of major depression, obsessive–compulsive disorder, or post-traumatic stress disorder (PTSD). Concern over mistakes was the strongest and most consistent correlate of food anxiety regardless of time during the meal that anxiety was assessed. Other significant correlates were fear of positive evaluation, social appearance anxiety, BMI, and trust. Conclusions These findings show how diagnoses, perfectionism (concern over mistakes), and other correlates relate to anxiety during meals. Food exposure interventions may benefit from personalizations that address these factors. Level of evidence IV Evidence from a randomized control trial, but from the first session before effects of the design would be present. PubDate: 2019-12-01
Abstract: Abstract The present manuscript describes the multiphase optimization strategy (MOST) and its potential applications to treatments for eating disorders (EDs). The manuscript describes the three phases of MOST, discusses a hypothetical case example of how MOST could be applied to developing a disseminable ED treatment, and reviews the pros and cons of the MOST approach. Outcomes from treatments for EDs leave room for improvement. However, traditional methods of treatment development and evaluation (i.e., the treatment package approach) make it challenging to determine how best to improve ED treatments. For example, testing full treatment packages in open trials and RCTs without systematic testing of each component is inefficient (as it is unknown which components are effective), and often does not provide concrete future directions for optimization of the treatment. Much stands to be gained by optimizing treatments in the early stages before testing them in open trials or RCTs. MOST is an alternative, engineering-inspired research framework that is well-suited to address the issues of inefficiency associated with the treatment package approach. MOST entails identifying the most promising treatment components for inclusion in interventions, then eliminating or deemphasizing less efficacious/inert components. This strategy results in a treatment comprised of only effective components that can then be tested via RCT. Though the MOST approach has limitations, it has the potential to greatly benefit ED treatment research and is worthy of application in the field. PubDate: 2019-12-01
Abstract: Purpose To examine the association of self-esteem with the body mass index (BMI), perceived body image (BI), and desired BI of college-age Saudi females. Methods A cross-sectional study was conducted with 907 randomly selected females using a multistage stratified cluster sampling technique. Self-esteem and BI were assessed using the Rosenberg Self-Esteem Scale and Stunkard Figure Rating Scale, respectively. Results The prevalence of low self-esteem was only 6.1% among college females; however, this percentage was higher (9.8%) among overweight or obese participants. The total self-esteem scores showed significant negative correlations with actual BMI and perceived BI, but not with desired BI. Meanwhile, multivariate analyses revealed significant differences in total self-esteem scores according to obesity/overweight status and perceived BI group, but not desired BI group. Conclusion Despite the high prevalence of overweight and obesity in Saudi Arabia, few Saudi college females have low self-esteem. In addition, body weight, BMI, perceived BI, and the BMI corresponding to the perceived BI all significantly differed between females with low self-esteem and those with normal self-esteem. Level of evidence Level V, cross-sectional descriptive study. PubDate: 2019-12-01
Abstract: Purpose Food addiction, eating disorders and obesity are all mutually reinforcing factors, or factors that can trigger each other. The aim of this study was to determine the relationship between food addiction, disordered eating behaviours and obesity. Methods The study was conducted with 370 university students. Food addiction was assessed using the Yale Food Addiction Scale (YFAS) and disordered eating behaviours were assessed with the Eating Attitude Test (EAT)-26. A digital scale was used to measure weight, while for the measurement of height, waist and hip circumferences a non-stretching tape measure was used according to standard techniques. Results Among the participants, 35.7% scored high on the EAT-26, while 21.1% scored high on the YFAS. Females constituted a higher ratio of those who had high scores on the YFAS and EAT-26 (p < 0.05). Overall, the ratio of YFAS high scorers was higher in the case of EAT-26 high scorers (32.6%) than that of low scorers (14.7%) (p < 0.001). A positive weak relationship existed between YFAS and EAT-26 scores (r = 0.165, p = 0.001) and the same between YFAS scores, weight, and body mass index (r = 0.263, p < 0.001; r = 0.319, p < 0.001, respectively). Conclusion In summary, a positive relation was found between food addiction, disordered eating behaviours and body mass index. Females were shown to have a higher risk of food addiction and eating disorders than that of males. Further studies can be carried out to analyze these correlations using a wider range of controlling factors. Level of evidence Level V, cross-sectional descriptive study. PubDate: 2019-12-01
Abstract: Abstract Ghrelin is a gastric hormone circulating in acylated (AG) and unacylated (UnAG) forms. This narrative review aims at presenting current emerging knowledge on the impact of ghrelin forms on energy balance and metabolism. AG represents ~ 10% of total plasma ghrelin, has an appetite-stimulating effect and is the only form for which a receptor has been identified. Moreover, other metabolic AG-induced effects have been reported, including the modulation of glucose homeostasis with stimulation of liver gluconeogenesis, the increase of fat mass and the improvement of skeletal muscle mitochondrial function. On the other hand, UnAG has no orexigenic effects, however recent reports have shown that it is directly involved in the modulation of skeletal muscle energy metabolism by improving a cluster of interlinked functions including mitochondrial redox activities, tissue inflammation and insulin signalling and action. These findings are in agreement with human studies which show that UnAG circulating levels are positively associated with insulin sensitivity both in metabolic syndrome patients and in a large cohort from the general population. Moreover, ghrelin acylation is regulated by a nutrient sensor mechanism, specifically set on fatty acids availability. These recent findings consistently point towards a novel independent role of UnAG as a regulator of muscle metabolic pathways maintaining energy status and tissue anabolism. While a specific receptor for UnAG still needs to be identified, recent evidence strongly supports the hypothesis that the modulation of ghrelin-related molecular pathways, including those involved in its acylation, may be a potential novel target in the treatment of metabolic derangements in disease states characterized by metabolic and nutritional complications. Level of evidence Level V, narrative review. PubDate: 2019-12-01
Abstract: Purpose “Making weight” behaviors are unhealthy weight control strategies intended to reduce weight in an effort to meet weight requirements. This study aimed to examine a brief measure of making weight and to investigate the relationship between making weight and weight, binge eating, and eating pathology later in life. Methods Participants were veterans [N = 120, mean age 61.7, mean body mass index (BMI) 38.0, 89.2% male, 74.2% Caucasian] who were overweight/obese and seeking weight management treatment. Participants completed the making weight inventory (MWI), a measure of making weight behaviors engaged in during military service, and validated measures of eating behavior. Analyses compared participants who engaged in at least one making weight behavior (MWI+) versus those who did not (MWI−). Results The MWI had good internal consistency. One-third of participants were MWI+ and two-thirds were MWI−. The most frequently reported behavior was excessive exercise, reported in one-quarter of the sample, followed by fasting/skipping meals, sauna/rubber suit, laxatives, diuretics, and vomiting. MWI+ participants were significantly more likely to be in a younger cohort of veterans, to be an ethnic/racial minority, and to engage in current maladaptive eating behaviors, including binge eating, vomiting, emotional eating, food addiction, and night eating, compared to the MWI− group. Groups did not differ on BMI. Conclusions One-third of veterans who were overweight/obese screened positive for engaging in making weight behaviors during military service. Findings provide evidence that efforts to “make weight” are related to binge eating and eating pathology later in life. Future research and clinical efforts should address how to best eliminate unhealthy weight control strategies in military service while also supporting healthy weight management efforts. PubDate: 2019-12-01
Abstract: Purpose The objective of this analysis was to assess whether the association between sleep duration and BMI and between sleep duration and waist circumference is moderated by age and self-perceived stress. Methods We analyzed data from 2034 participants enrolled in 2014 in the cross-sectional study Obesity in Romania Study—study of the prevalence of obesity and related risk factors in Romanian general population (ORO study). Results Interaction between sleep duration, self-perceived stress and age, with BMI as dependent variable, was statistically significant after adjustment for demographic and lifestyle factors (p value for interaction 0.003). In participants without self-perceived stress, a linear negative association between sleep duration and BMI was observed only in those 18–39 years old (p = 0.049), with BMI decreasing in parallel with increased sleep duration. In participants with self-perceived stress, a U-shaped relationship was observed between BMI and sleep duration in those 40–64 years old, with higher BMI in those sleeping ≤ 6 h and ≥ 9 h/night compared to those sleeping > 6 and < 9 h/night (p = 0.002 and 0.005). Those ≥ 65 years old with self-perceived stress sleeping ≥ 9 h/night had a significantly higher BMI compared to those in other sleep duration categories (p = 0.041 vs. those sleeping ≤ 6 h/night and p = 0.013 vs. to those sleeping > 6 and < 9 h/night). No interaction between age, self-perceived stress and sleep duration, with waist circumference as dependent variable was observed. Conclusions In our sample, the association between sleep duration and BMI was moderated by self-perceived stress and age. PubDate: 2019-12-01
Abstract: Background and purpose The association between weight status with simple cognitive tasks such as reaction time (RT) may not be observed in young people as cognitive functioning development has reached its peak. In the present study, we aimed to examine the association between overall and central adiposity with overall and central processing of RT in a sample of young adult men with different weight status from Ardabil, Iran. Methods Eighty-six young males between June-July 2018 completed RT tests as well as premotor time (PMT) using surface electromyography changes in isometric contraction response to an audio stimulus. Results No significant associations were observed between RT and PMT and different body mass index categories (underweight, normal weight, overweight and obese), as well as fat mass and fat to skeletal muscle mass ratio quartiles (Q). However, participants with greater waist to height ratio (WHtR) had longer PMT (but not RT) than their peers with lower WHtR (Q3 than Q2 and Q1 groups; p < 0.05, d = 1.23). Participants in the skeletal muscle mass quartile Q2 tended to have longer RT than participants in Q3 in an adjusted comparison model (p = 0.05, d = 0.72). Conclusions Although the association between weight status and RT might be elusive in young adults, our results show that higher central adiposity is negatively associated with PMT in young adults. Longitudinal studies are needed to explore the changes in obesity indexes and process speed in longer terms. Level of evidence Level I, experimental study. PubDate: 2019-12-01
Abstract: Abstract Although it is well documented that women evaluate their own body differently from other bodies, it remains unclear whether this discrepancy is based on double standards because of identity or on objective differences between these bodies. The aim of this study was therefore to test whether women apply double standards depending on a body’s identity when evaluating the same bodies presented with different faces. Average-weight women (N = 104) rated body attractiveness, body fat, and muscle mass of thin, average-weight, overweight, athletic, and hypermuscular bodies with either another female’s face or their own face. With their own face, subjects rated overweight bodies as more unattractive, higher in body fat and lower in muscle mass than with another female’s face. However, for non-overweight bodies, body ratings did not differ depending on body identity. Based on the self-deprecating double standards for overweight bodies, a body-related identity bias might be considered in theoretical models of body image. Level of evidence Level V, descriptive study. PubDate: 2019-12-01
Abstract: Background Intimacy is a key psychological problem in anorexia nervosa (AN). Empirical evidence, including neurobiological underpinnings, is however, scarce. Objective In this study, we evaluated various emotional stimuli including intimate stimuli experienced in patients with AN and non-patients, as well as their cerebral response. Methods Functional magnetic resonance imaging was conducted using stimuli with positive, neutral, negative and intimate content. Participants (14 AN patients and 14 non-patients) alternated between passive viewing and explicit emotion regulation. Results Intimate stimuli were experienced less positively in AN patients compared to non-patients. AN patients showed decreased cerebral responses in superior parietal cortices in response to positive and intimate stimuli. Intimate stimuli led to stronger activation of the orbitofrontal cortex, and lower activation of the bilateral precuneus in AN patients. Orbitofrontal responses decreased in AN patients during explicit emotion regulation. Conclusions These results show that intimate stimuli are of particular importance in AN patients, who show experiential differences compared to non-patients and altered activation of orbitofrontal and parietal brain structures. This supports that AN patients have difficulties with intimacy, attachment, self-referential processing and body perception. Level of evidence Level III, case–control study. PubDate: 2019-12-01
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