Associations between interoceptive sensitivity, intuitive eating, and body mass index in patients with anorexia nervosa and normal‐weight controls

Richard, Anna; Meule, Adrian; Georgii, Claudio; Voderholzer, Ulrich; Cuntz, Ulrich; Wilhelm, Frank H.; Blechert, Jens

doi:10.1002/erv.2676

Cited by 37 publications

(46 citation statements)

References 21 publications

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“…Contrary to the hypothesis that people with AN would exhibit lowered cardiac interoceptive accuracy compared to HC, the study found no significant differences between groups in heartbeat tracking performance. This is in line with a number of recent studies, including two that were published after the hypotheses for the current study were generated (12)(13)(14). The findings of the present study, and more recent research, contrast with previous research using the heartbeat tracking task in AN which found lowered accuracy in this population (10,11).…”

Section: Discussionsupporting

confidence: 90%

“…The findings of this study did not support this hypothesis, with no relationships found. Consequently, it is possible that interoceptive accuracy is not linked to alexithymia and autistic traits in AN, and is rather associated with other drivers, such as treatment duration or BMI (14). However, it should be noted that interoceptive accuracy, autism, and alexithymia have not consistently been linked in previous studies: two recent studies have found no associations between autism and interoceptive accuracy in adults (33,34).…”

Section: Discussionmentioning

confidence: 92%

“…However, groups in the current study significantly differed on other variables, including anxiety, depression, BMI, and alexithymia. Although the present study is the one of the largest studies on interoceptive accuracy in AN to date [n= 74 compared to n = 76 in Richard et al (14)], it was not possible to account for the potential roles of all these variables owing to the relatively small sample size limiting the ability to perform a large multivariable regression analysis. Additionally, the nonparametric distribution limited the ability to control for variables in group comparisons using ANCOVAs.…”

Section: Discussionmentioning

confidence: 94%

“…This reflects concerns that heartbeat tracking task performance is associated with state-dependent factors (25). For example, Richard et al (14) found that interoceptive accuracy was associated with inpatient treatment progress, with higher accuracy associated with higher BMIs and longer time in treatment (14).…”

Section: Discussionmentioning

confidence: 99%

“…Using the heartbeat tracking task, two initial studies found that people with AN had lower interoceptive accuracy (10,11). By contrast, three more recent studies using the same measure found no significant differences between people with AN and healthy controls (HC) (12)(13)(14). One previous study has used a heartbeat discrimination task, finding no differences between people with AN and HC (15).…”

Section: Introductionmentioning

confidence: 99%

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Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

2020

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Background: Previous research on whether interoception is altered in anorexia nervosa (AN) using the heartbeat tracking task has yielded inconsistent results. However, no previous research has examined whether interoception is associated with alexithymia and autistic traits in AN, conditions which are more prevalent in this population and thought to be related to performance in this task. The aim of this study was to explore whether altered interoception in AN is associated with alexithymia and autistic traits. Methods: We assessed interoceptive accuracy using the heartbeat tracking task in n = 37 people with AN, and n = 37 age and gender matched healthy controls (HC), and explored within the AN group if interoceptive accuracy was related to self-rated alexithymia or autistic traits. We also assessed self-reported interoceptive ability, and the relationship between subjective and actual performance. Results: Heartbeat tracking task performance was not found to be altered in the AN group compared to the HC group. However, confidence ratings in task performance in the AN group were lower compared to the HC group. Unlike the HC group, confidence ratings in the AN group did not correlate with task performance. Within the AN group there was no relationship between interoceptive accuracy, alexithymia, and autistic traits, after controlling for the potential confounders of anxiety and depression. There was a relationship between confidence ratings and illness severity in the AN group. Conclusion: The results found no differences between heartbeat tracking task performance in people with AN compared to HC. There was no association between task performance, alexithymia and autistic traits in AN. Results do suggest that people with AN exhibit lowered confidence in their task performance, and that they may lack insight into this performance compared to HC. The findings are discussed in the context of potential significant limitations of the heartbeat tracking task, with recommendations for future research into interoception in AN.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

2020

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Emotional eating across different eating disorders and the role of body mass, restriction, and binge eating

Reichenberger

Schnepper

Arend

et al. 2021

Intl J Eating Disorders

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Objective Different subtypes of eating disorders (ED) show dysfunctional eating behaviors such as overeating and/or restriction in response to emotions. Yet, systematic comparisons of all major EDs on emotional eating patterns are lacking. Furthermore, emotional eating correlates with body mass index (BMI), which also differs between EDs and thus confounds this comparison. Method Interview‐diagnosed female ED patients (n = 204) with restrictive (AN‐R) or binge‐purge anorexia nervosa (AN‐BP), bulimia nervosa (BN), or binge‐eating disorder (BED) completed a questionnaire assessing “negative emotional eating” (sadness, anger, anxiety) and “happiness eating.” ED groups were compared to BMI‐matched healthy controls (HCs; n = 172 ranging from underweight to obesity) to exclude BMI as a confound. Results Within HCs, higher BMI was associated with higher negative emotional eating and lower happiness eating. AN‐R reported the lowest degree of negative emotional eating relative to other EDs and BMI‐matched HCs, and the highest degree of happiness eating relative to other EDs. The BN and BED groups showed higher negative emotional eating compared to BMI‐matched HCs. Patients with AN‐BP occupied an intermediate position between AN‐R and BN/BED and reported less happiness eating compared to BMI‐matched HCs. Discussion Negative emotional and happiness eating patterns differ across EDs. BMI‐independent emotional eating patterns distinguish ED subgroups and might be related to the occurrence of binge eating versus restriction. Hence, different types of emotional eating can represent fruitful targets for tailored psychotherapeutic interventions. While BN and BED might be treated with similar approaches, AN‐BP and AN‐R would need specific treatment modules.

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Intuitive eating and its psychological correlates: A meta‐analysis

Linardon

Tylka

Fuller‐Tyszkiewicz

2021

Intl J Eating Disorders

124

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Objective Intuitive eating is an adaptive style of eating that has generated significant research attention. Theoretically, intuitive eating is a core construct that features prominently in the Acceptance Model of Intuitive Eating, a framework that explains how positive environmental influences can foster intuitive eating practices via body appreciation. Empirically, intuitive eating has been connected to a broad range of adaptive mental health indices. At present, a quantitative synthesis of intuitive eating and its correlates has yet to be conducted. This was the objective of the current meta‐analysis. Method Ninety‐seven studies (89% cross‐sectional) were included. Random effects meta‐analyses were conducted on 23 psychological correlates, divided into three clusters: eating behavior and body image disturbances, positive body image and other adaptive factors, and general psychopathology. Meta‐analytic path analyses were also computed to test the validity of the Acceptance Model. Results Intuitive eating was inversely associated with multiple indices of eating pathology, body image disturbances, and psychopathology (rs = −.23 to −.58). Intuitive eating was positively associated with numerous positive psychological constructs, such as positive body image, self‐esteem, and wellbeing (rs = .20 to .58). Men reported higher levels of intuitive eating than women (d = 0.39), with differences being largest in Caucasian samples. Meta‐analytic path analyses strongly supported the hypothesized pathways specified in the Acceptance Model of Intuitive Eating. Conclusions There is a strong evidence base for intuitive eating's connection to numerous adaptive psychological constructs. Attention should now shift toward prospective and experimental designs so that the temporal nature of these relationships can be identified.

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Associations between interoceptive sensitivity, intuitive eating, and body mass index in patients with anorexia nervosa and normal‐weight controls

Cited by 37 publications

References 21 publications

Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

Emotional eating across different eating disorders and the role of body mass, restriction, and binge eating

Intuitive eating and its psychological correlates: A meta‐analysis

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