Executive Functions Profile in Extreme Eating/Weight Conditions: From Anorexia Nervosa to Obesity

Abstract

BackgroundExtreme weight conditions (EWC) groups along a continuum may share some biological risk factors and intermediate neurocognitive phenotypes. A core cognitive trait in EWC appears to be executive dysfunction, with a focus on decision making, response inhibition and cognitive flexibility. Differences between individuals in these areas are likely to contribute to the differences in vulnerability to EWC. The aim of the study was to investigate whether there is a common pattern of executive dysfunction in EWC while comparing anorexia nervosa patients (AN), obese subjects (OB) and healthy eating/weight controls (HC).MethodsThirty five AN patients, fifty two OB and one hundred thirty seven HC were compared using the Wisconsin Card Sorting Test (WCST); Stroop Color and Word Test (SCWT); and Iowa Gambling Task (IGT). All participants were female, aged between 18 and 60 years.ResultsThere was a significant difference in IGT score (F(1.79); p<.001), with AN and OB groups showing the poorest performance compared to HC. On the WCST, AN and OB made significantly more errors than controls (F(25.73); p<.001), and had significantly fewer correct responses (F(2.71); p<.001). Post hoc analysis revealed that the two clinical groups were not significantly different from each other. Finally, OB showed a significant reduced performance in the inhibition response measured with the Stroop test (F(5.11); p<.001) compared with both AN and HC.ConclusionsThese findings suggest that EWC subjects (namely AN and OB) have similar dysfunctional executive profile that may play a role in the development and maintenance of such disorders.

The influence of hot and cool executive function on the development of eating styles related to overweight in children

“…Although the relation between early food-avoidance styles and the later development of eating disorders related to underweight, such as Anorexia Nervosa, has not yet been determined (Wardle et al, 2001), the present results resemble findings from studies on clinical populations, concluding that extreme weight conditions, such as over-and underweight, may share some biological and neurocognitive risk factors, such as similar profiles of executive dysfunction (e.g., Fagundo et al, 2012). For example, subjects with either excessive food intake or food restriction (as seen in Anorexia Nervosa) showed similar deficits on an affective decisionmaking task, which points to an inability to effectively regulate reward and punishment that applies to both groups, but probably for different reasons (Brogan, Hevey, & Pignatti, 2010;Fagundo et al, 2012). A decreased ability to learn associations between reward and punishment as required in the affective decision-making task can result either from higher levels of impulsivity or from rigid and inflexible decision making (Fagundo et al, 2012).…”

Physical Exercise Induces Irisin Levels Associated With Improved Cognitive Functions and Glucose Tolerance in Obese and Normal Weight Egyptian Subjects: A 3-Month Interventional Study.

“…30 Our results demonstrated significant decline in executive functions in obese subjects as evidenced by significantly higher scores in trail making B test compared to the normal weight controls. This was in agreement with previous studies demonstrated that executive functions, especially decision making 26,31,32 , cognitive flexibility, as well as inhibition response 1 , were impaired in obese subjects. Psychomotor performance is considered the coordination of a sensory or cognitive activity and motor performance.…”

Effect of Obesity on Cognitive Function among School Adolescents: A Cross-Sectional Study

“…Higher sensitivity is observed in obese individuals as compared to a normal-weight control group. High impulsivity associated to reduced weight control during treatment is also reported in some studies [27-29]. Therefore, weight management intervention may address deficiency in attention and impulsivity.…”