Body appearance values modulate risk aversion in eating restriction.

Abstract

The understanding of eating disorders is hindered by the lack of integration between existing psychosocial and neurobiological approaches. We address this problem by developing a novel transdiagnostic and computational approach to eating restriction decisions. We first validated a novel paradigm which extends an established monetary risk task to involve body stimuli with psychosocial values. We used advanced behavioral data analysis of a large (total N = 539) sample of women from across the eating restraint spectrum, including those with anorexia nervosa (AN; n = 31), recovered from AN (n = 23), and subclinical women with varying levels of eating restraint (n = 485), obtained from an online experiment, public event, and laboratory-based study. We found that social and motivational values regarding body appearance have a significant effect on value-based, decision making in eating restriction. Subsequently, validated descriptive and predictive advanced computational modeling indicated that these behaviors are driven by an aversion to risk rather than loss, with desirable body outcomes being associated with less risk aversion, and undesirable body outcomes linked to greater risk aversion. These findings indicate that cognitive and social factors influence eating decisions by distinct mechanisms. Public Significance StatementThis study demonstrates how socially derived values about the body's ideal appearance can influence risk taking in women who restrict their eating. We cast new light on eating decisions and why some women may choose to take significant health risks in the pursuit of thinness.

Greater Risk Taking in Cosmetic Surgery Acceptance and History: An Experimental and Computational Study

“…By contrast, increasing age predicts fewer balloon pumps (b = -0.34, p =.006, 95% CI [-0.59--0.10]; R 2 Marginal Increment = 0.011). Eating disorder symptoms, while not statistically significant, showed an effect direction consistent with our previous research looking at eating restraint [23], such that increasing eating disorder symptoms predicts a decrease in pumping (b = -1.21, p =.112, 95% CI [-2.71-0.28]; R 2…”

Greater Risk Taking in Cosmetic Surgery Acceptance and History: An Experimental and Computational Study

“…Participants responded to advertisements posted on message boards, social media, email and a university research participant pool (SONA). They were aged 18 years or above with a BMI [16.5 [consistent with a lower average observed in similar studies of this student population; see [23], and no reported history of eating disorder, neurological disease, or brain damage. Exclusion criteria were a history of psychiatric illness, substance abuse or dependency, or a firstdegree relative with an eating disorder].…”

“…In recent research involving women with restrictive eating (including women with anorexia nervosa), we found that body-based stimuli with high social-motivational salience (i.e. images of women of varying degrees of 'thinness') moderated risktaking behaviour, with greater risk taking observed in women with greater restrictive eating when decisions were linked to an thinner versus a larger body [23]. An interesting area for future research would be to examine whether cosmetic surgery-related risk taking is even greater when the potential reward is obtaining their ideal body after surgery, such as when specific, desired body modifications (e.g.…”

“…Our results support this hypothesis, finding significantly greater risk-taking behaviour in women with greater acceptance of cosmetic surgery, as well as (a statistical trend for) increased risk taking in a smaller sample of women with a history of cosmetic procedures. Furthermore, using a previously validated method of computationally modelling performance on the risk-taking task [23,38], we were able to draw conclusions regarding the 123 latent (hidden) parameters that may drive participants' behaviour. More specifically, we were able first to determine that, as predicted, the observed increased risk taking related to how participants in both samples made decisions when the task involved 'risk' (knowing the probabilities of loss), and not 'uncertainty' (not knowing the probabilities of loss), or the point at which people switch from uncertainty to risk.…”

Updating Prospective, Self-Efficacy Beliefs About Cardiac Interoception in Anorexia Nervosa: An Experimental and Computational Study

“…AN patients met the restrictive subtype AN DSM-5 criteria (American Psychiatric Association, 2013) as diagnosed by an experienced clinician using standard clinical measures (patient history, psychometric questionnaires and a physical assessment), and had a BMI<18.5. Given growing concerns around weight-restoration criteria (e.g., (Harrop et al, 2021;Khalsa et al, 2017;Lebow et al, 2018;Ralph et al, 2022), we chose a combination of objective and clinical criteria to best represent the patients' clinical reality (see also (Jenkinson et al, 2023)) instead of relying only on BMI criteria, as it inadequately reflects the clinical complexity of the AN recovery stages and symptom evolution. The AN-WR group no longer met DSM-5 restrictive subtype AN criteria according to their psychiatrist and met at least two of the following: BMI >16.5, clinical and behavioural signs of AN recovery (e.g., no restrictive eating patterns) for at least 6 months, and/or a global Eating Disorders Examination Questionnaire (EDE-Q; (Fairburn & Beglin, 1994)) score <4.…”