Thursday, April 18, 2024
4/18/2024
Project Summary/Abstract Loss of control (LOC) eating, a hallmark feature of binge eating disorder, involves the subjective experience of being unable to control what or how much is being eaten. Common in adolescent girls, LOC eating is a precursor to partial- or full-syndrome binge eating disorder as well as worsening of depressive and anxiety symptoms, higher risk for excess weight and fat gain, and worsening of metabolic syndrome components. These data indicate that LOC eating in childhood may be a prospective marker for adverse outcomes. LOC eating in youth is highly comorbid with anxiety, and is predictive of increases in anxiety symptoms over time, suggesting shared neural underpinnings and/or etiologies. Indeed, at least one neuroimaging study found that girls with overweight and obesity and reported LOC eating demonstrated a similar neural response to social distress as youth with anxiety. These data suggest youth with LOC eating may have an attention bias (preferential allocation of attention to highly salient stimuli) to socially threatening stimuli, similar to that of youth with anxiety. This attention bias may be explained by the interpersonal model of disordered eating. According to interpersonal theory, LOC eating may develop as a result of maladaptive coping with negative affective states, such as anxiety, that arise from socially distressing situations. Food consumption is triggered as an attempt to escape from the uncomfortable affective state. This maladaptive coping strategy may be due, in part, to heightened sensitivity to incoming social cues and abnormalities in anxiety processing socio-emotional neural circuits. Notably, there are data to suggest that anxiety, specifically, plays a role in the relationship between social cues and consumption of overeating highly palatable foods in youth with reported LOC eating. However, the interpersonal model has not been directly tested making use of a task to assess attention bias to social threat cues among youth with LOC eating. Further, there are no data to indicate whether LOC eating impacts the relationship between attention bias to social threat and neural aspects of anxiety processing and subsequent eating behaviors. The temporal nature of attention bias to social threat and activity in neural circuits involved in anxiety processing is ideally suited for measurement by magnetoencephalography (MEG), which has both excellent temporal and spatial resolution. Utility of MEG has been supported for differentiating between neural components of attention bias to social threat. Thus, utilizing MEG may elucidate the neural bases of attention bias toward threat that may contribute to LOC eating. The proposed study will examine the relationship between attention bias to social threat cues and neural activation implicated in social anxiety (i.e. anterior cingulate cortex, amygdala, dorsolateral prefrontal cortex, medial prefrontal cortex, ventrolateral prefrontal cortex) and subsequent energy intake at a laboratory test meal in youth with overweight, with and without LOC eating. A better understanding of the neural underpinnings involved in the links between LOC eating and anxiety may aid in the development of novel targets for reducing excess intake that leads to disordered eating and obesity.
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