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See detailNahrungsvermeidung versus Nahrungsaversion bei restriktiven Essstörungen.
Garcia-Burgos, David; Wilhelm, Peter; Vögele, Claus UL et al

in Zeitschrift für Psychiatrie, Psychologie und Psychotherapie (2019), 67(1), 1-9

The terms food avoidance and food aversion are often used interchangeably in the eating disorders (EDs) literature. However, they represent two different (but closely related) constructs that are the ... [more ▼]

The terms food avoidance and food aversion are often used interchangeably in the eating disorders (EDs) literature. However, they represent two different (but closely related) constructs that are the result of different processes. In patients suffering from anorexia nervosa, bulimia nervosa and avoidant / restrictive food intake disorder, food avoidance / restriction is usually assumed to be motivated by fear / anxiety (e. g., “intense fear of gaining weight or becoming fat” or “being afraid to eat after a frightening episode of choking”). In contrast, studies show that taste aversion often leads to food avoidance. Unlike fear-motivated avoidance in which the flavour of food becomes a signal for danger, avoidance produced by taste aversions involves a reduction in the amount consumed due to a hedonic downshift. Here the attractiveness of the flavour changes by its association with a nauseogenic event. It is noteworthy that both sources of food avoidance exhibit different behavioural characteristics, contents of learning, and activate different brain regions and neuromodulators. This is especially important for the understanding and treatment of the EDs and their most serious behavioural manifestation: the life-threatening food refusal. Finally, the clinical implications of such a distinction and promising future research directions are discussed. [less ▲]

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See detailHow does food taste in anorexia and bulimia nervosa? A protocol for a quasiexperimental, cross-sectional design to investigate taste aversion or increased hedonic valence of food in eating disorders
Garcia-Burgos, David; Maglieri, Sabine; Vögele, Claus UL et al

in Frontiers in Psychology (2018), 9

Background. Despite on-going efforts to better understand dysregulated eating, the olfactory-gustatory deficits and food preferences in eating disorders (ED), and the mechanisms underlying the perception ... [more ▼]

Background. Despite on-going efforts to better understand dysregulated eating, the olfactory-gustatory deficits and food preferences in eating disorders (ED), and the mechanisms underlying the perception of and responses to food properties in anorexia nervosa (AN) and bulimia nervosa (BN) remain largely unknown; both during the course of the illness and compared to healthy populations. It is, therefore, necessary to systematically investigate the gustatory perception and hedonics of taste in patients with AN and BN. To this end, we will examine whether aversions to the taste of high-calorie food is related to the suppression of energy intake in restricting-type AN, and whether an increased hedonic valence of sweet, caloric-dense foods may be part of the mechanisms triggering binge-eating episodes in BN. In addition, the role of cognitions influencing these mechanisms will be examined. Method. In study 1, four mixtures of sweet-fat stimuli will be presented in a sensory two-alternative forced-choice test involving signal detection analysis. In study 2, a full-scale taste reactivity test will be carried out, including psychophysiological and behavioural measures to assess subtle and covert hedonic changes. We will compare the responses of currently-ill AN and BN patients to those who have recovered from AN and BN, and also to those of healthy normal-weight and underweight individuals without any eating disorder pathology. Discussion. If taste response profiles are differentially linked to ED types, then future studies should investigate whether taste responsiveness represents a useful diagnostic measure in the prevention, assessment and treatment of EDs. The expected results on cognitive mechanisms in the top-down processes of food hedonics will complement current models and contribute to the refinement of interventions to change cognitive aspects of food aversions, to establish functional food preferences and to better manage food cravings associated with binge-eating episodes. No trial registration was required for this protocol, which was approved by the Swiss ethics committee (CER-VD, nº2016-02150) and the Ethics Review Panel of the University of Luxembourg. [less ▲]

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