ArticleJournal of psychiatry & neuroscience : JPN2020
Metabolic state and value-based decision-making in acute and recovered female patients with anorexia nervosa
Article in Journal of psychiatry & neuroscience : JPN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Altered value-based decision-making in anorexia nervosa: A systematic review.Neuroscience and biobehavioral reviews · 2024Pooled it
- Pooled it
- A randomized controlled experimental medicine study of ghrelin in value-based decision making.The Journal of clinical investigation · 2023Trial
- Nutritional state-dependent changes in subcortical limbic structures in anorexia nervosa are linked to leptin, ghrelin, and neurofilament light.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Recovery From Anorexia Nervosa: A Concept Analysis.Journal of advanced nursing · 2026Review
- Intact delay discounting but more optimal reward-based decisions in anorexia nervosa during an experiential task.Psychiatry and clinical neurosciences · 2026Article
- Longer duration of amenorrhea is associated with lower delay discounting and less hedonic eating in girls and young women with low-weight eating disorders.Scientific reports · 2026Article
- The role of LEAP2 on cognitive impulsivity after refeeding: evidence from a preclinical study in female mice and from patients with anorexia nervosa.Translational psychiatry · 2026Article
- Comprehensive insights into emerging advances in the Neurobiology of anorexia.Journal of advanced research · 2026Review
- Examining the biological causes of eating disorders to inform treatment strategies.Nature reviews. Neuroscience · 2025Review
- Leptin Levels in Acute and Recovered Eating Disorders: An Arm-Based Network Meta-Analysis.European eating disorders review : the journal of the Eating Disorders Association · 2025Review
- [Clinical analysis of nutritional components in children with acute leukemia].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025Article
- Endogenous opioid receptors and the feast or famine of maladaptive feeding.Nature communications · 2025Review
- Cholinergic regulation of decision making under risk of punishment.Neurobiology of learning and memory · 2025Article
- Article
- The Contribution of the Brain-Gut Axis to the Human Reward System.Biomedicines · 2024Review
- Gene-environment interaction in functional hypothalamic amenorrhea.Frontiers in endocrinology · 2024Review
- What influences food choices in anorexia nervosa? Disentangling cognitive and emotional components of decision-making by translational research.Neuroscience applied · 2024Review
- To eat or not to eat: A role for ghrelin and LEAP2 in eating disorders?Neuroscience applied · 2024Review
- Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Patients with anorexia nervosa forgo eating despite emaciation and severe health consequences. Such dysfunctional decision-making might be explained by an excessive level of self-control, alterations in homeostatic and hedonic regulation, or an interplay between these processes. We aimed to understand value-based decision-making in anorexia nervosa and its association with the gut hormone ghrelin. Besides its homeostatic function, ghrelin has been implicated in the hedonic regulation of appetite and reward via the modulation of phasic dopamine signalling. Methods: In a cross-sectional design, we studied acutely underweight (n = 94) and recovered (n = 37) patients with anorexia nervosa of the restrictive subtype, as well as healthy control participants (n = 119). We assessed plasma concentrations of desacyl ghrelin and parameters of delay discounting, probability discounting for gains and losses, and loss aversion. Results: Recovered patients displayed higher risk aversion for gains, but we observed no group differences for the remaining decision-making parameters. Desacyl ghrelin was higher in acutely underweight and recovered participants with anorexia nervosa relative to healthy controls. Moreover, we found a significant group × desacyl ghrelin interaction in delay discounting, indicating that in contrast to healthy controls, acutely underweight patients with anorexia nervosa who had high desacyl ghrelin concentrations preferably chose the delayed reward option. Limitations: We probed decision-making using monetary rewards, but patients with anorexia nervosa may react differently to disorder-relevant stimuli. Furthermore, in contrast to acyl ghrelin, the functions of desacyl ghrelin are unclear. Therefore, the interpretation of the results is preliminary. Conclusion: The propensity for risk aversion as found in recovered patients with anorexia nervosa could help them successfully complete therapy, or it could reflect sequelae of the disorder. Conversely, ghrelin findings might be related to a mechanism contributing to disease maintenance; that is, in acutely underweight anorexia nervosa, a hungry state may facilitate the ability to forgo an immediate reward to achieve a (dysfunctional) long-term goal.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.