ArticleThe International journal of eating disorders2020
On bells, saliva, and abdominal pain or discomfort: Early aversive visceral conditioning and vulnerability for anorexia nervosa.
Article in The International journal of eating disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed.
- Early reduction in anxiety sensitivity predicts greater reduction in disordered eating and trait anxiety during treatment for bulimia nervosa.The International journal of eating disorders · 2024Trial
- The Developmental Role of Atypical Interoception in Youth Anxiety and Eating Disorders.Child psychiatry and human development · 2026Review
- Aorto-mesenteric space reduction in women with anorexia nervosa: retrospective audit and analysis.Journal of eating disorders · 2026Article
- Mapping the path to recovery: the intersection of cortical thickness reductions and serotonin transporter expression in anorexia nervosa.Molecular psychiatry · 2026Article
- GDF15 Is Elevated in Eating Disorders and Is Involved in the Gut-Brain Axis via Ghrelin.European eating disorders review : the journal of the Eating Disorders Association · 2026Article
- Endorsement of Avoidant/Restrictive Eating Motivations Across Restrictive Eating Disorders: A Trait- and State-Level Examination.European eating disorders review : the journal of the Eating Disorders Association · 2026Article
- Eating disorder cognitions: a comparison between Avoidant/Restrictive Food Intake Disorder (ARFID) and Anorexia Nervosa.Journal of eating disorders · 2025Article
- Avoidant and restrictive food intake disorder among children with eosinophilic esophagitis.JPGN reports · 2025Article
- A GI-Interoceptive Threat Theory of Restrictive Eating: Insights From Active Inference and Chronic Pain.Brain and behavior · 2025Review
- Identifying Active Ingredients of the Association Between Neighborhood Disadvantage and Disordered Eating in Youth.The International journal of eating disorders · 2025Article
- Perceptual Dysfunction in Eating Disorders.Current topics in behavioral neurosciences · 2025Review
- Assessing Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms Using the Nine Item ARFID Screen in >9000 Swedish Adults With and Without Eating Disorders.The International journal of eating disorders · 2024Article
- A living experience proposal for the co-occurring diagnosis of avoidant/restrictive food intake disorder and other eating disorders.Journal of eating disorders · 2024Article
- Latent profile analysis reveals overlapping ARFID and shape/weight motivations for restriction in eating disorders.Psychological medicine · 2024Article
- Validation of a measure of hypervigilance and anxiety about gastrointestinal symptoms for individuals with elevated eating pathology.Psychological assessment · 2024Article
- Advancing the Assessment and Treatment of Comorbid Pediatric Chronic Functional Abdominal Pain (CFAP) and Restrictive Eating Disorders.Children (Basel, Switzerland) · 2023Review
- Binge-eating disorder with and without lifetime anorexia nervosa: A comparison of sociodemographic and clinical features.The International journal of eating disorders · 2023Article
- Food Restriction in Anorexia Nervosa in the Light of Modern Learning Theory: A Narrative Review.Behavioral sciences (Basel, Switzerland) · 2023Review
- Diet, Digestion, and the Dietitian: A Survey of Clinicians' Knowledge, Attitudes and Practices to Advance the Treatment of Gastrointestinal Disturbances in Individuals with Anorexia Nervosa.Journal of clinical medicine · 2022Article
- "Feeling fat," disgust, guilt, and shame: Preliminary evaluation of a mediation model of binge-eating in adults with higher-weight bodies.Body image · 2022Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
Gastrointestinal (GI) symptoms are common in anorexia nervosa (AN), can predate illness onset, complicate renourishment, and persist after recovery. We explore how, through processes of aversive visceral conditioning, early GI pain and discomfort may increase vulnerability to AN in some individuals. Processes include enhanced preoccupation with the gut resulting from aversive visceral memories and disruptions in the typical acquisition of self-attunement when children learn to map and interpret interoceptive sensations and develop adaptive actions. We question whether a fear of weight gain, in some cases, may be an epiphenomenon of the recapitulation of actual or perceived GI symptoms that is especially relevant during puberty, especially in girls. This conceptualization has immediate clinical implications and offers ideas for future research. We propose that GI discomfort associated with renourishment may reignite prior aversive visceral experiences. We encourage development of a formulation that organizes the individual's current experience of the body with respect to these prior aversive experiences. Our conceptualization underscores the importance of assessment of GI experiences in individuals with AN; the examination of dietary strategies that minimize GI symptoms and enhance renourishment efficacy; and strategies that attempt to alter this aversive visceral conditioning by mapping sensations to meanings and adaptive actions.
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Registered trials
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