Neurocognitive impairments in eating disorders patients with and without comorbid food addiction

BACKGROUND: Research into the presence of Food Addiction (FA) in Eating Disorders (EDs) has gained increasing attention due to its association with greater symptom severity and poorer treatment outcomes. While the clinical and psychopathological significance of FA in EDs is well established, its neurocognitive impact remains largely unexplored. This study had two primary aims: (1) to examine the psychopathological profile and neurocognitive performance of patients with Eating Disorders (EDs), comparing those with Food Addiction (ED FA+) to those without (ED FA-), alongside a Healthy Control (HC) group; and (2) to explore potential correlations between neurocognitive performance and clinical-psychopathological variables.

METHODS: The sample consisted of N = 152 female participants that met the following conditions: EDs FA+ (N = 65), EDs FA- (N = 24), and HC (N = 63). All participants completed a comprehensive battery of questionnaires, including the Yale Food Addiction Scale 2.0. (YFAS-2), and others for the assessment of the eating disorder symptoms, general psychopathology, impulsivity and emotion regulation. Decision-making and inhibitory control were assessed using the Iowa Gambling Task and The Connors Continuous Performance Test II.

RESULTS: Neurocognitive differences were moderate, with lower IGT performance in Block 3 and greater CPT variability, especially in the ED FA + group. Although the ED FA + group presented a more severe clinical profile-characterized by heightened eating symptomatology and general psychopathology (ED F - vs. ED FA+: EDI-2 Total score p 0.001 d 0.95; SCL-90R Global Severity Index p 0.008 d 071)-this was not directly associated with greater cognitive impairment.

CONCLUSIONS: The results underscore the need to assess Food Addiction in ED patients, as its presence may exacerbate symptom severity. Additionally, the results suggest that patients with EDs could benefit from incorporating cognitive rehabilitation into their treatment plans, regardless of FA status.