Stress is not the reason behind loss of self-control in eati
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A unique residential study has concluded that, contrary to perceived wisdom, people with eating disorders do not lose self-control—leading to binge-eating—in response to stress. The findings of the Cambridge-led research are published in the Journal of Neuroscience.

Binge-eating is a distressing, transdiagnostic eating disorder symptom associated with impulsivity, particularly in negative mood states. Neuroimaging studies of bulimia nervosa (BN) report reduced activity in fronto-striatal regions implicated in self-regulatory control, and an influential theory posits that binge-eating results from self-regulation failures under stress.

Researchers therefore determined the effect of acute stress on inhibitory control in 85 women (33 BN, 22 the anorexia nervosa bingeing/purging subtype; AN-BP, 30 controls). Participants underwent repeated functional MRI scanning, during performance of the stop-signal anticipation task, a validated measure of proactive (i.e., anticipation of stopping) and reactive (outright stopping) inhibition. Neural and behavioral responses to induced stress and a control task were evaluated on two, consecutive days.

--Women with BN had reduced proactive inhibition while prefrontal responses were increased in both AN-BP and BN.

--Reactive inhibition was neurally and behaviorally intact in both diagnostic groups.

--Both AN-BP and BN groups showed distinct, stress-induced changes in inferior and superior frontal activity during both proactive and reactive inhibition. However, task performance was unaffected by stress.

--These results offer novel evidence of reduced proactive inhibition in BN, yet inhibitory control deficits did not generalize to AN-BP.

The findings identify intriguing alterations of stress responses and inhibitory function associated with binge-eating, but they counsel against stress-induced failures of inhibitory control as a comprehensive explanation for loss-of-control eating.