Food Choices and Changes of Mind (Mousetracking) in Anorexia Nervosa, Bulimia Nervosa and Healthy Controls

Dataset for: Georgii, C., Richard, A., Eichin, K. N., Schnepper, R., Naab, S., Voderholzer, U., Treasure, J., & Blechert, J. (under review). I change my mind to get better: Mouse-tracing based micro-analysis of food choice processes reveals differences between Anorexia Nervosa and Bulimia Nervosa during inpatient treatment.

Objective: To unravel bottom-up vs. top-down processes during food choice in Anorexia Nervosa (AN) and Bulimia Nervosa (BN) as a function of treatment days we analyzed mouse trajectories, choice outcomes and evaluative food ratings. Method: Patients with AN (n= 36) and BN (n=27) during different inpatient treatment states were included alongside matched healthy controls (HC, n=59). Participants made 153 binary choices between foods varying in liking and calorie density while their mouse movements were tracked. Results: Compared to BN and HC, AN patients showed a clear calorie avoidance in most trials. On those trials where high-calorie foods were chosen, AN patients early in treatment showed choice paths indicative of the presence of top-down cognitive control. AN patients later in treatment showed more frequent choices for high-calorie foods, with mouse paths indicating less controlled and more habitual processes, paralleled by increased liking ratings for these foods. BN patients’ showed more top-down control in low-calorie choices and low calorie choices were more frequent in patients later in treatment. Discussion: Patients with AN & BN learn to counteract their strong preferences to choose low-calorie food (AN) or high-calorie food (BN) across treatment. In AN, this behavioral change is most pronounced and is accompanied by reduced top-down cognitive regulation and an increased liking for high-calorie foods. Both of these changes facilitate the formation of healthier habits, which may be essential for recovery. Treatment strategies for both groups should thus become more subgroup specific and might be based on dual process models of cognitive control.