Food-independent tendency to disadvantageous decisions in obese individuals with regular binge eating

The objective of this study was to explore whether or not obese patients with and without regular binge eating differ with regard to their decision-making abilities.

Decision-making was measured by using a computerized version of the Iowa Gambling task (IGT) in 34 obese patients with regular binge eating (BE(+)) and 34 obese individuals without binge eating (BE(-)) matched for age and sex. In addition, computerized versions of the Auditory Verbal Learning Test and the Corsi Block Tapping Test were administered. Participants further answered questionnaires concerning eating disorder symptoms (Eating Disorder Examination-Questionnaire) and depression (Patient Health Questionnaire depression scale).

The BE(+) group reported more eating disorder and depressive symptoms than the BE(-) group but did not differ with regard to BMI, working memory deficits, depressive symptoms, somatic comorbidity (i.e., hypertension, diabetes, sleep apnea, hyperlipidemia, pain disorder), or education. Binge eating participants showed poorer decision-making abilities based on the total IGT net scores. However, they did not differ from those without regular binge eating in improving their choice behavior over the task.

The group difference in total IGT net scores suggests more general, food-independent decision making problems in obese individuals with regular binge eating compared to those without. Treatment of obese patients with BED could be enhanced by training them to better control risky decisions, to delay gratification in an effortful way and to activate appropriate alternative behaviors.