Maladaptive Restrictive Food Choice Behavior in Adolescents With Anorexia Nervosa

Individuals with anorexia nervosa persistently restrict their food intake while often severely underweight. This maladaptive food choice behavior and related decision-making processes have mainly been investigated in adults. It is unknown whether the same decision-making processes drive food choices in adolescents, given their more favorable treatment outcomes. This study investigated maladaptive food choice behavior in adolescents with AN and examined whether they display the same decision-making processes as adults.

Adolescents with AN (n = 42) and age-matched controls (n = 42) completed a computer-based food choice task, rating food images for healthiness and tastiness before choosing between two food items.

Adolescents with AN chose high-fat foods less frequently than controls, with food choices more influenced by their perceived "healthiness" and less by their "tastiness" than they did among controls. Relative to controls, adolescents with AN also reported lower overall tastiness ratings and greater habit strength of restrictive eating, which was, however, not related to food choices.

Adolescents with AN display the same maladaptive food choice behavior as adults, namely the persistent restriction of high-fat food choices. Their choices were more strongly influenced by the perceived healthiness of a food item, compared to the choices of controls.