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Control of Eating Behavior Using a Novel Feedback System
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Gastrointestinal Interoception and Relapse in Anorexia Nervosa.

Charles Verdonk1,2,3, Keller Mink1, Emily Choquette1

  • 1Laureate Institute for Brain Research, Tulsa, Oklahoma.

JAMA Psychiatry
|June 17, 2026
PubMed
Summary

Gastrointestinal interoception is disrupted in individuals with anorexia nervosa (AN), impacting relapse risk. These findings highlight the potential of ingestible sensors and computational modeling for monitoring treatment and preventing relapse in AN patients.

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Area of Science:

  • Neuroscience
  • Gastroenterology
  • Psychiatry

Background:

  • Anorexia nervosa (AN) has high relapse rates post-weight restoration, potentially linked to disrupted gastrointestinal (GI) interoception.
  • Understanding GI interoception markers is crucial for predicting and preventing relapse in AN.

Purpose of the Study:

  • To investigate behavioral, computational, neural, and physiological markers of GI interoception in weight-restored individuals with AN.
  • To assess the association between these GI interoception markers and relapse risk.

Main Methods:

  • A randomized crossover trial involving females with weight-restored AN and healthy comparators (HCs).
  • Participants ingested a vibrating capsule for gut stimulation, with assessments including behavioral detection, electroencephalography, and computational modeling.
  • Interoceptive accuracy, prior beliefs, precision, learning rates, gastric-evoked potentials (GEPs), and hunger were measured.

Main Results:

  • Individuals with AN exhibited lower perceptual accuracy and higher miss rates compared to HCs.
  • Computational modeling revealed maladaptive priors, altered interoceptive precision, and learning asymmetries in the AN group.
  • Initial priors, response bias, and stomach unpleasantness predicted relapse; miss rate, interoceptive precision difference, and initial priors predicted symptom severity.

Conclusions:

  • GI interoception is significantly disrupted in weight-restored individuals with AN.
  • Specific interoceptive markers are associated with relapse and symptom severity, suggesting their utility in treatment monitoring.
  • Ingestible mechanosensory probes and computational modeling show promise for relapse prevention strategies in eating disorders.