Clinical Guidance: Responses to Sweet Taste in Eating Disorders
Appreciation of abnormal brain activation to food in anorexia nervosa or bulimia nervosa, even after recovery, may help patients understand its pathological mechanisms. Oberndorfer et al. (p. 1143) demonstrated that in response to the taste of sugar, the brain’s higher center for taste processing, the anterior insula, activated less in women recovered from anorexia nervosa than in healthy women. Conversely, women recovered from bulimia nervosa had exaggerated responses. An attenuated response to food might call for small meals throughout the day, whereas help to cope with excessive activation might combat purging. A study of brain structure by Frank et al. (CME, p. 1152) found associations between sweet taste and the volume of brain regions related to both taste and reward sensitivity in both anorexia nervosa and bulimia nervosa. In an editorial, Alonso-Alonso (p. 1082) distinguishes between “liking” and “wanting” food, noting that both healthy subjects and eating disorder patients considered the sweet taste to be pleasant but that the patients had higher sensitivity to it as a reward.