Interoceptive profiles of eating and weight disorders

Signals from the body’s interior undergo several interoceptive processing steps, from the periphery to the central nervous system, to conscious recognition and evaluation. Alterations in some of these steps have been reported for eating and weight disorders, but systematic comparisons between steps and disorders are necessary to develop targeted interventions. We recorded electrocardiogram and electroencephalogram from adult women with anorexia nervosa (AN; n = 38), bulimia nervosa (BN; n = 35), binge eating disorder (n = 22), obesity (OB; n = 20), and healthy control individuals (n = 46) during resting state and a heartbeat counting task. On the peripheral level, patients with AN, BN, and OB had reduced vagally-mediated heart-rate variability. On the central level, only patients with AN showed increased processing of heartbeats (heartbeat-evoked potentials). On the conscious level, there were no significant group differences in heartbeat-counting performance, beliefs, or insight, but a marked negative evaluation reported by patients with AN and BN. We conclude that fasting could serve to reduce negatively perceived (AN, BN) and increased (AN) bodily sensations. Overeating is not associated with marked alterations in cardiac interoception. The results do not support the notion of general interoceptive deficits, but rather disorder-specific interoceptive profiles.