Reduced capacity in automatic processing of facial expression in restrictive anorexia nervosa and obesity

There is growing evidence that disordered eating is associated with facial expression recognition and emotion processing problems. In this study, we investigated the question of whether anorexia and obesity occur on a continuum of attention bias towards negative facial expressions in comparison with healthy individuals of normal weight. Thirty-three patients with restrictive anorexia nervosa (AN-R), 30 patients with obesity (OB) and 63 healthy age and social–economic status matched controls were recruited. Our results indicated that AN-R patients were more attentive to angry faces and had difficulties in being attentive to positive expressions, whilst OB patients had problems in looking for or being attentive to negative expressions independently of self-reported depression and anxiety. Our findings did not support the idea that AN-R and OB occur on a continuum. We found that AN-R was associated with a reduced capacity in positive facial expression processing, whereas OB was associated with a reduced capacity in negative facial expressions processing. The social relevance of our findings and a possible explanation based upon neuroscience are discussed.