Decision-making and impulsivity in eating disorder patients

Impairment in decision-making can be related to some pathological behaviors in eating disorders. This ability was assessed in 71 eating disorder patients (27 restricting type patients and 44 binge/purging type patients) and compared with 38 healthy controls using the Iowa Gambling Task. This task simulates real-life decision-making by assessing the ability to sacrifice immediate rewards in favor of long term gains. Furthermore, some studies have demonstrated a relationship between impulsivity and decision-making, so in our study the Barratt Impulsiveness Scale was also used. Eating disorder patients, both the restricting and the binge/purging groups, performed poorly in the Iowa Gambling Task compared to controls, confirming a deficit in decision-making in these patients. The restricting group showed poorer IGT performance than the binge/purging group. Interestingly, impulsivity was negatively correlated with decision-making, but only in the binge/purging group. In conclusion, our results confirm a specific deficit in eating disorder patients which may be related to their pathological eating behavior, and suggest that this impairment might be explained by different mechanisms in restricting and binge/purging disorders.