Implicit and explicit affect toward food and weight stimuli in anorexia nervosa

• A study of implicit affect toward eating disorder salient stimuli in AN patients.
• AN patients had implicit negative affect toward images of high-calorie food.
• AN patients had implicit negative affect toward images of overweight bodies.
• Implicit and explicit judgments of underweight bodies differed for AN patients.
• Recovered and control groups had similar implicit responses to all stimuli.

We know strikingly little about the core affective processes that drive the development and maintenance of, and recovery from anorexia nervosa (AN). To partially address this knowledge gap, we measured implicit and explicit affect toward pleasant, neutral, unpleasant, food-relevant, and weight-relevant images in three groups: in patients with acute AN, individuals recovered from AN, and healthy controls with no history of AN. Compared with the other two groups, acutely ill AN participants displayed significantly greater implicit positive affect toward pleasant images and significantly greater implicit negative affect toward unpleasant, high-calorie food, and overweight body type images. Recovered participants did not differ significantly from controls on any implicit affect measure. Explicit affective patterns were similar to implicit, but explicit measures yielded much smaller effect sizes and failed to detect certain group differences. Overall, negative implicit affect toward high-calorie foods and overweight body types may represent core affective processes that are operative during acute AN.