Gastrointestinal Interoception in Eating Disorders: Charting a New Path

Curr Psychiatry Rep. 2022 Jan;24(1):47-60. doi: 10.1007/s11920-022-01318-3. Epub 2022 Jan 21.

Abstract

Purpose of review: Abnormal interoception has been consistently observed across eating disorders despite limited inclusion in diagnostic conceptualization. Using the alimentary tract as well as recent developments in interoceptive neuroscience and predictive processing as a guide, the current review summarizes evidence of gastrointestinal interoceptive dysfunction in eating disorders.

Recent findings: Eating is a complex process that begins well before and ends well after food consumption. Abnormal prediction and prediction-error signals may occur at any stage, resulting in aberrant gastrointestinal interoception and dysregulated gut sensations in eating disorders. Several interoceptive technologies have recently become available that can be paired with computational modeling and clinical interventions to yield new insights into eating disorder pathophysiology. Illuminating the neurobiology of gastrointestinal interoception in eating disorders requires a new generation of studies combining experimental probes of gut physiology with computational modeling. The application of such techniques within clinical trials frameworks may yield new tools and treatments with transdiagnostic relevance.

Keywords: Anorexia nervosa; Avoidant/restrictive food intake disorder; Binge-eating disorder; Bulimia nervosa; Digestion; Interoceptive awareness.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anorexia Nervosa* / diagnosis
  • Bulimia Nervosa*
  • Feeding and Eating Disorders* / diagnosis
  • Humans
  • Interoception* / physiology
  • Neurobiology