AI Insight
This narrative review examines how subjective food preferences and reward processing are altered in eating disorders, revealing disorder-specific patterns of disrupted brain responses to food cues. Anorexia nervosa is characterized by reduced reward responses and increased cognitive control, while bulimia nervosa and binge eating disorder show heightened reward sensitivity to food cues and dysregulated reward learning. The findings suggest that understanding eating disorders through the lens of disrupted food valuation may provide a unified neurobehavioral framework for comprehending these conditions.
Why it matters
This perspective could inform the development of targeted interventions that specifically address maladaptive reward processing in eating disorders, potentially improving treatment outcomes. Recognizing disorder-specific patterns of food valuation may enable clinicians to tailor therapeutic approaches based on individual neural and behavioral profiles.
Understand the Science
Subjective food preferences significantly influence eating behavior, and in eating disorders (EDs), these preferences are often altered. Neuroimaging and neurobehavioral studies have revealed atypical brain responses to food cues in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), and these findings may point to disrupted subjective food valuation as a key neurobiological mechanism. This narrative review synthesizes recent findings suggesting that altered reward processing and valuation contribute to the persistence and complexity of disordered eating behaviors. The review is based on a comprehensive search of PubMed and additional citation searching, with study selection guided by conceptual relevance to subjective food valuation, reward processing, and decision-making in EDs. The review begins by outlining the conceptual foundations of subjective valuation and preference formation, followed by empirical evidence of altered reward processing and neural correlates of food valuation in AN, BN, and BED. Studies in clinical populations showing disrupted reward learning and maladaptive food choices are integrated to illustrate disorder-specific patterns. Across EDs, converging evidence indicates disorder-specific alterations in subjective food valuation and reward processing. While AN is characterized by reduced hedonic valuation, diminished reward responsiveness, and increased reliance on cognitive control mechanisms, BN and BED are more strongly associated with heightened hedonic and motivational salience of food cues, alongside dysregulated reward learning and variable engagement of cognitive control systems. The review concludes with a discussion of broader implications, future research directions, and potential clinical applications that emphasize integrating subjective preferences into ED research and treatment. Investigating EDs as disorders of disrupted subjective food valuation offers a unifying neurobehavioral perspective that expands our understanding of ED psychopathology and may lay the groundwork for targeted interventions addressing maladaptive reward processing.