Neuropsicología y cognición social en los trastornos alimentarios y la obesidad

Introduction: Eating disorders (ED) and obesity have similarities in various aspects, so that there is a justification to consider them as part of the same eating-related disorders spectrum. They all present, moreover, psychopathology and interpersonal difficulties that may indicate executive and theory of mind deficits, which could have a relevant influence in their eating self-regulation ability. Objectives: the general objective was to study the executive and socio-emotional functioning of ED and obesity, trough 3 research studies. The first study aimed to analyze the executive functioning of mental flexibility, decision making and central coherence. The second study aimed to investigate the affective and cognitive theory of mind. And the third study aimed to analyze the predictive power of emotional, personality and neuropsychological variables over eating self-regulation in ED and obesity. Method: 39 ED patients were recruited and classified according to the symptoms profile (19 restrictive ED and 20 purgative ED), 21 obesity patients with a BMI of 30 or more, and 20 healthy controls. They all were administered a battery of neuropsychological tasks, theory of mind tasks and self-reports (emotional, personality and eating self-regulation). Results: patients with ED and obesity shared their inability to make advantageous decisions, and patients with obesity showed less mental flexibility and less detail focus. Regarding theory of mind tasks, all groups had a similar performance in affective theory of mind, while purgative and obese patients showed an impaired performance in cognitive theory of mind task. Executive functions of mental flexibility and central coherence showed an association with the expectation of control eating, while decision making showed an association with those situations that raise the urge to eat. Finally, impulse control difficulties and emotional personality revealed as relevant in the urge to eat prediction. On the other hand, positive affect and detail focus were relevant in the control expectation prediction. Conclusions: patients with ED and obesity are similar in their executive functioning, above all, in their worse decision making. Purgative ED patients and obesity patients have difficulties in taking other´s perspective. Variables that can explain the urge to eat and the expectation of control seem to be different. Obesity patients could benefit from a cognitive remediation and emotion skills training, as it has been proved in ED.