Pleasure for visual and olfactory stimuli evoking energy-dense foods is decreased in anorexia nervosa Tao Jiang ⁎, Robert Soussignan ⁎, Daniel Rigaud, Benoist Schaal Centre des Sciences du Goût et de l'Alimentation, Dijon, France abstract article info Article history: Received 12 August 2009 Received in revised form 16 March 2010 Accepted 27 April 2010 Keywords: Anorexia nervosa Anhedonia Pleasure Food Olfaction Vision Although patients with anorexia nervosa have been suggested to be anhedonic, few experiments have directly measured their sensory pleasure for a range of food and non-food stimuli. This study aimed to examine whether restrictive anorexia nervosa (AN-R) patients displayed: i) a generalized decline in sensory pleasure or only in food-related sensory pleasure; ii) a modification of hedonic responses to food cues (liking) and of the desire to eat foods (wanting) as a function of their motivational state (hunger vs. satiety) and energy density of foods (high vs. low). Forty-six female participants (AN-R n = 17; healthy controls (HC) n = 29) reported before/after lunch their pleasure for pictures/odorants representing foods of different energy density and non-food objects. They also reported their desire to eat the foods evoked by the sensory stimuli, and completed the Physical Anhedonia Scale and the Beck Depression Inventory. AN-R and HC participants did not differ on liking ratings when exposed to low energy-density food or to non-food stimuli. The two groups also had similar physical anhedonia scores. However, compared to HC, AN-R reported lower liking ratings for high energy food pictures regardless of their motivational state. Olfactory pleasure was reduced only during the pre-prandial state in the AN-R group. The wanting ratings showed a distinct pattern since AN-R participants reported less desire to eat the foods representing both low and high energy densities, but the effect was restricted to the pre-prandial state. Taken together these results reflect more the influence of core symptoms in anorexia nervosa (fear of gaining weight) than an overall inability to experience pleasure. © 2010 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Energy-rich foods are particularly aversive in patients suffering from anorexia nervosa (AN). Such persons are indeed characterized by an everyday avoidance to eat high-fat and sweet foods and by an obsessive fear of gaining weight (American Psychiatric Association, 1994; Crisp et al., 2006; Kaye, 2008). Several investigators advocated that palatable foods as reinforcers are avoided in AN patients due to low sensitivity to reward or a diminished ability to experience sensory pleasure (physical anhedonia), and suggested a possible etiological role of dysfunctioning brain reward systems (dopamine and opioid systems) (Davis and Woodside, 2002; Berridge, 2007; Kaye, 2008). Although recent neuroimaging and psychophysiological studies have begun to address the hypothesis of altered reward or appetitive systems in AN patients (Friederich et al., 2006; Wagner et al., 2007; Soussignan et al., 2010), the issue remains to be clarified because studies based on self-report scales of physical anhedonia and measurement of sensory pleasure in AN patients provided conflicting results. In some studies, as compared to controls, AN women were found to be anhedonic (Bydlowski et al., 2002; Davis and Woodside, 2002; Deborde et al., 2006) and reported higher dislike for the sight of high energy foods (Bossert et al., 1991; Stoner et al., 1996; Stormark and Torkildsen, 2004; Herpertz et al., 2008), for fat taste (Drewnowski et al., 1987; Sunday and Halmi, 1990; Simon et al., 1993), and the smell of food (Schreder et al., 2008). In some studies, AN patients evinced unchanged hedonic responses to low- caloric food pictures (Bossert et al., 1991; Stoner et al., 1996), olfactory stimuli (Lombion-Pouthier et al., 2006), and sweet taste (Drewnowski et al., 1987). Finally, AN patients reported a decreased pleasure when sweet solutions were swallowed but not spat out (Eiber et al., 2002), suggesting that they exhibited an excessive fear of gaining weight rather than a diminished ability to experience pleasure. Taken together, currently available studies do not make clear whether the low sensitivity to food reinforcement in AN patients relies on (i) a general decrease in pleasure responses to any kind of actual and imagined events (i.e., anhedonia), (ii) a specific reduction in pleasure responses to food cues, or (iii) a reduction to cues carried by high energy-density foods as a consequence of fear of gaining weight. Further, little is known on how hedonic experience in AN patients relates to hunger/satiety states since in healthy people the expression of pleasure for olfactory and visual food cues fluctuates as a function of motivational states Psychiatry Research 180 (2010) 42–47 ⁎ Corresponding authors. Centre des Sciences du Goût et de l'Alimentation, UMR- 6265 CNRS, Université de Bourgogne, Inra, 15 Rue Hugues Picardet, 21000 Dijon, France. Tel.: 33 80681611; fax: 33 80681601. E-mail addresses: tao.jiang@u-bourgogne.fr (T. Jiang), robert.soussignan@u-bourgogne.fr (R. Soussignan). 0165-1781/$ – see front matter © 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.psychres.2010.04.041 Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres