The ability of the brain to receive and interpret hunger signals from the gut—known as gastrointestinal (GI) interoception—appears to be impaired among women with anorexia nervosa (AN) and might serve as a predictor of symptom relapse, according to a report in JAMA Psychiatry.Why It’s Relevant
AN is a severe and often enduring psychiatric disorder with one of the highest premature mortality rates and similarly alarming relapse rates—up to 50% within one year of weight restoration. Given its central role in promoting food anticipation and feeling full, GI interoception is likely associated with AN, but studying this pathway has been limited because of methodological difficulties.
By the Numbers
- Sixty-two women with weight-restored AN and 57 age-matched controls ingested a capsule that delivered alternating periods of normal or enhanced vibrations. Participants pressed and held a button when they detected capsule-induced sensations and released the button once the sensation ceased.
- There were no differences between the two groups in terms of response time or response accuracy for enhanced vibrations. However, women with AN were significantly less accurate at detecting normal vibrations on average—incurring both more false alarms and signal misses.
- A total of 16 women with AN were in full relapse at a six-month follow-up. The researchers found that women who had a negative response bias (tendency to not press the button) were more likely to experience relapse, while those with high signal miss rates were more likely to have severe symptoms.
- Further, women who had strong prior beliefs that they could not detect the capsule’s signals were more likely to relapse and/or have severe symptoms.
The Other Side
The study was limited to women with AN, and recruitment was at only one site. Additionally, diagnoses were determined during routine clinical care rather than by structured interviews, and the follow-up time was relatively short.
Takeaway Message
Interoceptive disruptions may compromise the ability to detect and interpret hunger and fullness cues, prompting greater reliance on rigid cognitive rules around eating, which may hinder treatment response and heighten relapse risk, the researchers wrote, adding that their findings “support the use of ingestible mechanosensory probes and computational modeling as scalable tools to monitor treatment response and guide relapse prevention in eating disorders.”
Related Information
Source
Charles Verdonk, et. al. Gastrointestinal interoception and relapse in anorexia nervosa. JAMA Psychiatry. Published June 17, 2026. doi:10.1001/jamapsychiatry.2026.1301
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