Cognitive flexibility and decision-making in eating disorders and obesity

  • Conxa PerpiñáEmail author
  • Mara Segura
  • Sergio Sánchez-Reales
Original Article



The aim of the present study was to compare decision-making and cognitive flexibility in patients with disordered eating and weight, ranging from anorexia nervosa to obesity, and a healthy group.


Participants were 113 patients (86 with eating disorders and 27 with obesity), and a group of 39 healthy subjects; all completed the Iowa gambling task, the Wisconsin Card Sorting Test and several clinical self-report measures.


Eating disordered and obese patients showed impaired performance on the decision-making task, and the obese group showed the worst performance on the set-shifting task. There were no associations between neuropsychological performance and eating or obsessive symptomatology, although significant associations were found with anxiety and depression measures.


Considering the executive functions as a transdiagnostic process in ED and obesity could provide explanations for the inability to regulate food intake, present in both ED and obese patients. Implications of these executive impairments in the development and maintenance of ED and obesity are discussed.


Eating disorders Obesity Set-shifting Decision-making Executive functions 


Compliance with ethical standards

Ethical approval

The work has been performed according to ethical standards of the national ethics committee.

Informed consent

Written informed consent was obtained from all of the participants before participation in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding sources

This study is supported by the Spanish Ministerio de Ciencia y Tecnología (Grant PSI2009/10957); Ministerio de Economía y Competitividad (PSI2014-51920-R) and by the Conselleria d’ Educació, Cultura i Esport, Generalitat Valenciana (PROMETEO/2013/066). Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición is an initiative of ISCIII.

Conxa Perpiñá, as member of University of Valencia, has received research grants.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Dpto. Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de PsicologíaUniversidad de ValenciaValenciaSpain
  2. 2.CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos IIIMadridSpain
  3. 3.Servicio de Salud Mental Hospital General Universitario de ElcheAlicanteSpain

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