Eating disorders often go hand-in-hand with anxiety and isolation. So much so, that helping people with eating disorders learn to enjoy social interaction could improve the illness.
A recent study assessed 148 people with current or former eating disorders and compared them to healthy people. The study’s findings showed people with eating disorders felt significantly less pleasure from social interactions than those in the healthy group.
This study's results indicate those with eating disorders could benefit from developing interpersonal skills.
Kate Tchanturia, PhD, senior lecturer at the Section of Eating Disorders within the Institute of Psychiatry at King’s College London in the UK, led a group of colleagues to investigate how people with eating disorders felt about social situations.
Hedonia is when a person enjoys and finds pleasure in something. Anhedonia is when a person doesn’t have interest or has lost interest in something.
Researchers were looking for links between social anhedonia, or reduced pleasure in socializing, and eating disorders of anorexia nervosa (AN) and bulimia nervosa (BN).
AN is an eating disorder that involves dieting and sometimes exercising to the point of being below a healthy body weight. It is often characterized by an intense fear of being overweight, even if the person is underweight.
BN is an eating disorder that involves binge eating to a point of loss of control and then using either vomiting or laxatives to rid the body of the excess food.
Authors said, “Evidence exists, however, that highlights the potential effects of starvation on the reward system individuals would usually gain from social contact.”
For the study, 148 participants were given surveys to assess mood, social anhedonia and the ability to understand and process emotions. Of the group, 72 had AN, 19 had BN, 14 were recovered from AN and 43 were healthy controls (HC).
A total of 31 percent of those in the AN group had social phobia, 22 percent had panic disorder, 17 percent had agoraphobia (fear of large/open spaces or uncontrollable situations) and 50 percent had generalized anxiety disorder.
Of those in the BN group, 6 percent had panic disorder, 6 percent had agoraphobia, 31 percent had social phobia and 31 percent had generalized anxiety disorder.
Participants with BN or AN were scored more than 11 times higher on the depression scale than the HC group and more than 3 times higher than the recovered AN group. Those with AN or BN scored 3 times higher than the HC group on the social anhedonia scale. Those in the recovered AN group still scored almost twice as high as the HC group on the social anhedonia scale.
Authors said, “Difficulty identifying and expressing feelings could be related to this diminished drive for social pleasure.”
Authors recommended treatment for eating disorders incorporate a focus on improving and developing interpersonal skills, as social anhedonia helps people maintain their eating disorder through isolation.
Finding pleasure in social interaction and reinforcing that hedonia could help redirect positive reinforcement for people with eating disorders.
This study was published in June in the International Journal of Eating Disorders. Funding was supported by the NIHR Biomedical Research Centre for Mental Health in South London, Maudsley NHS Foundation Trust, the Institute of Psychiatry at King’s College London and the Swiss Anorexia Foundation. No conflicts of interest were reported.