Neurocognitive performance and appetite-regulating hormones in obesity with and without eating disorders: A comprehensive review and empirical analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Obesity and eating disorders (ED) share neurocognitive vulnerabilities involving executive control and reward processing, yet the neuroendocrine–cognitive links underlying their comorbidity remain underexplored. This study synthesizes current evidence on neurocognitive mechanisms in obesity and ED and examines associations between neurocognition and appetite-regulating hormones in clinical groups. A cross-sectional analysis was conducted in 171 women: obesity with ED (OB + ED; n = 43), obesity without ED (OB–ED; n = 70), and healthy controls (HC; n = 58). Neurocognition was assessed using the Conners’ Continuous Performance Test-II (attention/inhibition) and Iowa Gambling Task (decision-making); impulsivity with UPPS-P; fasting ghrelin, insulin, leptin, and LEAP2 were measured. OB + ED showed higher omission errors than HC (p<0.001, d = 0.40) and higher commission errors than OB–ED (p=0.035, d = 0.46), indicating greater attentional lapses and impulsive responding. Iowa Gambling performance did not differ overall, but OB + ED outperformed OB–ED in mid-learning phases, suggesting enhanced feedback sensitivity. Impulsivity profiles diverged, with OB + ED showing higher Lack of Premeditation. Endocrine profiles revealed higher LEAP2 and lower ghrelin in both obesity groups versus HC, with insulin elevated in OB–ED. Structural equation modeling indicated leptin uniquely predicted attentional lapses, slower reaction times, and impulsivity traits, with downstream links to BMI and decision-making. These findings support integrated models in which leptin-linked neuroendocrine dysregulation intersects with attention, decision-making, and impulsivity in obesity and ED comorbidity, highlighting targets for mechanistically informed, combined metabolic–cognitive interventions.
Authors: Lucía Camacho-Barcia, Melody Torao-Angosto, Isabel Baenas, Guillem Diego-Esteve, Jana Katharina Throm, Ignacio Lucas, Katrin Elisabeth Giel, Stephan Zipfel, Sulay Tovar, Carlos Diéguez, Nuria Vilarrasa, Fernando Guerrero-Pérez, Juan Carlos Cejudo, Susana Jiménez-Murcia, Fernando Fernández-Aranda
Institutions: Instituto de Salud Carlos III, Bellvitge University Hospital, Institut d'Investigació Biomédica de Bellvitge, Universitätsklinikum Tübingen, University of Tübingen, Universitat de València, Deutsches Zentrum für Psychische Gesundheit, Universidade de Santiago de Compostela, Center for Research in Molecular Medicine and Chronic Diseases, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas, Hospital Universitari Sagrat Cor, Universitat de Barcelona
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $5,590
Funders: Centres de Recerca de Catalunya, European Commission, Generalitat de Catalunya, Institució Catalana de Recerca i Estudis Avançats, Ministerio de Ciencia e Innovación, HORIZON EUROPE Framework Programme, Agència de Gestió d'Ajuts Universitaris i de Recerca, Instituto de Salud Carlos III, European Regional Development Fund
Awards: G1984435823, Preventing lifetime obesity by early risk-factor identification, prognosis and intervention, Avanzando en la medicina personalizada de la anorexia nerviosa: Un Enfoque Biomarcador-Diana, G2702798117, G3571711701, Smart Health Community (SHC), promoviendo la medicina basada en el valor., G5504820196, G7728232459, G8453080119
OpenAlex ID: W7141162733