Decision-making in obesity: a study using the Gambling Task.

The present study addresses the issue of whether a "decision-making disorder" could account for the behavioral problems of severely obese patients (BMI score >34) who are not classified by traditional psychiatric Eating Disorder tests. The neuropsychological test employed, the Gambling Task (GT), is not directly related to the food domain, but it is sensitive to failure in making long-term advantageous choices. A comparison was made of 20 obese subjects (OS) and 20 normal-weight subjects (NWS) matched in age, education and IQ. The subjects' personalities and food behavior were assessed from psychological questionnaires, and then the Gambling Task was administered. The number of "good" choices made by the two groups during GT performance differed significantly, and the OS did not learn to maximize advantageous choices like the NWS did. OS behavior could be consistent with a prefrontal cortex defect that implies difficulties in inhibition of excessive food intake.