Eating disorder symptoms and emotional arousal modulate food biases during reward learning in females.

Food seeking and avoidance engage primary reward systems to drive behavior. It is nevertheless unclear whether innate or learned food biases interact with general reward processing to interfere with goal-directed choice. To this end, we recruited a large non-clinical sample of females with high eating-disorder symptoms ('HED') and a matched sample of females with low eating-disorder symptoms ('LED') to complete a reward-learning task where the calorie content of food stimuli was incidental to the goal of maximizing monetary reward. We find and replicate a low-calorie food bias in HED and a high-calorie food bias in LED, reflecting the strength of pre-experimental food-reward associations. An emotional arousal manipulation shifts this group-dependent bias across individual differences, with interoceptive awareness predicting this change. Reinforcement-learning models further identify distinct cognitive components supporting these group-specific food biases. Our results highlight the influence of reinforcement-based mechanisms and emotional arousal in eliciting potentially maladaptive food-reward associations.