The Khalsa Lab’s NIH-funded study “A Neurocomputational Assay of Gastrointestinal Interoception in Anorexia Nervosa” (R01MH127225) continues to advance our understanding of gut-brain signaling disruptions in eating disorders.

This study uses an ingestible vibrating capsule to deliver controlled mechanosensory stimulation to the stomach — a first-of-its-kind approach that overcomes the methodological limitations of previous GI interoception research. So far, 62 weight-restored females with restrictive anorexia nervosa and 57 matched healthy comparisons have completed the gastrointestinal detection task while behavioral, electroencephalographic, and peripheral physiological signals were recorded.

Key findings to date:

• Participants with AN showed reduced perceptual accuracy and higher miss rates despite intact neural and physiological responses
• Computational modeling revealed stronger prior beliefs against perceiving gut sensations, diminished interoceptive precision, and maladaptive learning patterns
• Initial priors, response bias, and stomach unpleasantness predicted six-month relapse
• Miss rate and precision shifts predicted symptom severity

These results reveal mechanistic disruptions in gastrointestinal interoception that predict relapse, offering scalable biomarkers to personalize treatment and prevent recurrence in anorexia nervosa.

The study is registered on ClinicalTrials.gov (NCT05111977) and is supported by the NIMH. A preprint describing the initial results is available on medRxiv.