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These different directions of effect between metabolic health and motivational decision-making are not necessarily in competition: instead, our results could be explained by a positive feedback loop wherein decreased motivational tendencies and a behavioural bias towards energy conservation inhibits behaviours such as physical exercise, leading to weight gain and the continued maintenance or progression of metabolic dysfunction, which due to biological interactions between metabolic and neurocognitive mechanisms, also alter cognition and worsen motivational tendencies

The precise definition of these terms is not universally agreed upon, so clinical judgment is required: Shock

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