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Decision making is impaired in female patients with anorexia nervosa (AN), but it is unclear if the same impairment is present in male patients with AN.Decision making was assessed in 48 AN individuals (19 male and 29 female patients) and 61 healthy controls (20 male and 41 female patients) using the Iowa Gambling Task (IGT).Both male and female patients with AN performed significantly worse than healthy controls on the IGT. No gender differences in IGT performance were found across groups. Male patients had higher impulsivity scores, but impulsivity had not predicted poor decision-making performance.Impaired decision making is present in male and female patients with AN. These data suggest that male patients with AN are very similar to female patients in decision making, and as a result, treatment approaches that seek to improve this ability should be similar in both genders. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.