Table 1 Characteristics of the studies included in the scoping review
Study | Participants | Method | Interventions/ Exposures | Highlights | Outcomes | Limitations |
|---|---|---|---|---|---|---|
Braden et al.[22] (USA) | Adults living with overweight/obesity (n = 188) (Emotional Eaters and different types of EE among them) | Questionnaires / Scales | Emotion regulation | ER difficulties positively correlated with EE in response to depression, anxiety and boredom EE in response to depression associated with ER difficulties (regression analysis) | "[…] eating in response to positive emotions was not significantly related to poorer psychological well-being, greater eating disorder symptoms, or emotion dysregulation." "Exploratory analyses suggest possible unique relationships between types of emotional eating and specific facets of emotion regulation." "It is possible that when experiencing low intensity negative emotions (e.g., depression, boredom), an inability to attend to alternative, adaptive tasks may increase vulnerability for eating as a strategy for regulating negative affect." "Impulse control difficulties were closely related to the tendency to eat in response to depression and anxiety/anger which suggests that these two types of emotional eating may share an underlying impairment in inhibition." "[…] findings suggest that certain emotion regulation strategies may be more closely linked to various types of emotional eating." | - Only self-report measures (questionnaires/scales) - Specific EE population of adults with overweight or obesity: may not be representative of emotional eaters without overweight or obesity |
Leehr et al. [25] (Germany) | Overweight participants with BED (BED +) (n = 24); Overweight controls without BED (BED-) (n = 23); Normal weight healthy controls (NWC) (n = 26) | Questionnaires / Scales Eye-tracking Anti-saccade task EEG | Inhibitory control Emotion regulation | Impulsivity and ER difficulties in BED > other groups EEG: Conflict processing less thorough in BED and NWC group | "Overall, results support the assumption of inhibitory control deficiencies in BED on a behavioral level." "Participants with BED reported higher impulsivity, trait craving, and lower emotion regulation capacities." "[…] the BED + sample committed significantly more errors than the NWC sample, suggesting inhibitory control difficulties in the BED + sample, which might be food-specific […]." "From a clinical perspective eating behavior of the three groups can be seen on a continuum from normal eating behavior to overeating, to binge eating." "Participants with BED reported higher impulsivity and lower emotion regulation capacities. The combined investigation of electrocortical processes and behavior contributes to an advanced understanding of behavioral and electrocortical processes underlying inhibitory control in BED." | - Mood was not directly measured before the mood induction procedure (before/after induction comparisons are not possible) - The mood induction procedure induced negative mood in general (no specific facets) - Only women among participants |
Preuss et al. (2019) (Germany) | Overweight individuals with BED (n = 24) Overweight individuals without BED (n = 47) Healthy control group (n = 30) | Food Stroop task (FST) Door Opening task Stop Signal task Questionnaires / Scales | Inhibitory control | Deficits in interference inhibition in the FST: BED > healthy controls Performance on interference inhibition: BED < healthy controls | "Outpatients with BED showed more deficits in interference inhibition and by trend also in decision-making […]" "[…] poorer performance on interference inhibition […] in outpatients with BED compared to healthy controls but not compared to those without BED." "[…] absence of significant impairments in response inhibition […] in outpatients with overweight and disinhibited eating compared to healthy individuals." | - Very specific inclusion criteria: participants "had to report the therapeutic objective of weight reduction and at least two long-term unsuccessful weight maintenance efforts " - Unequal balance of sample size between groups - Unequal balance of gender among participants |
Walenda et al. [27] (Poland) | Women with BED (n = 35) Healthy women (n = 41) | Questionnaires / Scales | Emotion regulation | Nonacceptance of emotional responses, lack of emotional clarity, difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to emotion regulation strategies: BED > healthy controls Rumination and self-blame (negative strategies): BED > healthy controls | "[…] a higher nonacceptance of emotional responses, lack of emotional clarity, difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to emotion regulation strategies were observed in the BED group compared to healthy women." "When it comes to negative strategies, in the present study women from clinical group were more inclinated to use rumination and self-blame (strong effects) than healthy women." "[…] important and still insufficiently understood role of emotional dysregulation in the clinical picture of this disorder" | - Only self-report measures (questionnaires, scales) - Self-report measures are mainly retrospective: possibility of recall biases - Only women among participants |
Hege et al. (2015) (Germany) | Obese and overweight women with BED (n = 17—Overweight 4 / Obese 13) BMI-matched control group (n = 17—Overweight 3 / Obese 14) | Questionnaires / Scales Go / No-go task Magnetoencephalography (MEG) | Impulsivity Response inhibition | BIS-11 attentional impulsiveness scores: BED individuals > overweight and obese controls Decreased response inhibition performance in individuals with BED Individuals with BED: Hypoactivity in the prefrontal control network | "Specifically, increased attentional impulsiveness (a subscale of the BIS-11) in BED was related to decreased response inhibition performance and hypoactivity in the prefrontal control network, which was activated when response inhibition was required." "[…] attentional impulsiveness-related attenuation in response inhibition performance in individuals with BED." "[…] participants with BED showed a trend for a food-specific inhibition performance decline." | - Inclusion of participants with depressive symptoms and using antidepressant medication - Small sample sizes - Only women among participants |
Loeber et al. [34] (Germany) | Obese women with BED (n = 17) Obese women without BED or any other eating disorder (n = 20) Normal-weight healthy control women (n = 20) | Questionnaires/Scales Go / No-go paradigm (computer-based experimental task) | Response inhibition Impulsivity | Obese BED: Less impairment of response inhibition to food-associated than to control stimuli Normal-Weight healthy control: pattern reversed No difference for obese participants | "[…] obese BED participants were better at inhibiting their responses to food associated than to neutral stimuli." "[…] restrained eating and mood are factors that moderate response inhibition to food-associated stimuli in obese patients with BED. […] apart from negative mood, positive mood might as well be a trigger for loss of control over eating behaviour." | - Go / No-go task only performed with food-related stimuli and no other rewarding stimuli - Mood was not systematically manipulated - Small sample sizes - Only women among participants |
Grant & Chamberlain [28] (USA) | Young adults with BED (n = 17) Healthy controls (n = 17) | Questionnaires / Scales Cambridge Neuropsychological Test Automated Battery (CANTAB) A computerised version of the Wisconsin Card Sorting task Stop-Signal task One-Touch Stockings of Cambridge task (OTS) Cambridge Gamble Task (CGT) Spatial Working Memory Task (SWM) | Motor disinhibition Impulsivity | Impairments in stop-signal response inhibition (Stop-Signal Task) and executive planning (Stockings of Cambridge Task) in BED group > to healthy controls | "Binge-eating disorder was associated with impaired response inhibition and executive planning." | - Comorbidities were not excluded nor controlled in the BED group - Unequal balance of gender among participants - Small sample sizes |
Munsch et al. [35] (Switzerland) | Female obese patients with BED (n = 22) | Questionnaires / Scales EMA (Ecological Momentary Assessment) | Emotion regulation | During binge days compared with non-binge days: Values for negative mood: ↗ Values for positive mood: ↘ Recovery of mood after binge eating: BED < BN | " Binge eating in BED seems to be triggered by an immediate breakdown of emotion regulation." "Values for negative mood were higher and those for positive mood lower during binge days compared with non-binge days." "After binge eating, in contrast to findings from BN, we found a less pronounced and only slow recovery of mood after binge eating in BED." | - Only self-report measures (questionnaires, scales, or interviews) - Small sample size - Only treatment-seeking BED patients (no generalization possible to non-treatment-seeking BED) - Only women among participants |
Görlach et al. [32] (Germany) | Participants with BMI < 30 (n = 124) Participants with BMI ≥ 30 (n = 190) Overeaters among them | Questionnaires / Scales | Emotion regulation Expressive suppression | Overeating frequency: Individuals with obesity > individuals without obesity | "[…] expressive suppression has a strong association with overeating in individuals with obesity." "Individuals with obesity reported more frequent overeating compared with individuals without obesity. " "[…] a moderating effect of BMI on the association of expressive suppression and overeating was found." | - Only self-report measures (questionnaires, scales, or interviews) - Data were collected via an internet survey: data may not be representative of the general population - Unequal balance of gender among participants |
Svaldi et al., (2012) (Germany) | Women with BED (n = 25) Women with Anorexia Nervosa (n = 20) Women with Bulimia Nervosa (n = 18) Women with Major Depressive Disorder (n = 16) Female Healthy Controls (n = 42) | Questionnaires / Scales | Emotion regulation | For most ER variables: No significant differences between the ED groups Difficulties in ER: All clinical groups > HC Scores on the Difficulties in Emotion Regulation Scale (DERS) subscale “limited access to strategies”: BED < all other disorder groups | Participants with BED (like all other disorder groups) self-reported more emotion regulation problems than HC "Although differing from HC on this variable, participants with BED showed lower scores on the DERS subscale limited access to strategies than all other disorder groups." | - Only self-report measures (questionnaires, scales, or interviews) - The levels of depression were not considered - The sample sizes of the groups are not balanced, and some groups have very small sample sizes - Only women among participants |
Kornacka et al. [20] (Poland) | Overweight / obese (n = 38) (Emotional Eaters among them) Control group (n = 50) | Questionnaires / Scales EMA (Ecological Momentary Assessment) | Rumination | Study 1: “[…] emotional eating mediates the link between rumination and uncontrolled eating or snacking, but only in healthy participants and not in the participants with overweight.” Study 2: “[…] when both momentary rumination and sad mood are entered into the model predicting momentary daily emotional eating, only rumination remains a significant predictor of emotional eating. This relationship is not modified by the fact that the participants are from healthy controls or the overweight/obese group.” | "[…] when both predictors (momentary rumination and affect) are included in the model predicting emotional eating, only rumination remains a significant predictor, suggesting that in daily functioning, rumination might be further explored as a mediator of the link between affect and emotional eating […]" "[…] the results of the two studies confirm the crucial role of ruminative thinking in the occurrence of emotional eating […]." "[…] in both healthy and participants with overweight rumination might lead to increased emotional eating, even when controlling for negative affect." "[…] emotional eating might be not caused directly by negative affect but it is enhanced by repetitive dwelling on the negative issue and negative affect itself." "The role of emotional eating in the link between rumination and uncontrolled eating is different in overweight vs. healthy individuals. Momentary rumination is linked to emotional eating." | - Only self-report measures (questionnaires, scales, or interviews) - Small sample sizes - Study may be underpowered for the computation of cross-sectional analyses - The gender of the participants was not mentioned |
Schag et al. [29] (Germany) | Overweight or obese women with a diagnosis of BED or subthreshold BED (BED +) (= 25) Overweight or obese women without BED (BED-) (n = 26) Healthy, normal-weight women controls (NWC) (n = 25) | Free exploration paradigm Modified antisaccade paradigm Eye-tracking Questionnaires / Scales | Trait impulsivity Disinhibition, rash-spontaneous behaviour | Experiment 1: BED + participants gazed longer on food stimuli in comparison with BED- and NWC participants Experiment 2: “[…] BED + participants had more difficulties inhibiting saccades towards food and nonfood stimuli compared with both other groups in first saccades, and especially towards food stimuli in second saccades and concerning sequences of first and second saccades.” Performances in both experiments: BED- = NWC participants | "[…] food-related reward sensitivity and rash-spontaneous behaviour, as the two components of impulsivity, are increased in BED in comparison with weight-matched and normal-weight controls. This indicates that BED represents a neurobehavioural phenotype of obesity that is characterised by increased impulsivity." | - The rewarding stimuli are food-related only - Some participants had depressive symptoms - Only women among participants |
Willem et al. [36] (France) | Obese adults (n = 120) (Emotional Eaters among them) | Questionnaires / Scales | Emotion dys-regulation | In Moderate Obesity: association emotion dys-regulation and more EE only through more anxiety In Severe Obesity: “[…] emotion dys-regulation was both directly and indirectly associated with more EE, but only through more depression in the latter.” | "Emotion dys-regulation, anxiety and depression have different impacts on emotional eating (EE) depending on obesity severity Emotion dys-regulation is only associated with more EE through more anxiety in moderate obesity Emotion dys-regulation is associated with more EE both directly and through more depression in severe obesity." | - Only self-report measures (questionnaires, scales, or interviews) - BMI was calculated from self-reported height and weight - Unequal balance of gender among participants |
Gianini et al. [26] (USA) | Obese participants with BED (n = 326) | Questionnaires / Scales | Emotion regulation | Two DERS subscales (limited access to emotion regulation strategies and lack of emotional clarity) predicted emotional overeating in BED participants Two DERS subscales (nonacceptance of emotional responses and difficulties engaging in goal-directed behavior) predicted general eating pathology | "Emotion regulation may play a significant role in the maintenance of emotional overeating and eating pathology in obese adults with BED." "[…] limited access to emotion regulation strategies and lack of emotional clarity were the emotion regulation difficulties most strongly associated with emotional overeating." "Our results suggest that when obese individuals with BED experience negative affect they may lack effective strategies for managing these emotions." "Nonacceptance of emotional responses and difficulties engaging in goal-directed behavior were the emotion regulation difficulties most strongly associated with eating pathology." | - Only self-report measures (questionnaires, scales, or interviews) - Emotional Overeating was based upon recall of the past 28 days, which may be a too-long period - Only treatment-seeking BED patients (no possible generalization to non-treatment-seeking BED individuals) - Unequal balance of gender among participants |
Racine & Horvath [33] (USA) | Women with Overeating only (n = 25) Women without pathological eating (No PE) (n = 137) Women with Loss of control only (LOC) (n = 32) Women with Objective binge episodes (OBEs) (n = 27) | Questionnaires / Scales | Emotion dys-regulation | Across all facets of emotion dysregulation: women with OBEs score > women No PE Women with OBEs: “[…] more problems with impulse control, less access to effective emotion regulation strategies, and greater overall emotion dysregulation than women with overeating only or LOC only.” Lack of emotional clarity: Women with OBEs = women with overeating | "The combination of overeating and LOC eating is associated with the greatest emotion dysregulation, but certain emotion regulation facets may differentially relate to overeating and LOC." | - Only self-report measures (questionnaires, scales, or interviews) - The sample sizes of the groups are not balanced, and some groups have very small sample sizes - Only women among participants |
Sultson & Akkermann [19] (Estonia) | Women (n = 605) categorized in: Four-class model: Overweight women without Emotional Eating (n = 56) Obese women with Emotional Eating (n = 30) Normal weight women with Emotional Eating (n = 140) Normal weight women without Emotional Eating (n = 379) Five-class model: Obese women with Emotional Eating (n = 28) Normal weight women without Emotional Eating (n = 209) Normal weight women with Emotional Eating (n = 111) Normal weight women with Positive Emotional Eating (n = 196) Overweight women without Emotional Eating (n = 61) | Questionnaires / Scales | Emotion regulation | Level of ER difficulties and eating pathology: Obese and normal weight individuals with EE > other groups “Overweight individuals without EE showed moderate levels of eating pathology and low levels of ER difficulties […]” Normal weight individuals with positive EE: low levels of eating pathology, but moderate levels of ER difficulties | Four-profile model: "[…] the presence of high level of negative EE among profiles proved to be a particularly important indicator of ED psychopathology, whereas high BMI itself was not." Five-profile model: "[…] positive EE was associated with elevated levels of ER difficulties, suggesting that overeating in response to positive emotions might also include some features of emotion dysregulation." "Higher level of ER difficulties among obese and normal weight individuals with EE also lend further support for the assumption that emotion dysregulation might underlie EE." | - Only self-report measures (questionnaires, scales, or interviews) - The sample sizes of the groups are not balanced, and some groups have small sample sizes - Only women among participants |
Wolz et al. [23] (Germany) | Healthy normal-weight women (n = 28) (Emotional Eating tested later) | EEG Go / No-go task Questionnaires / Scales | Inhibition | EE not correlated with habitual emotion suppression Go/No-go task: “[…] higher emotional eating scores were positively related to higher late positive potential (LPP) amplitudes in response to negative affective scenes.” | "[…] emotional eating tendencies might be related to increased neural reactivity specifically to negative stimuli." "[…] emotional eating was not related to general inhibitory control deficits, but was associated with higher behavioral inhibitory control difficulties only while suppressing negative emotions. Hence, the difficulty to inhibit behavioral responses while regulating negative emotions may contribute to disinhibited food intake while experiencing negative emotions." "The results of the current study suggest that people with emotional eating tendencies have response inhibition difficulties specifically when suppressing negative emotions […]" "Higher emotional eating scores were not related to higher scores in habitual use of emotion suppression." "No evidence was found supporting the hypothesis that emotional eating tendencies are related to generally lower inhibitory control capacities, but results showed preliminary evidence for an association between emotional eating and problems to inhibit behavioral responses specifically while trying to suppress negative emotions." | - EE scores may not be high enough among participants: the association between EE and suppression may be stronger in samples with higher mean EE scores - Measure of emotion suppression may not be sufficient - Only women among participants |
Crockett et al. [3] (USA) | Undergraduate students (n = 552 including 334 women) (Emotional Eating tested later) | Questionnaires / Scales | Emotion regulation | Boredom proneness and emotion regulation predicted DEBQex scores | "In every model we tested, difficulties in emotion regulation predicted emotional eating." "Boredom proneness and emotional regulation were both strongly correlated with the emotional eating variables." | - Only self-report measures (questionnaires, scales, or interviews) - All participants were undergraduate students (cannot generalize to the general population) |
Svaldi et al. [39] (Germany) | Women with BED (n = 31) Group without BED / No-BED (n = 29) | Questionnaires / Scales Stop Signal Task (SST) | Behavioral inhibition | Stop signal reaction time (SSRT): BED > No-BED Difficulty inhibiting responses elicited by food stimuli: BED > No-BED “The deficits in behavioral response inhibition were also found to be related to the severity of reported symptoms.” | "The stop signal reaction time (SSRT) was found to be increased in BED participants compared with the No-BED group, indicative of a deficit in response stopping in BED." "Of note, both previous and current findings suggest that response inhibition at different stages of the response process may be impaired in BED." "[…] the BED group experienced more difficulty inhibiting a response elicited by food stimuli than by neutral stimuli." "In conclusion, the present study supports a general deficit in late stage response inhibition in BED relative to obese No-BED group, particularly when the response is elicited in the context of food stimuli. Additionally, the magnitude of the inhibitory deficit was found to be related to the reported severity of eating pathology." | - Food consumption before the study was not assessed - Only women among participants |
Wood et al. [24] (USA) | Healthy adults (n = 20) (Emotional Eaters among them) | Questionnaires / Scales fMRI (functional magnetic resonance imaging) Go / No-go task | Self-control (inhibition) | Emotional eating: Positive associations with insula and dorsolateral prefrontal cortex activation in response to high-calorie versus low-calorie foods Positive associations with dorsolateral prefrontal cortex activation in response to approach versus inhibition towards high-calorie foods | "[…] our results demonstrate an increase in activation across brain regions related to self-control and urges in response to high-calorie food associated with both emotional eating and routine restraint." | - Go / No-go task only performed with food-related stimuli and no other rewarding stimuli - Compensatory restraint and external eating may not induce differential brain activation in response to a food-related Go / No-go task - Statistical power may be not powerful enough to detect an association between the reward circuitry and the external eating / compensatory restrain |
Mobbs et al. [38] (Switzerland) | Obese patients with BED (n = 16) Obese patients without BED (n = 16) Normal-weight controls (n = 16) | Questionnaires / Scales Mental flexibility task | Inhibition | Errors rate and omissions rate: All obese patients > controls Obese patients with BED > obese patients without BED | “Concerning our second objective, namely to compare obese patients with and without binge eating disorder, the pattern of results (increased errors for all types of stimuli in the whole task, increased omissions for all types of stimuli in the food section of the task and absence of performance improvement in the food section for obese patients with binge eating disorder) suggests that obese patients with binge eating disorder have a more severe global impairment of inhibition and more difficulty focusing their attention. This result raises the possibility that there is a continuum of increasing inhibition and cognitive problems with increasingly disordered eating among obese patients.” “[…] the difference between obese persons with binge eating disorder and obese persons without binge eating disorder suggests that the former have a more severe fundamental inhibition problem.” “[…] these cognitive deficits are more severe in obese patients with binge eating disorder, which indicates that there is a continuum of increasing inhibition and cognitive problems with increasingly disordered eating.” | - The shifting rule may be too easy to observe differences between obese patients and normal-weight controls - The shifting task does not allow to assess the nature of the inhibition deficit - Unequal balance of gender among participants |
Mole et al. (2015) (UK) | EtOH—abstinent alcohol-dependent subjects (n = 30) HV-EtOH—healthy volunteers abstinent alcohol-dependent subjects (n = 30) Obese subjects with BED (n = 30) HV—healthy volunteers (n = 30) Obese controls (n = 30) HV—healthy volunteers (n = 30) | Questionnaires / Scales Delay discounting task (DTT) Stop signal task (SST) Information sampling task (IST) | Impulsivity | Stop signal task: "In BED subjects, there were no significant differences in GoRT […] compared to HV.” (GoRT = Go-trial Reaction Time) “Obese subjects without BED compared to those with BED also had greater impairments in motor response inhibition […]” Information sampling task: "There were no significant differences between HV and BED subjects […]” Delay discounting task: "All three groups had greater delay discounting relative to healthy volunteers.” | "Our findings are compatible with both a conceptualization of BED as an extreme neurobehavioural subtype of obesity and BED having similarities with other behavioural and substance addictions." “Unexpectedly, obese subjects without BED showed greater impulsivity than obese subjects with BED.” | - Income was not taken into account for the DDT - Rather small sample sizes |
Smith et al. (2020) (USA) | Women with BED (n = 29) Women with Bulimia Nervosa (BN) (n = 9) Woman with AN-BP (anorexia nervosa binge-purge type) (n = 1) Woman with and Other Specified Feeding or Eating Disorder (OSFED, subthreshold BED presentation) (n = 1) "Participants were grouped based on their DSM-5 ED diagnoses, such that those with AN-BP or BN were categorized in the “compensatory behavior” group, and those with BED or subthreshold BED were categorized in the “no compensatory behavior” group." | Questionnaires / Scales EMA (Ecological Momentary Assessment) Ambulatory Go / No-go task | Inhibitory control Affect | See the “Outcomes” column | "[…] there were no significant independent or interactive effects of momentary negative affect and daily inhibitory control in predicting binge eating among individuals with BED or subthreshold BED." | - The Go / No-go task may not be challenging enough - The sample sizes of the groups are not balanced, and some groups have very small sample sizes - Only women among participants |
Leehr et al. [30] (Germany) | Obese women with BED (n = 21) Obese controls (women) without BED (n = 23) Normal-weight healthy controls (women) (NWC) (n = 25) | Questionnaires / Scales Eye-tracking Antisaccade task Genotyping | Impulsivity (trait and behavioural) Inhibitory control | See the “Outcomes” column | "[…] the BED + sample showed higher trait and behavioural impulsivity. Furthermore, within the BED + group, COMT Met/Met homozygous individuals showed stronger deficits in inhibitory control." "COMT Met/Met homozygous individuals with BED might represent a specific group in the BED spectrum, which shows a higher behavioural impulsivity." "[…] our results hint towards an interaction of the COMT Met/Met homozygote genotype with increased behavioural impulsivity and suggest that this might play a role in binge eating mechanisms in BED." | - Behavioral impulsivity was only measured with high caloric food-related stimuli - Small sample sizes - Only women among participants |
Eneva et al. (2017) (USA) | Overweight women with BED (OW-BED) (n = 32) Normal-weight women with BED (NW-BED) (n = 23) Overweight women without BED (OW-HC) (n = 48) Normal-weight women without BED (NW-HC) (n = 29) | Questionnaires / Scales Set of tests that assesses higher-level cognitive functions Clinical interviews | Inhibitory control | “NW-BED individuals demonstrated significantly greater inhibition as measured by the Flanker Inhibitory Control task than all other groups.” | "In contrast to a past study that showed that obese individuals with BED did better on motor inhibitory tasks than obese HCs (Mole et al., 2015), we did not observe better performance in our OW-BED group, only in our NW-BED group. It is possible that the relatively higher inhibitory control observed in NW-BED relative to all other groups serves as a protective factor, preventing weight gain." “Thus, our findings suggest that EF of participants in the NW range, even with a diagnosis of BED, is generally characterized by better psychomotor performance than OW, as captured by multiple EF tasks.” "Replication of the finding that normal-weight BED is associated with enhanced inhibitory control is needed." | - Only women among participants - The sample sizes of the groups are not balanced, and some groups have small sample sizes |
Balodis et al. (2013) (USA) | Obese BED individuals (n = 11) Non-BED obese individuals (OB) (n = 13) Lean comparison group (LC) (n = 11) | Questionnaires / Scales fMRI Stroop task | Inhibitory control | “[…] the BED group showed diminished activity in the ventromedial prefrontal cortex (vmPFC), inferior frontal gyrus (IFG), and insula during Stroop performance.” | "Relative to the OB and LC groups, activity in the BED group was differentiated by relative hypoactivity in brain areas involved in self-regulation and impulse control." "[…] the BED group demonstrated diminished activity in frontal regions subserving inhibitory control, including the vmPFC and the IFG. In addition, diminished activity was also noted in the insula, in superior and middle temporal areas, as well as in the middle occipital gyrus." "[…] BED individuals’ diminished ability to recruit impulse-control-related brain regions appears associated with impaired dietary restraint. The observed differences in neural correlates of inhibitory processing in BED relative to OB and LC groups suggest distinct neurobiological contributions to binge eating as a subgroup of obese individuals." | - The Stroop task does not only involve cognitive control, but also many other cognitive processes - No Stroop behavioral measures during fMRI scanning - Low contrast map threshold (p < .05 for group comparison) - Small sample sizes - The average age is much higher in the BED group than in the other groups - Only treatment-seeking BED patients (no generalization possible to non-treatment-seeking BED individuals) |
Brockmeyer et al. (2014) (Germany) | Women with AN-R (anorexia nervosa-restricting type) (n = 35) Women with AN-BP (anorexia nervosa–binge/purge type) (n = 22) Women with BN (bulimia nervosa) (n = 34) Women with BED (binge-eating disorder) (n = 29) Normal-weight controls (NWC) (n = 60) Over-weight controls (OWC) (n = 29) | Questionnaires / Scales | Emotion regulation | ER difficulties (experience and differentiation of emotions + attenuation and modulation of emotions): all ED subtypes > controls Some ER domains difficulties: Other ED subtypes > BED > controls Impulse control: BN = BED = AN-R ER difficulties in impulse control: AN-BP > BED > BN | "[…] all ED subtypes reported significantly more ER difficulties than healthy controls in the domains of both experience and differentiation of emotions as well as attenuation and modulation of emotions." "[…] BED reported less problems than other ED subtypes regarding some ER domains, albeit still differing from healthy controls." "However, that BN and BED did not differ from AN-R regarding impulse control is rather surprising." "Our fourth hypothesis (impulse control difficulties: AN-BP, BN > BED) also received only partial support since AN-BP but not BN exceeded BED regarding ER difficulties with impulse control." "[…] BN did not show greater ER difficulties in impulse control than BED in the present study, which is rather surprising, given that BN used to show more problems than BED regarding different facets of impulsivity." "[…] self-reported general impulse control difficulties in the context of ER seem to measure a different aspect of impulsivity than neuropsychological tests which BN and BED may share with each other." "The findings underscore the relevance of ER difficulties in ED and support the trans-diagnostic view of ER difficulties being present across the whole spectrum of ED. In addition, the present results suggest that certain domains of ER may be linked more closely to certain ED subtypes than to others." | - Only self-report measures (questionnaires, scales, or interviews) - The sample sizes of the groups are not balanced, and some groups have rather small sample sizes - The treatment status was not considered - Only the DERS was used to measure impulsivity (impulsivity subtypes could have been missed) - Only women among participants |
Ruscitti et al. (2016) (USA) | EDNOS (Eating Disorder, Not Otherwise Specified) (n = 120) Anorexia Nervosa (n = 29) Bulimia Nervosa (n = 22) Binge Eating Disorder (n = 20) | Questionnaires / Scales | Emotion regulation | Significant differences in ER: BED and EDNOS > psychiatric patients without EDs Difficulties in Limited Access to Emotion Regulation Strategies: BED > EDNOS | "[…] individuals with EDs have greater ER difficulties in most domains of ER and that those with BED and EDNOS demonstrate the most significant differences in ER as compared to psychiatric patients without EDs." "[…] it was found that ED subtypes typically did not differ in terms of specific difficulties in ER. One exception emerged indicating that individuals with BED demonstrated significantly greater difficulty on the Limited Access to Emotion Regulation Strategies subscale as compared to those with EDNOS." | - Only self-report measures (questionnaires, scales, or interviews) - The sample sizes of the groups are not balanced, and a very small sample of BED compared to EDNOS - No healthy weight-matched control subjects - ED within the EDNOS group can greatly vary - Unequal balance of gender among participants |
Deroost & Cserjési [21] (Belgium) | Low Emotional eaters group (n = 18) High Emotional eaters group (n = 23) | Questionnaires / Scales Exogenous Cueing Task (ECT) | Emotion regulation Attentional avoidance | Attentional avoidance of emotional faces (particularly negative faces): High EM group significant* Low EM group not significant Levels of avoidance coping: High EM group > Low EM group | "[…] these results indicate that the high EM group directed their attentional focus in a way that allowed them to avoid elaborative attentional processing of emotional stimuli." "Thus, both the ECT results and the self-reported data suggest that people with a high degree of EM use avoidance as a primary coping strategy." "Avoidance coping also significantly predicted the level of EM." "[…] overall, our results are in agreement with the hypothesis that EM acts as a maladaptive coping mechanism to avoid emotional distress […]." | - Small sample sizes - Unequal balance of gender among participants, especially in the High EM group |
Aloi et al. [31] (Italy) | BED patients (n = 155) | Questionnaires / Scales Network analysis (NA) | Emotion dysregulation Impulse control | See the “Outcomes” column | "[…] according to the present NA findings, impaired self-monitoring metacognition and difficulties in impulse control are the central nodes in the psychopathological network of BED, whereas eating symptoms seem to be marginal." | - Only self-report measures (questionnaires, scales, or interviews) - Small sample size compared to other studies that used NA in BED - Unequal balance of gender among participants |
Stapleton & Whitehead [18] (Australia) | Australian adults (n = 223) (Emotional Eating tested later) | Questionnaires / Scales | Emotion regulation Impulsivity | Difficulties with ER, impulsivity and sensitivity toward rewards: dysfunctional emotional eaters > non-dysfunctional emotional eaters The best at predicting emotional eating behavior: 1. ER difficulties, 2. impulsivity, 3. sensitivity to reward, 4. sensitivity to punishment | "Emotional eaters significantly differed from those who did not engage in dysfunctional levels of emotional eating in terms of their emotion regulation, impulsivity, and sensitivity towards reward, and difficulties in emotion regulation predicted emotional eating." "It was proposed that emotion regulation difficulties would contribute the most towards predicting emotional eating behaviour, followed by impulsivity, sensitivity to reward, and then sensitivity to punishment." "Higher levels of emotion regulation difficulties were associated with emotional eating […]." "Emotion regulation difficulties was the greatest predictor of emotional eating, suggesting that individuals who have difficulty regulating their emotions are more likely to engage in emotional eating behaviour." | - Only self-report measures (questionnaires, scales, or interviews) - Non-clinical population: findings may not be directly applicable to ED patients - Unequal balance of gender among participants |
Wang et al. [37] (USA) | Obese participants with BED (n = 237) | Questionnaires / Scales | Rumination (brooding and reflective) | “Hierarchical multiple regressions indicated that rumination was associated with eating-disorder psychopathology and weight-bias internalization above and beyond the influence of overvaluation of shape/weight.” | "Findings suggest that, among patients with BED/obesity, rumination is an important cognitive process associated with severity of eating-disorder psychopathology even after accounting for overvaluation of shape/weight. Patients with greater rumination might be more likely to dwell on weight-based discrimination experiences and internalize these negative attitudes." | - Only self-report measures (questionnaires, scales, or interviews) - Only treatment-seeking BED patients (no possible generalization to non-treatment-seeking BED individuals) - Unequal balance of gender among participants |