Food-Related Impulsivity in Obesity and Binge Eating Disorder-A Systematic Update of the Evidence

Abstract

The specific eating pattern of Binge Eating Disorder (BED) patients has provoked the assumption that BED might represent a phenotype within the obesity spectrum that is characterized by increased impulsivity. Following the guidelines of the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses), we here provide a systematic update on the evidence on food-related impulsivity in obese individuals, with and without BED, as well as normal-weight individuals. We separately analyzed potential group differences in the impulsivity components of reward sensitivity and rash-spontaneous behavior. Our search resulted in twenty experimental studies with high methodological quality. The synthesis of the latest evidence consolidates conclusions drawn in our initial systematic review that BED represents a distinct phenotype within the obesity spectrum that is characterized by increased impulsivity. Rash-spontaneous behavior in general, and specifically towards food, is increased in BED, while food-specific reward sensitivity is also increased in obese individuals without BED, but potentially to a lesser degree. A major next step for research entails the investigation of sub-domains and temporal components of inhibitory control in BED and obesity. Based on the evidence of impaired inhibitory control in BED, affected patients might profit from interventions that address impulsive behavior.

Keywords: binge eating disorder; eating disorders; food; impulsivity; inhibition; obesity; reward.

Figure 1

PRISMA (preferred reporting items for systematic reviews and meta-analyses) [21] flow chart for study inclusion. OB: obese sample; OB/BED: mixed sample; BED: sample with Binge Eating Disorder.

Figure 2

Model of impulsivity deficits in obese patients with and without BED, adapted from Schag et al., 2013 [5]. OB: patients with obesity; BED: patients with Binge Eating Disorder.