Executive Functions of Adults with Binge-Eating Disorder: The Role of Weight Status and Psychopathology.

Nele Busch,Anja Hilbert,Ricarda Schmidt

doi:10.3390/brainsci12010006

Abstract

Findings on executive functions (EFs) in binge-eating disorder (BED) are inconsistent and possibly biased by associated comorbidities. This study aimed to identify whether distinct levels of physical and mental comorbidity are related to EFs in BED. General and food-specific EFs in n = 77 adults with BED were compared to population-based norms and associations with weight status, depressive symptoms, and eating disorder psychopathology were analyzed. To detect within-sample patterns of EF performance, k-means clustering was applied. The results indicated that participants’ general EFs were within the average range with slight deficits in alertness. While depression and eating disorder psychopathology were unrelated to EFs, weight status was associated with food-specific attentional bias that was significantly higher in obesity class 2 than in overweight/obesity class 1 and obesity class 3. Four meaningful clusters with distinct strengths and impairments in general and food-specific EFs but without differences in clinical variables were identified. Altogether, adults with BED showed few specific deficits compared to normative data. Performance was unrelated to depression and eating disorder psychopathology, while weight status was associated with food-specific EFs only. The results highlight the need for longitudinal studies to evaluate the relevance of EFs in BED development and maintenance in neurologically healthy adults.

Highlights

Binge-eating disorder (BED) [1], characterized by recurrent objectively large bingeeating episodes without regularly occurring compensatory behaviors to prevent weight gain, is the most common eating disorder, with a lifetime prevalence of 0.9% to 1.9% in adults [2,3]
While depression and eating disorder psychopathology were unrelated to executive functions (EFs), weight status was associated with food-specific attentional bias that was significantly higher in obesity class 2 than in overweight/obesity class 1 and obesity class 3
Our results show that despite some heterogeneity in EFs among adults with binge-eating disorder (BED), there are hardly any global impairments present with EF performance majorly falling within the normative range

Summary

Introduction

Binge-eating disorder (BED) [1], characterized by recurrent objectively large bingeeating episodes without regularly occurring compensatory behaviors to prevent weight gain, is the most common eating disorder, with a lifetime prevalence of 0.9% to 1.9% in adults [2,3]. While some studies identified deficits in inhibitory control, working memory, planning, decision making, and problem solving in adults with BED compared to controls with overweight or obesity without BED [8,9,10,11], recent meta-analyses quantified deficient overall EFs in BED to be of small effect size only and evidence on impairment in specific EF subdomains remains inconclusive [12,13,14]. 67% to 90% of participants with BED were classified within the healthy range in each computerized test administered in the study; the authors did not provide particular information on specific EF components (response inhibition, decision making, set shifting, working memory, and central coherence) [19]

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Conclusion