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.

Highlights

  • Patients suffering from Binge Eating Disorder (BED) show an eating pattern that is characterized by recurrent episodes during which they ingest an unusually large amount of food in a discrete period of time, and experience a subjective loss of control over their eating behavior [1]

  • BED might represent a phenotype within the obesity spectrum that is characterized by increased impulsivity [3,4,5]

  • We provided a systematic update of the evidence on food-related impulsivity in BED and obesity that has been published since our initial systematic review on this topic [5]

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Summary

Introduction

Patients suffering from Binge Eating Disorder (BED) show an eating pattern that is characterized by recurrent episodes during which they ingest an unusually large amount of food in a discrete period of time, and experience a subjective loss of control over their eating behavior [1]. BED might represent a phenotype within the obesity spectrum that is characterized by increased impulsivity [3,4,5]. Theoretical concepts, rooted in personality psychology, have suggested slightly different localizations of impulsivity within the trait hierarchy and different sub-dimensions of impulsivity [7,8]. Most concepts have in common that they differentiate two sub-dimensions of impulsivity: (a) a motivational dimension, closely tied to reward-related processes and (b) a behavioral dimension, related to inhibition. We will follow the nomenclature by Dawe and Loxton [9] and term the motivational dimension reward sensitivity, and the behavioral dimension

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