Abstract
Compulsivity is a central feature of obsessive-compulsive and addictive disorders, which share considerable overlap with excessive eating in terms of repetitive behavior despite negative consequences. Excessive eating behavior is characteristic of several eating-related conditions, including eating disorders [bulimia nervosa (BN), binge eating disorder (BED)], obesity, and food addiction (FA). Compulsivity is proposed to be driven by four distinct cognitive components, namely, contingency-related cognitive flexibility, task/attentional set-shifting, attentional bias/disengagement and habit learning. However, it is unclear whether repetitive behavior in eating-related conditions is underpinned by deficits in these cognitive components. The current mini-review synthesizes the available evidence for performance on compulsivity-related cognitive tasks for each cognitive domain among populations with excessive eating behavior. In three of the four cognitive domains, i.e., set-shifting, attentional bias and habit learning, findings were mixed. Evidence more strongly pointed towards impaired contingency-related cognitive flexibility only in obesity and attentional bias/disengagement deficits only in obesity and BED. Overall, the findings of the reviewed studies support the idea that compulsivity-related cognitive deficits are common across a spectrum of eating-related conditions, although evidence was inconsistent or lacking for some disorders. We discuss the theoretical and practical importance of these results, and their implications for our understanding of compulsivity in eating-related conditions.
Highlights
Compulsivity is defined as ‘‘the performance of repetitive, unwanted and functionally impairing overt or covert behaviors without adaptive function, performed in a habitual or stereotyped fashion, either according to rigid rules or as a means of avoiding perceived negative consequences’’ (Fineberg et al, 2014, p. 70)
We define each of the cognitive components of compulsivity and the tasks that measure them, and review evidence of task performance in: (1) bulimia nervosa (BN) and binge eating disorder (BED); (2) obesity; (3) food addiction (FA); and (4) overlapping conditions
It has been posited that compulsivity arises from perseverating on a behavior that was once rewarded, but becomes associated with negative consequences, indicating less cognitive flexibility
Summary
Compulsivity is defined as ‘‘the performance of repetitive, unwanted and functionally impairing overt or covert behaviors without adaptive function, performed in a habitual or stereotyped fashion, either according to rigid rules or as a means of avoiding perceived negative consequences’’ (Fineberg et al, 2014, p. 70). Behavioral patterns of compulsive eating, defined as repetitive bouts, without homeostatic function, with adverse consequences, and as ways to relieve stress, are common across several eating-related conditions (Moore et al, 2017). These include: (1) eating disorders such as bulimia nervosa (BN) and binge eating disorder (BED); (2) obesity; and (3) food addiction (FA), which have very different diagnostic considerations (Table 1). We adopt the four cognitive components of compulsivity proposed in the framework by Fineberg et al
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