A systematic review and meta-analysis of cognitive bias to food stimuli in people with disordered eating behaviour

AimMaladaptive cognitions about food, weight and shape bias attention, memory and judgment and may be linked to disordered eating behaviour. This paper reviews information processing of food stimuli (words, pictures) in people with eating disorders (ED).MethodPubMed, Ovid, ScienceDirect, PsychInfo, Web of Science, Cochrane Library and Google Scholar were searched to December 2009. 63 studies measured attention, memory and judgment bias towards food stimuli in women with ED.ResultsStroop tasks had sufficient sample size for a meta-analyses and effects ranged from small to medium. Other studies of attention bias had variable effects (e.g. the Dot-Probe task, distracter tasks and Startle Eyeblink Modulation). A meta-analysis of memory bias studies in ED and RE yielded insignificant effect. Effect sizes for judgment bias ranged from negligible to large.ConclusionsPeople with ED have greater attentional bias to food stimuli than healthy controls (HC). Evidence for a memory and judgment bias in ED is limited.

Research Highlights
► Attention bias to food words is strong in ED, greater in BN than AN.
► Memory bias is more prominent for AN and restrained eaters than BN.
► Hunger reduces, satiation increases memory bias in AN and restrained eaters not BN.
► Food restriction increases food thoughts and amount consumed in restrained eaters.
► Cognitive bias may be a biomarker: ED symptoms increase but treatment reduces bias.