Impulsivity and compulsivity in binge eating disorder: A systematic review of behavioral studies.

Abstract Background Binge eating disorder (BED) often includes impulsive and compulsive behaviors related to eating behavior and food. Impulsivity and compulsivity generally may contribute to the etiology and maintenance of multiple psychiatric disorders including BED. This review aimed to identify and synthesize available behavioral studies of impulsivity and compulsivity among individuals with BED. Method A systematic search was performed focusing on BED and specific facets of impulsivity (rapid response and choice) and compulsivity (cognitive flexibility, set-shifting, and/or habit learning). All case-control studies comparing adults with either full-threshold or subthreshold BED to individuals with normal weight, overweight, or other eating disorders (e.g., bulimia nervosa) were included. Results Thirty-two studies representing 29 unique samples met inclusion criteria. Increased choice impulsivity was observed among individuals with BED relative to individuals with normal weight. There were mixed findings and/or a lack of available evidence regarding rapid response impulsivity and compulsivity. The presence of between-group differences was not dependent on sample characteristics (e.g., full or partial-threshold BED diagnosis, or treatment-seeking status). Heterogeneity relating to covariates, task methodologies, and power limited conclusions. Conclusions Literature supports an association between choice impulsivity and BED. More research is needed to determine if individuals with BED demonstrate elevated levels of either rapid response impulsivity or types of compulsivity. There exists a need for continued research, with particular attention paid to important covariates, task methodologies, and issues of power.