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Updated: Nov 16, 2025

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Published on: May 10, 2022
Metacognitive beliefs across eating disorders and eating behaviours: A systematic review
Sara Palmieri1,2,3, Giovanni Mansueto4,2,3, Giovanni Maria Ruggiero2,3
1Division of Psychology, London South Bank University, London, UK.
Background:
Literature has pointed out a probable association between metacognitive beliefs and eating disorders. To date, no study has synthetized all research exploring the differences or similarities in metacognitive beliefs across different eating disorders diagnoses and eating problems.
Aims:
To review the evidence on metacognitive beliefs across the spectrum of eating disorders and eating behaviours.
Method:
A comprehensive search was conducted on PubMed and PsycInfo. The search terms used were: 'eating disorders/anorexia/bulimia/binge eating disorder/binge eating' AND 'metacognitions/metacognitive beliefs'. A manual search of reference lists was also run.
Results:
Eleven studies were identified. Anorexia Nervosa was broadly characterized by higher levels of metacognitive beliefs compared to the general population, particularly negative beliefs about worry and beliefs about the need to control thoughts. Positive beliefs about worry were higher in Anorexia Nervosa compared to Bulimia Nervosa and Eating Disorder Not Otherwise Specified, and in Bulimia Nervosa compared to Eating Disorder Not Otherwise Specified. Negative beliefs about worry were higher in Anorexia Nervosa compared to Bulimia Nervosa. Cognitive self-consciousness was higher in Anorexia Nervosa compared to Bulimia Nervosa and Eating Disorder Not Otherwise Specified.
Conclusions:
Metacognitive beliefs appear to be implicated in eating disorders and eating behaviours.
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