Attentional bias toward food in binge eating disorder: baseline differences and the limits of attention modification...

Attentional processes toward high-calorie foods contribute to the maintenance of binge eating disorder (BED) and have been targeted by attentional modification trainings (AMTs). In this study, we quantified food-related attentional bias (AB) in individuals with BED versus control groups with normal-weight (NCG) and overweight (OCG), and evaluated whether AMT effects would persist after one week and generalize to novel stimuli.

We assessed eating pathology and AB in 135 participants (BED: n = 72; NCG: n = 32; OCG: n = 31). We used a dot-probe paradigm with concurrent eye-tracking and reaction-time measures. Sixty-one participants with BED were then randomized to four sessions of AMT or placebo training. All participants with BED underwent re-evaluations of AB and eating pathology one week after the final training session.

At baseline, the group with BED presented significantly greater AB toward high-calorie food cues than both the NCG and OCG did. One week post-training, no differential effects of AMT were observed: both the AMT and placebo groups showed modest, nonspecific reductions in initial fixation duration bias and reaction-time variability. Correlations between changes in AB toward food and eating pathology were small and not significant.

The presence of a food-related AB in individuals with BED was confirmed. However, AMT did not yield sustained or generalized modifications in attentional processing beyond those observed in the placebo condition. Nonspecific improvements may reflect enhanced overall attentional control or general exposure effects. Future research should isolate the active components of AMT and explore strategies to increase its ecological validity.

Registered in the German Clinical Trials Register (DRKS00012984) on 2017-11-30.