Efficacy of brain-based neurofeedback interventions for binge eating: a systematic review and meta-analysis of...

Binge eating behavior and food craving are associated with altered reward sensitivity and impaired inhibitory control, contributing to physical and psychological consequences. Neurofeedback (NFB) has emerged as a promising non-invasive intervention for reducing binge eating behaviors, yet its overall efficacy remains unclear and warrants quantitative synthesis. A systematic search was conducted across MEDLINE, CENTRAL, EMBASE, ClinicalTrial.gov, and PubMed to identify randomized controlled trials (RCTs) of NFB interventions for binge eating behaviors or binge eating disorder (BED) in adults. The primary outcome was food craving. The secondary outcomes were binge eating severity, binge eating frequency, and self-efficacy. Data synthesis was performed using a random-effects meta-analysis. Seven RCTs with 251 participants were included. NFB was associated with improved food craving (standard mean difference, SMD = -0.45, 95 % confidence interval, CI = -0.78 to -0.12) and binge eating frequency (SMD = -0.54, 95 % CI = -1.00 to -0.08) with moderate effect sizes. However, NFB did not significantly affect binge eating severity and self-efficacy (SMD = -0.22, 95 % CI = -0.56 to 0.12; SMD = 0.21, 95 % CI = -0.33 to 0.75). For food craving severity, NFB was more effective in non-clinical populations (SMD = -0.58, 95 % CI = -0.98 to -0.17) than in participants with BED (SMD = -0.20, 95 % CI = -0.84 to 0.44). NFB shows promise as a non-invasive intervention to reduce binge eating and food craving. Despite protocol variability and limited generalizability, its favorable safety profile and potential efficacy suggest it may serve as an adjunctive option for individuals with binge eating behaviors; however, the evidence remains preliminary and hypothesis-generating.