Biased self-body processing in bulimia nervosa: Combining eye tracking and event-related potentials

Bulimia nervosa (BN) has been linked to biases in self-body processing. Due to the particular importance of attentional biases, the aim of the current study was to further investigate their robustness in a large sample of females with BN or subthreshold BN (BN group) and a control group with low body dissatisfaction (LBD group) and comparable age and body mass index. Using a combined eye-tracking and electroencephalogram paradigm, we assessed overt attention orienting while viewing images of the self-body and neurophysiological correlates of attentional, emotional, and motivational processes when self-defined most unattractive body parts were fixated first. As hypothesized, the BN group (n = 69) exhibited a stronger attention bias toward self-defined most unattractive body parts compared with the LBD group (n = 37), as indicated by a higher number of fixations and longer fixation time on these regions relative to the self-defined most attractive body parts. Event-related potentials showed a higher mean amplitude of the early posterior negativity in the BN group (n = 59) compared with the LBD group (n = 27), indicating higher emotional salience of self-defined most unattractive body parts. Although the late positive potential is also typically modulated by the intensity of emotional stimuli, there were no group differences in late positive potential amplitude. This could reflect attentional avoidance and reduced elaborative processing at later stages following an initially increased attention allocation in the BN group. Future studies should aim to test this interpretation. Overall, our findings provide evidence for biased self-body processing in individuals with BN. (PsycInfo Database Record (c) 2026 APA, all rights reserved).