Micro-Level Attention Bias and Affect Dynamics Predict Binge Eating and Subsequent Weight Change in Adults With...

Affect regulation models posit that binge eating serves to reduce negative affect (NA) or increase positive affect (PA), and attention bias (AB) toward food cues may represent a cognitive mechanism that increases vulnerability to affect-driven binge eating. This study examined whether momentary AB toward high-calorie processed food cues strengthens associations between affect and binge-eating symptoms in daily life, and explored whether person-specific indices of these associations predict 6-month outcomes.

Adults with binge-eating disorder (BED) and subthreshold BED (N = 46) completed a 14-day ecological momentary assessment (EMA) protocol that included a smartphone-based dot-probe task. Generalized linear mixed models examined whether momentary AB moderated associations between affect and subsequent binge-eating symptoms. Person-specific slopes derived from EMA data were then examined as predictors of 6-month percent weight change and eating disorder severity.

A significant within-person interaction emerged between NA and AB, indicating that the association between elevated NA and subsequent binge-eating symptoms was stronger at moments characterized by greater AB toward high-calorie processed food cues. No significant effects emerged for PA. Prospectively, stronger person-specific associations between NA and binge-eating symptoms predicted greater percent weight gain over 6 months. Person-specific effects did not predict eating disorder severity at follow-up.

Findings support a role for food-cue attentional processes in binge-eating risk in daily life, such that momentary AB toward high-calorie processed food cues may potentiate associations between NA and binge eating in adults with BED. Results also suggest that NA-binge eating coupling may represent a prognostic marker of subsequent weight gain in BED.