title: Impulsivity in binge eating disorder: food cues elicit increased reward responses and disinhibition.
abstract: BACKGROUND
  Binge eating disorder (BED) represents a distinct eating disorder diagnosis. Current approaches assume increased impulsivity to be one factor leading to binge eating and weight gain. We used eye tracking to investigate both components of impulsivity, namely reward sensitivity and rash-spontaneous behaviour towards food in BED for the first time.
  
  
  METHODS
  Overweight and obese people with BED (BED+; n = 25), without BED (BED-; n = 26) and healthy normal-weight controls (NWC; n = 25) performed a free exploration paradigm measuring reward sensitivity (experiment 1) and a modified antisaccade paradigm measuring disinhibited, rash-spontaneous behaviour (experiment 2) using food and nonfood stimuli. Additionally, trait impulsivity was assessed.
  
  
  RESULTS
  In experiment 1, all participants located their initial fixations more often on food stimuli and BED+ participants gazed longer on food stimuli in comparison with BED- and NWC participants. In experiment 2, BED+ participants had more difficulties inhibiting saccades towards food and nonfood stimuli compared with both other groups in first saccades, and especially towards food stimuli in second saccades and concerning sequences of first and second saccades. BED- participants did not differ significantly from NWC participants in both experiments. Additionally, eye tracking performance was associated with self-reported reward responsiveness and self-control.
  
  
  CONCLUSIONS
  According to these results, food-related reward sensitivity and rash-spontaneous behaviour, as the two components of impulsivity, are increased in BED in comparison with weight-matched and normal-weight controls. This indicates that BED represents a neurobehavioural phenotype of obesity that is characterised by increased impulsivity. Interventions for BED should target these special needs of affected patients.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schag
authors.forename: Martin
authors.initials: M
authors.lastname: Teufel
authors.forename: Florian
authors.initials: F
authors.lastname: Junne
authors.forename: Hubert
authors.initials: H
authors.lastname: Preissl
authors.forename: Martin
authors.initials: M
authors.lastname: Hautzinger
authors.forename: Stephan
authors.initials: S
authors.lastname: Zipfel
authors.forename: Katrin Elisabeth
authors.initials: KE
authors.lastname: Giel
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000150:complications*; D003463:Cues; D005260:Female; D005403:Fixation, Ocular; D005502:Food; D006801:Humans; D007175:Impulsive Behavior / Q000150:complications*; D007266:Inhibition, Psychological; D010775:Photic Stimulation; D012201:Reward; D012438:Saccades / Q000502:physiology