title: A Meta-analysis on Resting State High-frequency Heart Rate Variability in Bulimia Nervosa.
abstract: Autonomic nervous system function is altered in eating disorders. We aimed to quantify differences in resting state vagal activity, indexed by high-frequency heart rate variability comparing patients with bulimia nervosa (BN) and healthy controls.
  
  
  
  A systematic search of the literature to identify studies eligible for inclusion and meta-analytical methods were applied. Meta-regression was used to identify potential covariates.
  
  
  
  Eight studies reporting measures of resting high-frequency heart rate variability in individuals with BN (n = 137) and controls (n = 190) were included. Random-effects meta-analysis revealed a sizeable main effect (Z = 2.22, p = .03; Hedge's g = 0.52, 95% CI [0.06;0.98]) indicating higher resting state vagal activity in individuals with BN. Meta-regression showed that body mass index and medication intake are significant covariates.
  
  
  
  Findings suggest higher vagal activity in BN at rest, particularly in unmedicated samples with lower body mass index. Potential mechanisms underlying these findings and implications for routine clinical care are discussed. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, USA.
authors.forename: Stephanie K V
authors.initials: SK
authors.lastname: Peschel
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, USA.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Feeling
authors.affiliation: Institute for Health and Behaviour, Research Unit INSIDE, Campus Belval, University of Luxembourg, Luxembourg.
authors.forename: Claus
authors.initials: C
authors.lastname: Vögele
authors.affiliation: Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, USA.
authors.forename: Julian F
authors.initials: JF
authors.lastname: Thayer
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, USA.|Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Koenig
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002032:Bulimia / Q000503:physiopathology; D052018:Bulimia Nervosa / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D014630:Vagus Nerve / Q000503:physiopathology*
keywords: bulimia nervosa; eating disorder; heart rate; meta-analysis; vagus nerve; variability