A Narrative Review on the Neurocognitive Profiles in Eating Disorders and Higher Weight Individuals: Insights for Targeted Interventions

Background: /Objectives: Recent research has increasingly focused on the neurocognitive characteristics associated with eating disorders (EDs), including, anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified feeding or eating disorders (OSFED) and individuals of higher weight (HW). This critical narrative review summarizes recent findings on neurocognitive processes across the weight spectrum, emphasizing implications for diagnosis and treatment. Results: Our review highlights that individuals with AN, especially the restrictive subtype of AN, exhibit reduced cognitive flexibility and increased attention to detail. In BN and BED, cognitive profiles are also marked by cognitive rigidity as well as impaired decision-making and impulsivity, with dysregulated reward processing and attentional bias toward food-related signals and reward sensitivity. OSFED presents a diverse neurocognitive profile, necessitating more focused research to delineate its specific characteristics. Finally, neurocognitive studies in individuals with HW highlight deficits in cognitive flexibility, increased impulsivity, and altered reward processing. These cognitive impairments may contribute to the intricate interplay of factors underlying overeating behaviours and subsequent weight gain. Conclusions: Comparing these profiles across the weight spectrum underscores unique and shared impairments, emphasizing the complexity of neurocognitive mechanisms in relation to body mass index (BMI) and eating behaviours. Future research should prioritize longitudinal and intervention studies to elucidate causal relationships and explore cognitive training, virtual reality, and neuromodulation techniques, ultimately informing more personalized treatment strategies for EDs.