Food-related attentional biases in restrained eaters: A meta-analysis

Objective: Dietary restraint may contribute to the development and maintenance of eating disorders (EDs), with food-related attentional biases (ABs) as a key underlying mechanism. We examined associations between dietary restraint and ABs and explored how several methodological factors (i.e. AB mechanism, mode of AB investigation, response task type, stimulus task relevance, type of food stimulus) might influence these associations. Method: Database searches followed the guidelines set by the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA; Page et al, 2021). We included empirical studies that measured both dietary restraint and ABs, excluding studies involving participants with clinical diagnoses or below 16 years of age. Fifty-one eligible articles were identified, of which 29 unique samples were included in the final analyses. The protocol for this meta-analysis was preregistered at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=532562 Results: We first examined associations between dietary restraint and attentional maintenance and orienting, separately. This was followed by subgroup analyses to examine whether these associations varied based on the chosen methodological factors. Our findings revealed significant associations between dietary restraint and attentional maintenance in studies that used response tasks (other than the dot probe task), and where the food stimuli were relevant to the task instructions. Discussion: Collectively, these findings suggest that dietary restrainers activated strategic top-down processing of foods cues, rather than the reflexive orienting linked to ED-driven saliency processing. Overall, this may be interpreted as more purposeful monitoring to facilitate restraint when food is relevant to the goals and actions of dietary restrainers.