Reward and Inhibitory Control as Mechanisms and Treatment Targets for Binge Eating Disorder

PURPOSE OF REVIEW: Recent research has highlighted alterations in reward and inhibitory control among individuals with binge eating disorder, identifying both constructs as potential targets for treatment. Treatments targeting reward and inhibitory control for binge eating disorder are emerging. This review aims to summarize the recent literature evaluating reward and inhibitory control in binge eating disorder compared to weight-matched controls using behavioral paradigms and neuroimaging. This review also aims to summarize recent literature evaluating treatments for binge eating targeting these mechanisms and highlights additional work needed in these areas. RECENT FINDINGS: Reward hypersensitivity and impaired inhibitory control are mechanisms underlying binge eating disorder. Individuals with binge eating disorder experience higher initial reward to food, and later, higher anticipatory reward but lower experienced food reward which maintains binge eating behavior. Treatments targeting reward and inhibitory control for binge eating include behavioral, computerized trainings, pharmacological, and neuromodulation treatments. The majority of trials are small but demonstrate promise in reducing binge eating and targeting theorized mechanisms. Larger, randomized trials are needed. Changes in reward and inhibitory control are present in individuals with binge eating disorder and treatments targeting these mechanisms demonstrate initial promise. Greater research is needed evaluating reward and inhibitory control simultaneously and with weight-matched comparison groups, as well as larger randomized trials that target both processes simultaneously.