Resting state heart rate variability in clinical and subthreshold disordered eating: A meta‐analysis

Objective Research has demonstrated mixed results regarding the direction of the association between vagal activation and disordered eating. The current meta‐analysis examined studies testing the link between resting‐state heart rate variability indices of vagal activation (vmHRV), and both clinical and subthreshold disordered eating. Method A systematic search of the literature resulted in the inclusion of studies that were correlational (associations between HRV and disordered eating symptoms) and that examined group differences (e.g., control group vs. disordered eating group), for a total of 36 samples. Results Findings indicated a small but reliable association of vmHRV with disordered eating, r = 0.12, indicating greater vagal activation in individuals with disordered eating compared to those with little or no disordered eating behavior. Moderation analyses identified predictors of the vmHRV/disordered eating association. Bulimia nervosa was found to have a large, positive effect size with vmHRV, r = 0.60, which was significantly greater than all other types of disordered eating, Q T = 10.74, p = .047. Compared to subthreshold disordered eating, clinical eating disorders demonstrated significant, persistent increased vagal activation with a medium, reliable effect size, r = 25, QT = 3.94, p = .045. Conclusion These insights contribute to an improved understanding of the pathophysiology in disordered eating.