Micro‐Level Attention Bias and Affect Dynamics Predict Binge Eating and Subsequent Weight Change in Adults With Binge‐Eating Disorder

OBJECTIVE: Affect regulation models posit that binge eating serves to reduce negative affect (NA) or increase positive affect (PA), and attention bias (AB) toward food cues may represent a cognitive mechanism that increases vulnerability to affect-driven binge eating. This study examined whether momentary AB toward high-calorie processed food cues strengthens associations between affect and binge-eating symptoms in daily life, and explored whether person-specific indices of these associations predict 6-month outcomes. METHOD: Adults with binge-eating disorder (BED) and subthreshold BED (N = 46) completed a 14-day ecological momentary assessment (EMA) protocol that included a smartphone-based dot-probe task. Generalized linear mixed models examined whether momentary AB moderated associations between affect and subsequent binge-eating symptoms. Person-specific slopes derived from EMA data were then examined as predictors of 6-month percent weight change and eating disorder severity. RESULTS: A significant within-person interaction emerged between NA and AB, indicating that the association between elevated NA and subsequent binge-eating symptoms was stronger at moments characterized by greater AB toward high-calorie processed food cues. No significant effects emerged for PA. Prospectively, stronger person-specific associations between NA and binge-eating symptoms predicted greater percent weight gain over 6 months. Person-specific effects did not predict eating disorder severity at follow-up. DISCUSSION: Findings support a role for food-cue attentional processes in binge-eating risk in daily life, such that momentary AB toward high-calorie processed food cues may potentiate associations between NA and binge eating in adults with BED. Results also suggest that NA-binge eating coupling may represent a prognostic marker of subsequent weight gain in BED.