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

: Recent research has increasingly explored the cognitive processes underlying eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified feeding or eating disorders (OSFEDs), and individuals with higher weight (HW). This critical narrative review focuses on neurocognitive findings derived from mainly experimental tasks to provide a detailed understanding of cognitive functioning across these groups. Where experimental data are lacking, we draw on self-report measures and neuroimaging findings to offer supplementary insights. A search of major databases that prioritized meta-analyses and recent publications (last 10 years) was conducted. Using comprehensive search terms related to EDs, HW, and neurocognition, eligible studies focused on human neurocognitive outcomes (e.g., cognitive flexibility, attentional bias, etc.) published in English were selected. We found that some neurocognitive characteristics, such as cognitive rigidity, impulsivity, emotion processing difficulties, and dysregulated reward processing, appear transdiagnostic, spanning multiple ED subtypes and HW populations. We also revealed neurocognitive features specific to ED subtypes and HW. For instance, individuals with AN demonstrate an enhanced focus on detail, and BN and BED are characterized by a pronounced attentional bias toward food-related stimuli. In individuals with HW, cognitive processes underpin behaviours associated with overeating and weight gain. These findings highlight the critical importance of understanding both the unique and shared neurocognitive patterns across ED subtypes and HW populations. By identifying transdiagnostic factors, such as cognitive rigidity and reward processing, alongside ED subtype/HW-specific vulnerabilities, researchers and clinicians can develop more nuanced, evidence-based interventions that address the core mechanisms driving disordered eating behaviours.