• Kelsey E Hagan, Ahmed Alasmar, Alexis Exum, Bernadette Chinn, and Kelsie T Forbush.
• Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: khagan@stanford.edu.
• Appetite. 2020 Aug 1; 151: 104710.

AbstractAttentional bias to food stimuli may contribute to the etiology and/or maintenance of overweight and obesity. We conducted a literature review and meta-analysis per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify the effect size associated with attentional bias to palatable food in persons with overweight/obesity across the age spectrum. Included studies measured attentional bias to food stimuli using two reaction-time tasks (dot-probe, emotional Stroop), eye-tracking methodology, and/or event-related potentials. Meta-analysis showed that persons with overweight/obesity did not differ from persons with a healthy weight on any of the following: automatic and maintained attention to food stimuli measured by the dot-probe task (Hedge's gautomatic = -0.355, 95% CI = -0.383, 0.486; and Hedge's gmaintained = 0.006, 95% CI = -0.187, 0.199); attentional bias to food stimuli measured by the emotional Stroop task (Hedge's g = 0.184, 95% CI = -0.283, 0.651); and attentional bias to food images on gaze-direction and gaze-duration bias eye-tracking metrics (Hedge's gdirection = 0.317, 95% CI = -0.096, 0.729; and Hedge's gduration = 0.056, 95% CI = -0.296, 0.407). Systematic review of preliminary event-related potentials research suggested automatic, but not maintained, attention to food images in persons with overweight/obesity. Limitations of past attentional bias research in overweight/obesity, such as poor reliability of measures and lack of consideration of moderators, such as binge eating and degree of overweight/obesity, preclude the ability to draw firm conclusions. We recommend implementation of empirically based methods for improving psychometric properties of attentional bias measures and examination of potential moderators so that the field can understand whether attentional bias to food is truly greater in overweight/obesity.Copyright © 2020 Elsevier Ltd. All rights reserved.

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