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Loss of control over eating, inhibitory control, and reward sensitivity in children and adolescents: a systematic review

Ramalho, Sofia Marlene Marques; Conceição, Eva Martins; Tavares, Ana Cristina; Freitas, Ana Luísa; Machado, Bárbara Freire Brito César; Gonçalves, Sónia

Abstract

Overview: In recent years, there has been increasing clinical and empirical interest in the concept of pediatric loss of control over eating, particularly about its link with the executive functions related to the concept of impulsivity, such as inhibitory control and reward sensitivity. However, there has yet to be a comprehensive literature synthesis about the associations between these variables. A comprehensive literature synthesis would help identify future research directions to advance the field in this area. Therefore, this systematic review aimed to synthesize evidence concerning the associations between loss of control over eating, inhibitory control, and reward sensitivity in children and adolescents. Methods: The systematic review was conducted according to the guidelines proposed by PRISMA in Web of Science, Scopus, PubMed, and PsycINFO. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. Results: Twelve studies met the selection criteria and were included in the final review. Overall, methodological heterogeneity, variability in assessment methods, and the age of participants make it difficult to draw general conclusions. Nevertheless, most studies with community samples of adolescents indicate that inhibitory control difficulties are linked to the concept of loss of control eating. The presence of obesity seems to be associated with inhibitory control difficulties, regardless of the presence of loss of control eating. Studies on reward sensitivity are scarcer. However, it has been suggested that higher reward sensitivity is related to loss of control eating behaviors in young people, particularly binge eating. Conclusions: The literature on the link between loss of control eating and trait-level facets of impulsivity (low inhibitory control and higher reward sensitivity) among young people remains limited, and more studies on children are needed. Findings from this review may make healthcare professionals more aware of the potential clinical importance of targeting the trait-level facets of impulsivity and help to inform existing and future weight-loss/maintenance interventions in childhood and adolescence.

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Citation: Ramalho, S.M.; Conceição, E.; Tavares, A.C.; Freitas, A.L.; Machado, B.C.; Gonçalves, S. Loss of Control over Eating, Inhibitory Control, and Reward Sensitivity in Children and Adolescents: A Systematic Review. Nutrients 2023,15, 2673. https://doi.org/10.3390/ nu15122673 Academic Editor: Diane Gilbert-Diamond Received: 22 May 2023 Revised: 2 June 2023 Accepted: 6 June 2023 Published: 8 June 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). nutrients Systematic Review Loss of Control over Eating, Inhibitory Control, and Reward Sensitivity in Children and Adolescents: A Systematic Review Sofia Marques Ramalho 1,2,* , Eva Conceição3, Ana Cristina Tavares 3, Ana Luísa Freitas 3, Bárbara César Machado 4and Sónia Gonçalves 3 1Centro de Investigação em Psicologia para o Desenvolvimento (CIPD), 4100-346 Porto, Portugal 2Instituto de Psicologia e de Ciências da Educação, Universidade Lusíada (Porto), 4100-348 Porto, Portugal 3Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal; [email protected] (E.C.); [email protected] (A.C.T.); [email protected] (A.L.F.); [email protected] (S.G.) 4Research Centre for Human Development (CEDH), Faculdade de Educação e Psicologia, Portuguese Catholic University, 4169-005 Porto, Portugal; [email protected] *Correspondence: [email protected]; Tel.: +351-22-557-08-00 Abstract: Overview: In recent years, there has been increasing clinical and empirical interest in the concept of pediatric loss of control over eating, particularly about its link with the executive functions related to the concept of impulsivity, such as inhibitory control and reward sensitivity. However, there has yet to be a comprehensive literature synthesis about the associations between these variables. A comprehensive literature synthesis would help identify future research directions to advance the field in this area. Therefore, this systematic review aimed to synthesize evidence concerning the associations between loss of control over eating, inhibitory control, and reward sensitivity in children and adolescents. Methods: The systematic review was conducted according to the guidelines proposed by PRISMA in Web of Science, Scopus, PubMed, and PsycINFO. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. Results: Twelve studies met the selection criteria and were included in the final review. Overall, methodological heterogeneity, variability in assessment methods, and the age of participants make it difficult to draw general conclusions. Nevertheless, most studies with community samples of adolescents indicate that inhibitory control difficulties are linked to the concept of loss of control eating. The presence of obesity seems to be associated with inhibitory control difficulties, regardless of the presence of loss of control eating. Studies on reward sensitivity are scarcer. However, it has been suggested that higher reward sensitivity is related to loss of control eating behaviors in young people, particularly binge eating. Conclusions: The literature on the link between loss of control eating and trait-level facets of impulsivity (low inhibitory control and higher reward sensitivity) among young people remains limited, and more studies on children are needed. Findings from this review may make healthcare professionals more aware of the potential clinical importance of targeting the trait-level facets of impulsivity and help to inform existing and future weight-loss/maintenance interventions in childhood and adolescence. Keywords: systematic literature review; executive functions; loss of control over eating; adolescents; children 1. Introduction Pediatric Loss of control over eating (LOC-eating) can be characterized by the subjective perception of being compelled or unable to control the amount and type of food consumed among young people [ 1 ]. The experience of LOC-eating can be associated with different eating episodes regardless of the amount of food consumed [ 2 ]. LOC-eating often results in subjective distress and/or eating beyond the point of satiety being considered an obesogenic eating behavior frequent in youth with overweight/obesity [ 3 ]. When present Nutrients 2023,15, 2673. https://doi.org/10.3390/nu15122673 https://www.mdpi.com/journal/nutrients Nutrients 2023,15, 2673 2 of 16 in childhood, it tends to persist in up to 50% of children and young people [ 1 ]. LOC-eating prospectively predicts excess weight gain and is related to several adverse developmental outcomes and psychosocial impairments such as emotional stress, depressive symptomatology, weight-based teasing, dieting, and cognitive functioning difficulties [1,4–6]. The term “executive functions” relates to a multidimensional construct that encompasses several complex cognitive processes. Examples of these include decision-making, planning, attention, problem-solving, inhibitory control, working memory, cognitive flexibility, etc. [ 7 – 11 ]. Inhibitory control and reward sensitivity are two executive functions that fall under the broader construct of impulsivity—a multi-dimensional construct describing a predisposition to engage in behaviors with reduced planning and seeking immediate reward despite the long-term consequences [ 12 ]. The construct of inhibitory control involves the ability to overcome an internal predisposition or external attraction by controlling attention, behavior, thoughts, and/or emotions to accomplish what is most appropriate [ 12 ]. It interferes with goal-directed behavior [ 13 , 14 ]. On the other hand, reward sensitivity refers to trait-level reactivity and responsivity to rewarding stimuli, including motivation to seek out rewards and tendencies to engage in approach behaviors [13,15]. The study of these two executive functions is significant since they are specifically associated with the onset and maintenance of obesity and interact to promote problematic eating behaviors, such as LOC-eating in young people [ 16 – 19 ]. Nevertheless, there is a relative scarcity of research and mixed conclusions about the link between these two constructs and LOC-eating in young people [ 20 – 22 ], and an examination of the existing literature may provide novel conclusions and directions for future studies. To our knowledge, this is the first study that systematically reviews the scientific literature regarding the associations between LOC-eating and executive functions, inhibitory control, and reward sensitivity in children and adolescents across the weight spectrum. Its main goal was to provide a comprehensive assessment of the current empirical evidence and identify the research gaps related to this topic. This work specifically assesses whether the relationship between LOC-eating, inhibitory control, and/or reward sensitivity varies by weight status (healthy weight, overweight, obesity) and summarizes information on the measures/procedures used in the literature to assess inhibitory control, reward sensitivity, and LOC-eating in this particular age group (Figure 1). Findings from this review could contribute to informing treatment development and alert healthcare professionals of the clinical importance of targeting these executive functions and LOC-eating in their interventions to prevent and treat overweight/obesity in childhood and adolescence. Nutrients 2023, 15, x FOR PEER REVIEW 2 of 15 considered an obesogenic eating behavior frequent in youth with overweight/obesity [3]. When present in childhood, it tends to persist in up to 50% of children and young people [1]. LOC-eating prospectively predicts excess weight gain and is related to several adverse developmental outcomes and psychosocial impairments such as emotional stress, depressive symptomatology, weight-based teasing, dieting, and cognitive functioning difficulties [1,4–6]. The term “executive functions” relates to a multidimensional construct that encompasses several complex cognitive processes. Examples of these include decisionmaking, planning, aention, problem-solving, inhibitory control, working memory, cognitive flexibility, etc. [7–11]. Inhibitory control and reward sensitivity are two executive functions that fall under the broader construct of impulsivity—a multi-dimensional construct describing a predisposition to engage in behaviors with reduced planning and seeking immediate reward despite the long-term consequences [12]. The construct of inhibitory control involves the ability to overcome an internal predisposition or external araction by controlling aention, behavior, thoughts, and/or emotions to accomplish what is most appropriate [12]. It interferes with goal-directed behavior [13,14]. On the other hand, reward sensitivity refers to trait-level reactivity and responsivity to rewarding stimuli, including motivation to seek out rewards and tendencies to engage in approach behaviors [13,15]. The study of these two executive functions is significant since they are specifically associated with the onset and maintenance of obesity and interact to promote problematic eating behaviors, such as LOC-eating in young people [16–19]. Nevertheless, there is a relative scarcity of research and mixed conclusions about the link between these two constructs and LOC-eating in young people [20–22], and an examination of the existing literature may provide novel conclusions and directions for future studies. To our knowledge, this is the first study that systematically reviews the scientific literature regarding the associations between LOC-eating and executive functions, inhibitory control, and reward sensitivity in children and adolescents across the weight spectrum. Its main goal was to provide a comprehensive assessment of the current empirical evidence and identify the research gaps related to this topic. This work specifically assesses whether the relationship between LOC-eating, inhibitory control, and/or reward sensitivity varies by weight status (healthy weight, overweight, obesity) and summarizes information on the measures/procedures used in the literature to assess inhibitory control, reward sensitivity, and LOC-eating in this particular age group (Figure 1). Findings from this review could contribute to informing treatment development and alert healthcare professionals of the clinical importance of targeting these executive functions and LOC-eating in their interventions to prevent and treat overweight/obesity in childhood and adolescence. Figure 1. Hypothesized associations among Executive Functions, Problematic Eating Behaviors and Weight Status. Note: ↑ arrow indicates increase. ↓ arrow indicates decrease. Bidirectional arrows indicate reciprocal influences between Problematic Eating Behaviors and other variables. Figure 1. Hypothesized associations among Executive Functions, Problematic Eating Behaviors and Weight Status. Note: ↑ arrow indicates increase. ↓ arrow indicates decrease. Bidirectional arrows indicate reciprocal influences between Problematic Eating Behaviors and other variables. 2. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [23]. Nutrients 2023,15, 2673 3 of 16 2.1. Search Strategy A search was conducted up to February 2021 on the following databases: Web of Science, Scopus, PubMed, and PsycINFO. The following terms were searched: adolescence, adolescents, child, children, youth, executive function, inhibition, inhibitory control, reward, reward sensitivity, impulsivity, loss of control over eating, loss of control eating, uncontrolled eating, dysregulated eating, and binge eating. Titles and abstracts of the studies identified through the keyword search were screened against the study selection criteria. Eligible articles were retrieved, and their full texts were assessed. Two co-authors independently performed title and abstract screening. Discrepancies were resolved through discussion under the participation of a third co-author. The search algorithm strategy is provided in the Supplementary Materials. 2.2. Study Selection Criteria Studies that met all of the following criteria were included in the review: (1)study designs—experimental (e.g., randomized controlled trials or pre-post-studies) and observational studies (e.g., longitudinal or cross-sectional studies) with humans; (2) study subjects—children and/or adolescents with ages ranging from 7 to 18 years old (the rationale behind selecting this age range is grounded in the reading ability and in available self-report measures in the literature to assess eating behavior in infancy since we want to exclude papers using parent proxy-report data); (3) outcomes—Problematic eating behaviors associated with LOC-eating (e.g., binge eating; uncontrolled eating, LOC-eating) and at least assess one of the following executive functions: inhibitory control and reward sensitivity; (4) article type—peer-reviewed journal publications; (5) time window of search—from January 2000 to February 2021; and (6) language—articles written in English or Portuguese. Duplicate studies and studies that met any of the following criteria were excluded from the review: (1) Studies that examined either samples with bulimia nervosa or anorexia nervosa since the focus of our work was on community samples and samples with overweight/obesity; (2) studies that include participants with a neurodevelopmental disorder (e.g., attention-deficit/hyperactivity disorder) that may influence their performance in executive functioning. If the study includes participants with and without these conditions, only results from participants without these conditions will be analyzed and described; (3) studies that only report an overall executive functioning score or do not provide it in the results, conclusion, and/or discussion sections information about the associations’ under study; and (4) book/book chapters, thesis, letters, editorials, study/review protocols, case reports, meta-analysis, or narrative or systematic review articles. 2.3. Data Extraction and Synthesis A standardized data extraction form was used to collect the following information from each included study: (1) study identification (title; journal; authors; language; year of publication); (2) methodological characteristics (study design and aims; executive functions assessed; measures used to assess the LOC-eating and the inhibitory control and/or reward sensitivity; sample characteristics (sample size, sex, age, and BMI z-score); and (3) key outcomes/conclusions regarding the relationship between LOC-eating, inhibitory control, and reward sensitivity. Two co-authors independently conducted the data extraction. After the initial screening of the study title, abstract, and type (e.g., RCT, etc.), the full texts of potential studies were screened in order to determine eligibility for inclusion. Study exclusion motives were documented. Final results were compared and conflicts between reviewers were resolved through discussion with a third co-author. 2.4. Assessment of Risk of Bias Two independent reviewers used the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies—National Institutes of Health [ 24 ] to assess the risk of bias in the cross-sectional/observational studies included in this systematic review and the strength of their scientific evidence (not to determine the study inclusion). Disagreements were Nutrients 2023,15, 2673 4 of 16 resolved by discussion and consultation with a third reviewer. For each of the 14 criteria, a score of 1 was assigned if “yes” was the response, whereas a score of 0 was assigned otherwise. A study-specific global score, ranging from 0 to 14, was calculated by summing up scores across all criteria. Quality was rated as poor (0–4 “yes” answers out of 14 questions), fair (5–10 “yes” answers out of 14 questions), or good (11–14 “yes” answers out of 14 questions). 3. Results 3.1. Study Selection Figure 2shows the PRISMA study selection flowchart. A total of 919 articles were identified through the databases (367 in Web of Science, 357 in Scopus, 95 in PubMed, and 100 in PsycINFO). No additional sources were considered. After removing duplicates, 473 articles underwent title and abstract screening, of which 454 were excluded according to the study selection criteria. This selection process resulted in the full-text examination of 19 articles, of which 7 articles were excluded for the following reasons: (a) they did not present data regarding the associations between LOC-eating and inhibitory control and/or reward sensitivity in the results, conclusion, or discussion sections (n= 4); (b) they presented a global measure of eating behavior psychopathology, but did not explicitly evaluate LOC-eating (n= 1); (c) they assessed general executive functioning rather than inhibitory control/reward sensitivity scores (n= 1); and (d) the results regarding the relationship between LOC-eating and inhibitory control did not contain any data for the sample without attention-deficit/hyperactivity disorder. Therefore, a total of 12 articles were included in this review [18,25–35]. 3.2. Study Characteristics Table 1summarizes the characteristics of the twelve studies included in this systematic review regarding their sample size/characteristics, measures used to assess inhibitory control, reward sensitivity, LOC-eating, and main conclusions. Despite the inclusion of a study with a prospective design, the remaining studies followed a crosssectional/observational study design. The age of participants across studies ranged from 8 to 18 years. One study was conducted exclusively with a sample of female adolescents [ 31 ], and the remaining studies involved participants from both sexes. The percentage of females ranged from 52% to 81.8%. The study sample size varied substantially across studies, from 40 to 4803 participants. Six studies focused exclusively on a community sample of adolescents [25,27,29–31,35], three studies focused on the comparison between children/adolescents with overweight/obesity, healthy weight, and/or binge-eating disorder [ 26 , 28 , 34 ], and one study focused exclusively on children and adolescents with overweight/obesity [ 18 ]. The research measures used in these studies include mostly behavioral tasks (one during fMRI) and self-report measures [26]. 3.3. Quality Assessment Table 2describes the criterion-specific report of the studies identified as relevant for this review, considering the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies [ 24 ]. Of the twelve studies included in the review, ten were classified as “fair” (5–10 out of 14 questions), and two were rated as “good” (11–14 out of 14 questions). All studies clearly defined the research questions and study population. The participant rate was representative of the target population, and all of them indicated eligibility criteria and how participants were recruited, clearly defining the independent and dependent variables under study. All of the studies took into account the potential impact of confounding variables in their statistical analysis. Yet, except for the studies conducted by Van Malderen et al. [ 35 ] and Goldschmidt et al. [ 34 ], the remaining ten studies did not provide a sample size justification. Nutrients 2023,15, 2673 5 of 16 Table 1. Characteristics of the studies included in the review. Author/Year Sample Characteristics Measures Key Findings Population Sample Size Age Range (M,SD)Female % Inhibitory Control Reward Sensitivity Loss of Control Eating Van Malderen et al. (2021) [35] Adolescents Community Sample N= 50 10–18 years (14.22, 2.58) 76% “Behavior Rating Inventory of Executive Function” (BRIEF)—“inhibition subscale” _________ Loss of Control over Eating Scale-Brief (LOCES-B) – In the neutral condition (no negative mood induction), inhibition subscale scores were not significantly associated with loss of control eating. – In the condition where negative mood was induced, low inhibitory control was positively associated with loss of control eating. Nelson et al. (2020) [30] Adolescents Community Sample N= 208 14–16 years (14.5, 0.75) 52% “GO/No-GO Task” “Behavioral rating inventory of executive function, second edition” (BRIEF-2)—“inhibit subscale” __________ “Three Factor Eating Questionnaire R-18” (TFEQ-R18)—scale: “uncontrolled eating” – The inhibit subscale significantly and uniquely predicted uncontrolled eating (more inhibitory control difficulties associated with greater loss of control eating). – Performance on the Go/No-Go task was not a significant predictor of uncontrolled eating. Schaumberg et al. (2020) [33] Children and adolescents Community Sample N= 4803 8; 10; 14; 16; 18 years _________ “Stop signal task” “Opposite worlds task” __________ “Youth Risk Behaviour Surveillance System questionnaire” – Measures of inhibition did not show a relationship with eating disorder symptoms throughout adolescence. – Higher scores on the Stop Signal Task (reflecting greater inhibitory control) were associated with decreased risk of binge eating disorder at age 14. – No consistent relationships were found between inhibition difficulties and binge eating. Van Malderen et al. (2019) [29] Adolescents Community Sample N= 301 10–17 years (13.46, 1.99) 67.2% “Behavior Rating Inventory of Executive Function (BRIEF)”—“inhibition subscale” _________ “Children’s Eating Disorder Examination Questionnaire” (ChEDE-Q) – The results provided no evidence for the unique effects of inhibitory control in predicting binge eating. Nutrients 2023,15, 2673 6 of 16 Table 1. Cont. Author/Year Sample Characteristics Measures Key Findings Population Sample Size Age Range (M,SD)Female % Inhibitory Control Reward Sensitivity Loss of Control Eating Munsch et al. (2019) [32] Children Community Sample N= 100 8–13 years 57% ___________ “Door opening task” (DOT) “Delay of gratification task” (DoGT) “Eating Disorder Examination adapted for Children” (ChEDE) – No significant differences were found in the level of reward sensitivity between children with and without loss of control eating. Goldschmidt et al. (2019) [19] Children and adolescents with overweight/ obesity N= 40 8–14 years (11.15, 1.89) 55% “Groton Maze Timed Chase Task” (GMTCT) “Sensitivity to Punishment and Sensitivity to Reward Questionnaire for children” (SPSRQ-C) “Child Eating Disorder Examination 12.0” (ChEDE) – Higher numbers of errors on a behavioral measure of visuo-motor processing (reflecting less inhibitory control) were related to a greater overall severity of loss of control eating. – The results suggest that impulsivity and inhibitory control may influence an individual’s tendency to engage in disordered eating behaviors. – No effect was found for reward sensitivity on loss of control in eating. Van Malderen et al. (2018) [25] Adolescents Community Sample N= 124 10–17 years (14, 1.90) 65.3% “Behavior Rating Inventory of Executive Function” (BRIEF)—“inhibition subscale” “Behavioral Inhibition Scale” (BIS) “Behavioral Activation Scale” (BAS) “Children’s Eating Disorder Examination” (Ch-EDE) – There were no significant differences between the group that experienced loss of control in eating and the group that did not, in the subscale measuring inhibition. – The reward sensitivity scale did not play a significant moderating role in the relationship between the inhibition subscale and loss of control eating. Goldschmidt et al. (2018) [34] Children of a healthy weight, overweight children, and obese children N= 75 9–12 years (10.5, 1.1) 58.7% “Flanker Test” “Dimensional Change Card Sort Test” _________ “Child Eating Disorder Examination 12.0” (Child EDE) – The results of behavioral measures (neurocognitive tasks) that assessed inhibitory control did not differ between the groups (healthy weight control group, overweight control group, and overweight group with loss of control eating). Nutrients 2023,15, 2673 7 of 16 Table 1. Cont. Author/Year Sample Characteristics Measures Key Findings Population Sample Size Age Range (M,SD)Female % Inhibitory Control Reward Sensitivity Loss of Control Eating Bodell et al. (2018) [31] Female adolescents’ Community Samples N= 122 16; 18 years 100% _____________ “Event-related reward-guessing task during an fMRI scan” “The Eating Attitudes Test” (EAT) – Compared to participants without binge eating disorder, participants prone to binge eating episodes showed a greater response from the caudate nucleus in a task with a monetary reward. – The results showed an association between greater activation of the ventro medial prefrontal cortex during reward receipt and the severity of binge eating. – No prospective association was found between ventromedial prefrontal cortex activation and binge eating. Kittel et al. (2017) [28] Adolescents with Binge Eating Disorders + Obesity (BED), with Obesity (O), and with healthy weight (N) N(BED) = 22 N(O) = 22 N(N) = 22 BED = (14.91, 2.22) O = (14.82, 2.63) N= (15.23, 2.39) BED = 81.8% O = 81.8% N= 81.8% “Stroop Color–Word Interference Test” ___________ “Eating Disorder Examination” (EDE) – In the task assessing inhibitory control (reflecting lower inhibitory control), compared to adolescents with healthy weight, the group of adolescents with binge eating disorder and obesity and the group of adolescents with just obesity showed no differences in performance. Ames et al. (2014) [27] Adolescents’ Community Samples N= 198 14–17 years (15.84, 0.94) 56.1% “Go/No-Go task” (food cued Go/NoGo and generic Go/No-Go) ___________ “Eating Disorder Diagnostic Scale”—“Binge Eating Subscale” – Greater inhibition difficulties, as assessed by the Go/NoGo tasks, were significantly associated with binge eating in the girls’ sample. – Inhibition difficulties on the generic Go/NoGo task were significantly associated with binge eating behavior and BMI percentile. Nutrients 2023,15, 2673 8 of 16 Table 1. Cont. Author/Year Sample Characteristics Measures Key Findings Population Sample Size Age Range (M,SD)Female % Inhibitory Control Reward Sensitivity Loss of Control Eating Nederkoorn et al. (2006) [26] Children with obesity (O); with obesity and binge eating (O+C); with obesity without binge eating (O−C); with healthy weight (N) N(O) = 32 N(O + C) = 15 N(O − C) = 15 N(N) = 31 O = 12–15 years (13.7) O + C = 12–15 years (13.7) O−C = 12–15 years (13.9) N= 13–15 years (13.7) O = 19/32 O + C = 10/15 O−C = 9/15 N= 19/31 “Stop Signal Task” “The opening door task” “Eating Disorder Examination— Questionnaire” (EDE-Q) – Children with obesity and who are prone to binge eating episodes and children with obesity but do not struggle with binge eating did not differ in inhibitory control. – Children with obesity and who are prone to binge eating were more sensitive to reward than children with obesity but do not struggle with binge eating. Note: In Munsch et al. (2019) [32], only the results of participants without attention deficit/hyperactivity disorder were analyzed and reported. Nutrients 2023,15, 2673 9 of 16 Table 2. Study quality assessment. Autor/Year Q1—Research Question QQ2—Study Population Q3—Participation Rate Q4—Recruitment and Eligibility Criteria Q5—Sample Size Justification Q6—Exposure Assessed Prior to Outcome Measurement Q7—Sufficient Timeframe to See an Effect Q8—Different Exposure Levels of Interest Q9—Exposure Measures and Assessment Q10—Repeated Exposure Assessment Q11—Outcome Measures Q12—Blinding of Outcome Assessors Q13—Follow-up Rate Q14—Statistical Analyses Total Score Overall Article Quality Van Malderen et al. (2021) [ 35 ] Yes Yes Yes Yes Yes No No N.A. Yes N.A. Yes N.R. N.A. Yes 8 Fair Nelson et al. (2020) [30] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Schaumberg et al. (2020) [33] Yes Yes Yes Yes No Yes Yes N.A. Yes Yes Yes N.A. Yes Yes 11 Good Van Malderen et al. (2019) [ 29 ] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Munsch et al. (2019) [32] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Goldschmidt et al. (2019) [18] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Van Malderen et al. (2018) [ 25 ] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Goldschmidt et al. (2018) [34] Yes Yes Yes Yes Yes No No N.A. Yes N.A. Yes N.A. N.A. Yes 8 Fair Bodell et al. (2018) [31] Yes Yes Yes Yes No Yes Yes N.A. Yes Yes Yes N.A. N.R. Yes 10 Good Kittel et al. (2017) [28] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Ames et al. (2014) [27] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Nederkoorn et al. (2006) [26] Yes Yes Yes Yes No No No N.A. Yes N.A. Yes N.A. N.A. Yes 7 Fair Note: This study quality assessment was adopted from the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies Quality was rated as poor (0–4 yes answers out of 14 questions), fair (5–10 yes answers out of 14 questions), or good (11–14 yes answers out of 14 questions); N.A.—Not applicable; N.R.: Not Reported. Nutrients 2023,15, 2673 16 of 16 46. Manly, T.; Anderson, V.; Nimmo-Smith, I.; Turner, A.; Watson, P.; Robertson, I.H. The Differential Assessment of Children’s Attention: The Test of Everyday Attention for Children [TEA-Ch], Normative Sample and ADHD Performance. J. Child Psychol. Psychiatry 2001,42, 1065–1081. [CrossRef] [PubMed] 47. Eriksen, B.A.; Eriksen, C.W. Effects of noise letters upon the identification of a target letter in a nonsearch task. Percept. Psychophys. 1974,16, 143–149. [CrossRef] 48. Zelazo, P.D. The Dimensional Change Card Sort [DCCS]: A method of assessing executive function in children. 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