Food-related attentional bias and its associations with appetitive motivation and body weight : a systematic review and meta-analysis

Theoretical models suggest that food-related visual attentional bias (AB) may be related to appetitive motivational states and individual differences in body weight; however, findings in this area are equivocal. We conducted a systematic review and series of meta-analyses to determine if there is a positive association between food-related AB and: (1.) body mass index (BMI) (number of effect sizes (k)=110), (2.) hunger (k=98), (3.) subjective craving for food (k=35), and (4.) food intake (k=44). Food-related AB was robustly associated with craving (r = .134 (95% CI .061, .208); p < .001), food intake (r = .085 (95% CI .038, .132); p < .001), and hunger (r = .048 (95% CI .016, .079); p = .003), but these correlations were small. Food-related AB was unrelated to BMI (r =.008 (95% CI -.020, .035); p = .583) and this result was not moderated by type of food stimuli, method of AB assessment, or the subcomponent of AB that was examined. Furthermore, in a between-groups analysis (k = 22) which directly compared participants with overweight/obesity to healthy-weight control groups, there was no evidence for an effect of weight status on food-related AB (Hedge’s g = 0.104, (95% CI -0.050, 0.258); p =.186). Taken together, these findings suggest that food-related AB is sensitive to changes in the motivational value of food, but is unrelated to individual differences in body weight. Our findings question the traditional view of AB as a trait-like index of preoccupation with food and have implications for novel theoretical perspectives on the role of food AB in appetite control and obesity.