Feedback-Based Treatments for Eating Disorders and Related Symptoms: A Systematic Review of the Literature
Open accessAbstract
The effectiveness of biofeedback and neurofeedback has been investigated in a range of psychiatric disorders. However, to date, there are few studies on the clinical usefulness of feedback-based techniques for eating disorders (EDs) and EDs-related symptoms (e.g., food craving). A systematic search of PubMed, Scopus and PsychINFO identified 162 articles. Among these, thirteen studies exploring the therapeutic use of biofeedback and neurofeedback in EDs or EDs-related symptoms were included. Biofeedback and neurofeedback were implemented respectively in five and eight of all reviewed articles. No studies incorporated different feedback modalities or both biofeedback and neurofeedback. The considered studies provide preliminary data of the usefulness of feedback-based techniques in the treatment of several dysfunctional eating behaviors (e.g., food craving, rumination). Although no significant effect has been reported for other important EDs-related symptoms (i.e., body image disturbance), feedback-based techniques are also associated with significant modifications of both sympathetic reaction to food-related stimuli and brain activity in several regions of the reward system (e.g., insula). Taken together the results of the present review suggest that feedback-based treatments may be useful in the treatment of several dysfunctional eating behaviors operating both on top-down and bottom-up individual coping strategies. Methodological and clinical issues are also discussed.
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Patients with mental health disorders benefit from feedback-based therapies.
“Overall, current research has already extensively demonstrated that patients with mental health disorders benefit from feedback-based therapies.”
From Evaluation of a manualised neurofeedback training in psychosomatic-psychotherapeutic outpatient treatment (Neuro-pp-out): study protocol for a clinical mixed-methods pilot study (2024) · cites this paper as [10]
The Discussion (page unavailable) reports preliminary benefits of biofeedback and neurofeedback for some eating-disorder-related behaviors. It does not establish that patients with mental health disorders generally benefit, and it cautions that most reviewed studies had a high risk of bias. The claim’s wording, particularly “extensively demonstrated,” overstates the evidence this review presents. (LLM, conf=0.88)
Experimental — accuracy not yet measuredRisks or harms that could affect patients during the study are not anticipated, nor are harms or serious adverse events, based on published literature in similar trials.
“Risks or harms that could affect patients during the study are not anticipated, nor are harms or serious adverse events. In case of unexpected disadvantage or serious adverse events, they are documented and reported by the study team. During the trial, patients have contact with a member of the study team. The risk of the proposed trial was evaluated based on published literature in similar trials”
From Evaluation of a manualised neurofeedback training in psychosomatic-psychotherapeutic outpatient treatment (Neuro-pp-out): study protocol for a clinical mixed-methods pilot study (2024) · cites this paper as [10]
The Introduction (page unavailable) says feedback-based treatments are not related to side effects, supporting the expectation of low harm. It does not assess the proposed trial’s risks or specifically address serious adverse events in similar trials. (LLM, conf=0.84)
Experimental — accuracy not yet measuredFeedback-based therapies have been used in psychosomatic medicine for depression and anxiety disorders, post-traumatic stress disorder, and eating disorders.
“feedback-based therapies have been used for depression and anxiety disorders,8 post-traumatic stress disorder9 and eating disorders.10”
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- Authors
- Imperatori, C., Mancini, M., Della Marca, G., Valenti, E. M., & Farina, B.
- Affiliations
- European University of Rome (IT)
- Sleep Disorders Unit, Institute of Neurology, Catholic University, 00153 Rome, Italy
- Corresponding author
- Imperatori, Claudio
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2018-11-20
- Volume
- 10
- Issue
- 11
- Pages
- 1806
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC6265864
- OpenAlex
- W2901795049
- Cited by
- 43
- References
- 74
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 3 · 2020: 4 · 2019: 5
- FWCI
- 0.51
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- eating disorders, biofeedback, neurofeedback, food cravings, rumination, body image disturbance, dysfunctional eating behaviors, reward systems, insula, sympathetic response, coping strategies
- MeSH terms
- Feeding and Eating Disorders, Biofeedback, Psychology, Body Image, Electroencephalography, Feeding Behavior, Food, Humans, Magnetic Resonance Imaging, Neurofeedback, Craving
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