The Role of Cognitive Functions in Eating Disorders

Eating Disorders (EDs) are characterized by cognitive alterations that contribute to their maintenance and affect treatment outcomes, yet subtype-specific neuropsychological profiles remain poorly defined. Following PRISMA 2020 guidelines, this umbrella review synthesized 25 systematic reviews and meta-analyses, evaluated via AMSTAR-2, to map these profiles. The results revealed distinct cognitive phenotypes. Anorexia Nervosa is marked by cognitive rigidity (set-shifting deficits), hyper-active inhibitory control, weak central coherence, and impaired social cognition. Bulimia Nervosa is characterized by global executive dysfunction, impaired inhibitory control toward disease-salient stimuli, and impulsive, reward-driven decision-making. Binge Eating Disorder features general regulatory deficits, inhibitory failure triggered specifically by food cues, and an inability to delay gratification. These findings highlight significant literature heterogeneity but strongly support moving away from uniform protocols. Interventions should shift toward individualized, neuropsychologically-informed assessment and rehabilitation strategies tailored to each patient's specific cognitive profile.