Distractor effect of food stimuli among patients with binge eating behaviour - a narrative review and pilot data

The distractor effect refers to performance impairments caused by task-irrelevant stimuli capturing attention and disrupt goal-directed behaviour, amplified by food-related cues due to their motivational salience. Individuals with binge eating behaviour (BE) show altered attentional and inhibitory control in response to food stimuli which may contribute to the development and maintenance of eating disorders. This work combines a narrative review with pilot data from a novel virtual reality (VR) paradigm. The review synthesized behavioural, neurobiological, and clinical findings on distractibility by food-related distractibility across different experimental paradigms and study samples (clinical, sub-clinical, healthy). The pilot study compared matched individuals with Binge Eating Disorder (BED) and healthy controls (N = 32) in a VR task assessing recognition, movement initiation and motor execution under food-related distraction in a two-choice-forced paradigm. The narrative review may point at food cues disrupting inhibitory control across populations, with BED associated with reduced prefrontal regulation and heightened responsivity to motivational stimuli, though findings remain mixed. Pilot data showed that individuals with BED displayed enhanced distractibility by food cues compared to healthy controls during both early recognition/movement initiation and later execution of goal-directed actions. No significant clinical associations were found in the BED group. The distractor effect emerges as a transdiagnostic phenomenon, with BED showing particular vulnerabilities extending from attentional capture to motor execution. VR paradigms provide ecological validity compared to classical button-press paradigms. Future research should employ multimodal and longitudinal approaches, and develop stage-specific interventions to strengthen control over food-related distractibility and reduce consecutively BE.