Behavior, Psychology and Sociology

Attentional bias and response inhibition in severe obesity with food disinhibition: a study of P300 and N200 event-related potential




In obesity there is growing evidence for common mechanism between food intake regulation and substance use disorders, especially more attentional bias and less cognitive control. In the present study we investigated whether severely obese subjects with or without disordered eating exhibit electroencephalographic (EEG) event-related potential (ERP) modifications as observed in substance abusers.


A total of 90 women were included; 30 in the normal-weight (NW) group (18.5 < BMI < 24.5 kg/m2; no food disinhibition or restriction on the Three-Factor Eating Questionnaire) and 60 participants with BMI ≥ 35 kg/m2 were separated into two groups (n = 30): without food disinhibition (disinhibition score ≤8; ObFD− group) and with food disinhibition (score >8; ObFD+). Clinical and metabolic parameters as well as compartmental aspects (Eating Disorders Inventory-2, EDI-2) were assessed. Participants underwent an ERP recording with an auditory oddball paradigm.


The mean ± SD P300 amplitudes in Pz were significantly (p < 0.05) lower in ObFD− (12.4 ± 4.6) and ObFD+ (12.5 ± 4.4) groups than in the NW group (15.8 ± 5.9). The mean ± SD N200 amplitude in Cz was significantly lower in the ObFD− group (−2.0 ± 5.4) than in the NW group (−5.2 ± 4.2 vs; p = 0.035). N200 Cz amplitude was correlated with EDI-2 Binge eating risk score (ρ = 0.331; p = 0.01), EDI-2 Body Dissatisfaction score (ρ = 0.351; p = 0.007), and Drive for Thinness score (ρ = 0.26; p = 0.05).


The present study provides evidence for reduction of P300 and N200 amplitude in obese women and that N200 amplitude may be related to more disordered eating and eating disorder risk. This leads to consider attentional bias and response inhibition as core mechanisms in obesity and as possible targets for new therapeutic strategy.

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We thank the Hospices Civils de Lyon for their financial support (young investigator award), the CRNH-RA clinical research team: Dr. N. Feugier for volunteer recruitment/follow-up; C. Maitrepierre, J. Peyrat, E. Bain for clinical/technical help; and M. Sothier for help in dietary analysis.


This study was supported by a young investigator award of the Hospices Civils de Lyon, France.

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Correspondence to Sylvain Iceta.

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All participants gave their written informed consent to participate in the study. The study sponsor was the Hospices Civils de Lyon, Lyon, France (a university hospital), and the study was performed after approval from the ethics committee (Comité de protection des personnes, CPP) and in accordance with the French Law on data protection and civil liberties and the ethical standards laid down in the 1964 Declaration of Helsinki.

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Iceta, S., Benoit, J., Cristini, P. et al. Attentional bias and response inhibition in severe obesity with food disinhibition: a study of P300 and N200 event-related potential. Int J Obes 44, 204–212 (2020).

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