Identifying the Specific Reward Processes Underlying the Maintenance of Binge-Eating Disorder using EEG and EMA

Identifying the Specific Reward Processes Underlying the Maintenance of Binge-Eating Disorder using EEG and EMA ABSTRACT Binge-eating disorder (BED) is the most common and most expensive eating disorder in the United States. Further, BED is associated with significant medical complications (e.g., obesity) and premature death. Treatments for BED have demonstrated limited effectiveness, signaling a critical need for improved understanding of the mechanisms underlying BED maintenance to help guide novel or enhanced interventions. Reward-related processes (e.g., wanting, liking, learning) are highlighted within the National Institute of Mental Health’s Research Domain Criteria (RDoC), and have been increasingly implicated in BED persistence. However, the specific reward processes that maintain BED are currently unknown. The incentive-sensitization theory suggests that food reward wanting, in particular, may serve as the primary maintenance factor underlying BED. Although preliminary data from our group indicate that food reward wanting may indeed play a critical role in BED maintenance, these data suggest that food reward liking and learning processes may also contribute to binge-eating persistence, highlighting their potential as novel targets for clinical intervention. Given this, research is critically needed to systematically evaluate the relative roles of food reward wanting, liking, and learning using both neural and naturalistic assessment approaches in BED, in order to pinpoint the specific reward mechanisms underlying BED persistence and guide treatment development. To address this need, the current proposal seeks to 1) evaluate the concurrent associations between binge-eating symptoms and food reward processes (i.e., wanting, liking, and learning) assessed at the neural level in the laboratory using electroencephalography (EEG); 2) evaluate the momentary prospective relationships between binge- eating symptoms and food reward processes (i.e., wanting, liking, and learning) assessed in the natural environment using ecological momentary assessment (EMA); and 3) evaluate the longer-term prospective associations between food reward processes (i.e., wanting, liking, and learning) assessed in the laboratory (via EEG) and the natural environment (via EMA), with change in binge-eating symptoms over 6-month follow-up. The research team includes experts in eating disorders, EMA, EEG, multilevel statistical modeling, and the neural basis of reward. Data from this study will clarify the specific neural and behavioral reward-related processes that contribute to binge-eating maintenance within BED. Knowledge gained from this study will help guide the development of targeted therapeutic approaches (e.g., neuromodulation, pharmaceutical, psychotherapy) that are designed to directly engage empirically-identified disorder-maintaining mechanisms, which will enhance the efficacy and efficiency of treatments for BED. Project Number: 1R21MH140145-01A1 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Mental Health (NIMH) | Principal Investigator: Lauren Schaefer | Institution: SANFORD RESEARCH NORTH, FARGO, ND | Award Amount: $442,750 | Activity Code: R21 | Study Section: Adult Lifespan Psychopathology Study Section[ALP] View on NIH RePORTER: https://reporter.nih.gov/project-details/11303090