Differences in the use of emotion regulation strategies between anorexia and bulimia nervosa: A systematic review and meta-analysis

Compr Psychiatry. 2021 Aug:109:152262. doi: 10.1016/j.comppsych.2021.152262. Epub 2021 Jul 8.


Objective: Research has identified abnormal emotion regulation (ER) as an underlying mechanism in the onset and maintenance of eating disorders. Yet, it still remains unclear whether different forms of ER, adaptive and maladaptive strategies, are similar across categories of eating disorders.

Method: A systematic review and meta-analysis were carried out to look at ER differences between anorexia nervosa (AN) and bulimia nervosa (BN), two common eating disorder pathologies with different eating patterns.

Results: 41 studies were included in the meta-analysis. The results revealed no differences in the use of maladaptive ER strategies between individuals with AN and BN, however patients with AN tend to use less adaptive ER strategies as compared to patients with BN.

Conclusions: Making less use of adaptive strategies in AN might be due to low body weight and high levels of alexithymia which define AN. In order to improve treatment outcome in individuals suffering from AN, these findings suggest to focus more on improving the use of adaptive ER strategies.

Keywords: Anorexia nervosa; Bulimia nervosa; Eating disorders; Emotion regulation.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anorexia
  • Anorexia Nervosa* / diagnosis
  • Anorexia Nervosa* / therapy
  • Bulimia Nervosa* / diagnosis
  • Bulimia Nervosa* / therapy
  • Emotional Regulation*
  • Feeding and Eating Disorders*
  • Humans