A Meta-analysis on Resting State High-frequency Heart Rate Variability in Bulimia Nervosa

Eur Eat Disord Rev. 2016 Sep;24(5):355-65. doi: 10.1002/erv.2454. Epub 2016 May 31.

Abstract

Objective: Autonomic nervous system function is altered in eating disorders. We aimed to quantify differences in resting state vagal activity, indexed by high-frequency heart rate variability comparing patients with bulimia nervosa (BN) and healthy controls.

Methods: A systematic search of the literature to identify studies eligible for inclusion and meta-analytical methods were applied. Meta-regression was used to identify potential covariates.

Results: Eight studies reporting measures of resting high-frequency heart rate variability in individuals with BN (n = 137) and controls (n = 190) were included. Random-effects meta-analysis revealed a sizeable main effect (Z = 2.22, p = .03; Hedge's g = 0.52, 95% CI [0.06;0.98]) indicating higher resting state vagal activity in individuals with BN. Meta-regression showed that body mass index and medication intake are significant covariates.

Discussion: Findings suggest higher vagal activity in BN at rest, particularly in unmedicated samples with lower body mass index. Potential mechanisms underlying these findings and implications for routine clinical care are discussed. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Keywords: bulimia nervosa; eating disorder; heart rate; meta-analysis; vagus nerve; variability.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Body Mass Index
  • Bulimia / physiopathology
  • Bulimia Nervosa / physiopathology*
  • Female
  • Heart Rate / physiology*
  • Humans
  • Male
  • Vagus Nerve / physiopathology*