*4.2. Effortful Control*

Variability in effortful control can also help explain differences between restrictive and binge eating/purging ED subtypes. While restrictive ED patients show similar levels of effortful control as healthy controls (except for attentional control), patients with binge eating/purging behaviors (AN-BP, BN) score significantly lower on effortful control. The lack of effortful control can explain why these patients lose control over their eating behaviors and eat comfort (sugary/fatty) food to deal with their negative effects [37], and then engage in compensatory purging behaviors to avoid weight gain [7,53]. Within this subgroup of obese patients, the lack of effortful control is clearly related to the presence of binge eating behaviors as well. Several studies have shown that obese patients with binge eating tend to have more comorbidity with impulsive psychopathology [54,55] than obese patients without binge eating. Other studies investigating subtypes of obese patients have also found support for the notion of a more resilient subgroup of obese patients and an emotional/behavioral dysregulated group, characterized by low levels of effortful control, psychological complaints, and avoidant and depressive coping patterns [23].
