**Transdiagnostic Perspective of Impulsivity and Compulsivity in Obesity: From Cognitive Profile to Self-Reported Dimensions in Clinical Samples with and without Diabetes**

**Giulia Testa 1,2,3,†, Bernat Mora-Maltas 1,2,†, Lucía Camacho-Barcia 1,2,3, Roser Granero 3,4, Ignacio Lucas 1,2, Zaida Agüera 1,2,3,5, Susana Jiménez-Murcia 1,2,3,6, Rosa Baños 3,7, Valerie Bertaina-Anglade 8, Cristina Botella 3,9, Mònica Bulló 3,10,11, Felipe F. Casanueva 3,12, Søren Dalsgaard 13, José-Manuel Fernández-Real 3,14, Barbara Franke 15, Gema Frühbeck 3,16, Montserrat Fitó 3,17, Carlos Gómez-Martínez 3,11,18, Xavier Pintó 3,6,19, Geert Poelmans 20, Francisco J. Tinahones 3,21, Rafael de la Torre 3,22,23, Jordi Salas-Salvadó 3,11,18,24, Lluis Serra-Majem 3,25, Stephanie Vos 26, Theresa Wimberley <sup>27</sup> and Fernando Fernández-Aranda 1,2,3,6,\***


**Citation:** Testa, G.; Mora-Maltas, B.; Camacho-Barcia, L.; Granero, R.; Lucas, I.; Agüera, Z.; Jiménez-Murcia, S.; Baños, R.; Bertaina-Anglade, V.; Botella, C.; et al. Transdiagnostic Perspective of Impulsivity and Compulsivity in Obesity: From Cognitive Profile to Self-Reported Dimensions in Clinical Samples with and without Diabetes. *Nutrients* **2021**, *13*, 4426. https://doi.org/10.3390/ nu13124426

Academic Editor: Roberto Cangemi

Received: 26 October 2021 Accepted: 7 December 2021 Published: 10 December 2021

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**Abstract:** Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive–compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity.

**Keywords:** impulsivity; compulsivity; decision making; cognitive flexibility; type 2 diabetes; novelty seeking; harm avoidance
