*4.2. General Psychopathology*

Looking at general psychopathology associated with BED, we investigated the role of impulse control impairments in relation to comorbid obesity using the BIS-15. Impulsivity has been frequently investigated in BED in the past. Experimental studies revealed that patients with BED show higher rash-spontaneous behavior, especially toward food, but also in general [17]. Neurobiological findings also link BED to impulsive/compulsive disorders, based on findings of the corticostriatal circuitry regulation of motivation and impulse control [81]. Likewise, the link between impulsivity and obesity has been of interest. A study gathering data about impulsivity in a large sample of the general population showed an association with obesity [82]. However, research suggests that BED surpasses obesity without BED in terms of impulsivity [17], which is consistent with the present findings. Specifically, OB-BED patients scored overall higher than OB and control participants on the BIS-15, with OB participants exceeding controls only on the subscale of attentional impulsivity. This scoring is in line with the findings of Loeber et al. [83], and further supported by the LDA associating impulsivity scores more strongly with the specific distinction between OB-BED and OB groups.

Further replicating previous findings on the relation between depressive symptoms and BED and obesity [84,85], we found that BDI scores of OB-BED patients exceeded those of OB, which exceeded those of controls. Interestingly, and although previous studies associated high BDI scores and depressed moods specifically with BED [21,22], the LDA suggests a linear transition from healthy controls to OB and OB-BED groups with increasing levels of depression. However, the effects of depression on BED are likely mediated through their effect on self-regulation impairments [21,86], which our analysis also suggested are more specific for the distinction of obese patients with and without obesity.
