Repetitive Negative Thinking and Eating Disorders: A Meta-Analysis of the Role of Worry and Rumination

The role of worry and rumination in eating disorders (EDs) is controversial. This meta-analysis of the literature is aimed at clarifying the relationship between repetitive negative thinking (RNT) and EDs. In accordance with the PRISMA criteria, a comprehensive search of the literature was conducted on PubMed and PsycInfo from inception to March 2021. Search terms: "eating disorder/anorexia/bulimia/binge eating disorder" AND "worry/rumination/brooding/repetitive thinking". A manual search of reference lists was also run. Forty-three studies were included. RNT was found to be associated with anorexia, bulimia, and binge eating disorder. A moderating effect was found for "presence/absence ED diagnosis" and "subtype of ED symptom". ED patients showed higher RNT than the general population. No differences were observed for age or between worry and rumination in the magnitude of their association with EDs.