A Systematic Review and Meta-Analytic Assessment of Unpredictability and Disordered Eating.

Perceived unpredictability, whether it relates to experiences, food availability, or belief systems, may predict disordered eating behaviors and affect weight gain and future health. Past studies investigating the associations of unpredictability and disordered eating, however, have shown inconsistent findings. The current review aimed to examine the associations between measures of unpredictability and subjective and objective measures of disordered eating behaviors in adults and children. A systematic review was conducted in July 2023, searching six databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science: Core Collection, PsycInfo, and ProQuest Dissertations and Theses, where 20 relevant research articles were identified. Eighty-three correlation coefficients were extracted from 15 articles (n = 9983). Results from a four-level random effects meta-analysis found a small, but significant association between unpredictability and disordered eating (r = 0.12, 95% CI = 0.08, 0.17, p < 0.0001), with a significant (Q [82] = 461.55, p < 0.0001) and large degree of heterogeneity (I² = 86.72%). Country of origin, mode of measurement for disordered eating, chronicity of unpredictability, and study percentage of women were identified as significant moderators. These findings highlight the need for assessment of unpredictability with more rigorous and improved measures of disordered eating to understand the impact on health outcomes.