A meta-analysis on resting state high-frequency heart rate variability in Bulimia Nervosa

Objective: Autonomic nervous system (ANS) function is altered in eating disorders. We aimed to quantify differences in resting state vagal activity, indexed by high-frequency heart rate variability (HF-HRV) comparing patients with bulimia nervosa (BN) and healthy controls. Methods: A systematic search of the literature to identify studies eligible for inclusion and meta-analytical methods were applied. Meta-regression was used to identify potential covariates. Results: 8 studies reporting measures of resting HF-HRV in individuals with BN (n=137) and controls (n=190) were included. Random-effects meta-analysis revealed a sizeable main effect (Z=2.22, p=.03; Hedge’s g=0.52, 95%CI[0.06;0.98]) indicating higher resting state vagal activity in individuals with BN. Meta-regression showed that BMI and medication intake are significant covariates. Discussion: Findings suggest higher vagal activity in BN at rest, particularly in un-medicated samples with lower body mass index. Potential mechanisms underlying these findings and implications for routine clinical care are discussed.