High- and Low-Calorie Food Cues, Visual Attention, and Subclinical Eating Pathology in University Students Assessed by Eye Tracking

Abstract

Background/Objectives: Eating disorders are increasingly conceptualized as information-processing disorders characterized by attentional biases toward food-related stimuli. However, whether such biases are already detectable in subclinical, non-treatment-seeking populations remains unclear. This study examined whether subclinical eating pathology, assessed with the Eating Attitudes Test-26 (EAT-26), is associated with distinct patterns of visual attention toward high- and low-calorie food images in university students. Methods: In this cross-sectional observational study featuring an experimental eye-tracking task, 89 university students completed the EAT-26 and a visual task displaying paired high- and low-calorie food images alongside neutral controls. Oculomotor metrics included first fixation duration (FFD), fixation count (FC), and average fixation duration (AFD). Data were evaluated using EAT-26 threshold-based group stratification (lower-risk vs. risky eating behavior) and Spearman rank correlation analyses. Results: Global EAT-26 scores showed a significant correlation with a directional attentional bias index (rho = 0.29, p = 0.006). The Dieting subscale demonstrated no significant relationships with any oculomotor metrics. Conversely, Oral Control scores were significantly negatively correlated with the directional attentional bias index (rho = −0.27, p = 0.009) and positively tracked with low-calorie fixation counts (rho = 0.30, p = 0.004). Bulimia subscale scores showed a moderate positive correlation with the directional attentional bias index (rho = 0.26, p = 0.013), characterized by a significant decrease in low-calorie fixation counts (rho = −0.32, p = 0.002) and a strong increase in high-calorie fixation counts (rho = 0.36, p < 0.001) during sustained viewing. Conclusions: Subclinical eating pathology tendencies are associated with distinct implicit attentional profiles regarding food caloric density during sustained cognitive evaluation. Oral control drives visual prioritization of low-calorie stimuli to maintain inhibitory control, whereas bulimic tendencies reflect prolonged visual preoccupation with high-calorie reward cues. Eye-tracking represents a promising non-invasive research tool for exploring early cognitive correlates of eating-disorder risk.