Interoceptive contributions to healthy eating and obesity

The causal associations between interoception, self-regulation, non-purposeful eating behaviors, and weight status in college women: a longitudinal cross-lagged model analysis

AIMS

Excessive weight gain has led to increased obesity and mortality risk among college students. Issues with maintaining a healthy weight may be attributed to poor internal awareness and unhealthy eating behaviors. The study's purpose was to determine the longitudinal effects among interoception, self-regulation, nonpurposeful eating behaviors, and weight status (BMI) among college women.

METHODS

Data from 103 females were collected via Qualtrics over 3 timepoints (T1, T2, T3) during an academic semester. Repeated measures ANOVA and cross-lagged model analyses were used. Significant changes were found in interoceptive responsiveness, external, and uncontrolled eating throughout 3 timepoints.

RESULTS

Longitudinally, significant causal effects were found among the study measures. Among all models, higher interoceptive responsiveness (T1) predicted increased self-regulation (T2). Higher non-purposeful eating behaviors (T1) predicted reduced self-regulation (T2). Higher BMI (T1) predicted reduced non-purposeful eating behaviors (T2), however higher BMI (T2) predicted increased non-purposeful eating (T3) and reduced interoceptive responsiveness (T3). Significant causal effects were found within each non-purposeful eating behavior models.

CONCLUSION

Overall, the research study provided foundational evidence of the importance of self-regulatory skills to help prevent unhealthy eating behaviors and increased weight status in college women. Future interventions educating college women to become more internally aware and better self-regulate are needed.

Bodily sensations and bariatric surgery: Links between interoceptive sensibility, intuitive and disordered eating behaviour in obesity and obesity surgery

OBJECTIVE

This study evaluated interoceptive sensibility, intuitive and disordered eating among bariatric candidates, operated individuals and individuals with obesity seeking non-surgical treatment.

METHOD

We recruited 57 individuals with obesity seeking nonsurgical weight-loss (IOB), 84 bariatric candidates (Pre) and 22 individuals post-bariatric surgery (Post) who responded to questionnaires: Multidimensional Assessment of Interoceptive Awareness, Intuitive Eating Scale-2 (IES-2), Dutch Eating Behaviour Questionnaire, Binge Eating Scale, State-Trait Anxiety Inventory, Beck's Depression Inventory.

RESULTS

Overall, the Post group manifested higher scores on 'Body-Listening' (F = 4.95, p = 0.01), 'Emotional Awareness' (F = 8.83, p < 0.001) and 'Trusting' (F = 6.71, p = 0.002) interoceptive dimensions, on the IES-2 total score (F = 5.48, p = 0.007) and 'Reliance on hunger and satiety cues' (F = 31.3, p < 0.001) when age was controlled. The IOB group presented higher scores on emotional (F = 3.23, p = 0.047) and binge eating (F = 5.99, p = 0.004). Among operated individuals, intuitive eating mediated the relationship between interoceptive sensibility dimensions and binge eating: 'Attention regulation' (54%) 'Self-regulation' (75.1%), 'Body listening' (94.09%) and 'Trusting' (84.9%).

CONCLUSIONS

Our results suggest the therapeutic potential of interoceptive sensibility and intuitive eating in obesity management in/beyond the bariatric context.

Interoceptive sensibility, intuitive eating, binge, and disordered eating behavior among individuals with obesity: A comparative study with the general population

The present study assessed the links between interoceptive sensibility, binge, disordered (emotional, restrained, and external) and intuitive eating among individuals with obesity (n = 57) and normal weight (n = 29). Individuals with obesity presented lower "attention regulation," "body-listening," and "trusting" interoceptive dimensions. When age was controlled, group differences on "trusting" remained significant. Individuals with obesity showed lower intuitive eating, higher emotional, and binge eating compared to controls. Higher "body listening," "eating for physical rather than emotional reasons," and "reliance on hunger and satiety cues" predicted lower binge eating whereas "external eating" predicted higher binge eating among individuals with obesity. Eating for physical reasons and reliance on hunger and satiety had protective mediating roles in the relationship between external and binge eating in both groups. Interoceptive sensibility and intuitive eating should conjointly serve as psychotherapeutic targets for disordered eating, obesity, and weight management.

Interoceptive beliefs moderate the link between physiological and emotional arousal during an acute stressor

Growing work suggests that interoception, that is, representations of one's internal bodily changes, plays a role in shaping emotional experiences. Past studies primarily examine how behavioral accuracy in detecting interoceptive signals (interoceptive ability) relates to emotional states, with less work examining self-reported interoceptive facets such as the characterizations of one's interoceptive abilities (interoceptive sensibility) or evaluative beliefs about the value versus danger of interoceptive signals (interoceptive beliefs). However, existing studies rarely examine physiological reactivity, behavioral, and self-reported dimensions of interoception together in the same sample. As such, it remains unclear whether and how much individual differences in interoceptive facets uniquely and in interaction with physiological reactivity may matter for emotional experience. Herein, 250 healthy young adults completed a heartbeat detection task assessing interoceptive ability and questionnaire measures of interoceptive sensibility and beliefs during an initial laboratory visit. At a follow-up session, 227 participants returned to undergo an acute psychosocial stressor. Measures of physiological arousal such as preejection period (PEP) and heart rate variability were acquired throughout the stressor with self-reported emotions acquired immediately after. Linear regressions revealed that greater sympathetic nervous system reactivity (i.e., PEP), poorer interoceptive ability (i.e., accuracy), and less positive interoceptive beliefs were related to more intense high arousal emotions during the stressor. Importantly, across models, interoceptive beliefs was the only interoceptive facet to moderate the concordance between physiological and emotional arousal. Implications for psychological theories of emotion, stress, and interoception are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sensing the Snacking Experience: Bodily Sensations Linked to the Consumption of Healthy and Unhealthy Snack Foods-A Comparison between Body Mass Index Levels

The World Health Organisation (WHO) has highlighted the need for immediate action regarding the escalating global prevalence of overweight and obesity. Based on the need for long-term strategies supporting dietary behaviour changes, the concept of 'interoception' (i.e., sensing the body's internal state) has been proposed as promising for understanding and controlling food intake behaviours. As eating behaviours are motivated by the need for securing energy demands as well as the desire for pleasure, investigating the bodily sensations perceived in relation to food consumption can support our understanding of human food and eating behaviours. Here, a consumer study was conducted on 286 Danish consumers to explore the interoceptive experience of snack food consumption. This study included an investigation of the consumers' interoceptive capabilities and ability to feel pleasure, intuitive eating behaviours, snack food consumption frequency, the drivers of snack food consumption, food-related pleasure, and post-ingestive sensations linked to snack food consumption. The study was conducted on consumers with different Body Mass Index (BMI) levels to study potential differences between these groups. The study showed normal interoceptive capabilities and abilities to feel pleasure, with no differences between BMI groups. Regarding intuitive eating, the study found intuitive eating to be more prevalent among the group holding normal BMI. No significant differences between BMI groups were found in terms of snack intake frequency. However, differences between BMI groups were found in terms of: the drivers of snack consumption, the aspects bringing food-related pleasure from snack consumption, and the post-ingestive sensations felt after eating snack foods.

Cognitive reappraisal of food craving and emotions: a coordinate-based meta-analysis of fMRI studies

Growing evidence supports the effectiveness of cognitive reappraisal in down-regulating food desire. Still, the neural bases of food craving down-regulation via reappraisal, as well as their degree of overlap vs specificity compared with emotion down-regulation, remain unclear. We addressed this gap through activation likelihood estimation meta-analyses of neuroimaging studies on the neural bases of (i) food craving down-regulation and (ii) emotion down-regulation, alongside conjunction and subtraction analyses among the resulting maps. Exploratory meta-analyses on activations related to food viewing compared with active regulation and up-regulation of food craving have also been performed. Food and emotion down-regulation via reappraisal consistently engaged overlapping activations in dorsolateral and ventrolateral prefrontal, posterior parietal, pre-supplementary motor and lateral posterior temporal cortices, mainly in the left hemisphere. Its distinctive association with the right anterior/posterior insula and left inferior frontal gyrus suggests that food craving down-regulation entails a more extensive integration of interoceptive information about bodily states and greater inhibitory control over the appetitive urge towards food compared with emotion down-regulation. This evidence is suggestive of unique interoceptive and motivational components elicited by food craving reappraisal, associated with distinctive patterns of fronto-insular activity. These results might inform theoretical models of food craving regulation and prompt novel therapeutic interventions for obesity and eating disorders.

Does feeling what you eat change how you eat? Implications of an intervention to promote consciousness of eating experiences

Introduction

This work aims to understand the experience of participating in the Food and Nutrition Education Program workshops with Sensory and Cognitive Exercises (PESC) and measure its impact on eating behavior.

Methods

The PESC consists of four workshops with exercises stimulating perception and reflection on bodily sensations triggered in eating situations. It was developed to promote consciousness of eating experiences in women who reported difficulty in controlling their body weight and who increased over 5% of their body weight in the previous year. This is a mixed-methods study designed as a controlled trial. The intervention group (n = 19) was evaluated before the first workshop (T0) and after the last workshop (T1) and the control group (n = 18), which did not participate in the workshops, was evaluated twice (T0 and T1), with an interval of 3 to 4 weeks. At T0 and T1, it was applied the Intuitive Eating Scale (IES-2) and the Three Factor Eating Questionnaire (TFEQ-R21). In T1, the intervention group also participated in a qualitative interview.

Results

After participating in the PESC, the intervention group showed an increase in the IES-2 total score (95% Confidence Interval = (0.10, 0.39)) and a decrease in the emotional eating scale score (95% Confidence Interval = (-16.03; -3.85)). The interviews' analysis revealed the participants' self-observation process, which led to the perception of their practices, priorities, intentions, eating difficulties, and the connection between these aspects and environmental issues. The following themes were considered: Food management/control, Body dissatisfaction, Reflection/re-signification, and Different ways of being in familiar contexts.

Discussion

The results allow us to infer that, after participating in the PESC, the intention to manage food intake became more effective, less susceptible to oscillations imposed by the external environment, and more supported by internal resources.

The role of emotion in eating behavior and decisions

The present paper aims to provide the latest perspectives and future directions on the association between emotions and eating behavior. We discussed individual differences in the impact of negative emotions on eating, emotional eating as disinhibited eating decisions with heightened reward values of and sensitivity to palatable foods in response to negative emotions and social isolation, in addition to emotional eating as maladaptive coping strategies under negative emotion and stress, hedonic (pleasure-oriented) eating decisions mediated by the brain reward system, and self-controlled (health-oriented) eating decisions mediated by the brain control system. Perspectives on future directions were addressed, including the development of early eating phenotypes in infancy, shared neural mechanisms mediated by the ventromedial prefrontal cortex and the dorsolateral prefrontal cortex in emotion and eating decision regulation, possible roles of interoception incorporating hunger and satiety signals, gut microbiome, the insula and the orbitofrontal cortex, and emotional processing capacities in hedonic eating and weight gain.

The role of interoception in age-related obesity: A structural equation modelling study

The obesity pandemic and its adverse effect on health and quality of life are well established. In younger populations, interoception and aberrant eating behaviour contribute to overconsumption and being overweight. Although the incidence of obesity is higher in older individuals, they remain under-researched in the obesity literature. Therefore, the present study considered the role of general (interoceptive sensibility) and appetite-specific (hunger drive and satiety responsiveness) interoception and obesogenic eating behaviour (food responsivity, emotional eating, enjoyment of eating) in the association between age and BMI. A total of 1006 female adults (aged 18 to 80) completed the Adult Eating Behaviour Questionnaire and the Interoceptive Attention and Accuracy scales. Structural Equation Modelling (SEM) in AMOS was used to explore the data for multiple serial mediation effects. Despite being more overweight, older adults reported lower interoceptive attention, hunger drive, emotional overeating, food responsivity, and enjoyment of food. In contrast, compared to younger adults, older adults reported a higher interoceptive accuracy, and a similar responsivity to satiety. Importantly, two indirect pathways positively mediated the link between age and BMI: (1) age ➤(-)➤ interoceptive attention ➤(+)➤ satiety responsivity ➤(-)➤ emotional eating ➤(+)➤ BMI and (2) age ➤(-)➤ interoceptive attention ➤(+)➤ satiety responsivity ➤(-)➤ food responsivity ➤(+)➤ BMI. However, a stronger antagonistic indirect pathway was also present: age ➤(-)➤ interoceptive attention ➤(+)➤ hunger drive ➤(+)➤ emotional eating ➤(+)➤ BMI. The present findings suggested that overall reduced interoceptive attention in older adults may protect against weight gain by lowering hunger and the propensity towards obesogenic eating behaviours. These findings have implications for the design of appetite interventions in older populations.

Reasons individuals stop eating questionnaire (RISE-Q) among adults in the United Arab Emirates

The relationship between obesity and satiation is complex and bidirectional. Understanding differences in reasons for meal termination may enhance our understanding of overeating risks and susceptibility to overconsumption. This study aimed to investigate the reasons why individuals in the UAE stop eating. A cross-sectional web-based study was conducted among adults ≥18 years in the UAE (n = 1482). Using a self-administered online questionnaire, we collected information on sociodemographic characteristics, lifestyle habits, and eating behavior using the Reasons Individuals Stop Eating-Questionnaire (RISE-Q-15) used twice for breakfast/main meal. The items were categorized into five scales; decreased food appeal (DFA), physical satisfaction (PS), planned amount (PA), self-consciousness (SC), and decreased priority of eating (DPE). All items were scored from 1 to 7 ranging between 3 to 21 on each scale. A paired t-test was used to evaluate the difference between the RISE-Q scores on each scale concerning the two meals. The main reason why participants stopped eating breakfast was under the PS scale (14.91 ± 3.72), followed by the PA scale (14.58 ± 3.00). The main reason why participants stopped eating main meals was under the PS scale (14.78 ± 3.56), followed by the PA scale (14.77 ± 43.81). The mean score of the DPE scale was significantly higher for breakfast than the main meal (p = 0.038). More than half of the participants reported an average eating rate (58.7%). Pearson's chi-square analysis revealed that the eating rate was dependent on BMI (p<0.001). Considering individual mealtimes and addressing factors related to PS and PA of food is crucial when designing nutrition interventions aiming to promote healthy eating habits among adults in the UAE.

Public's calorie literacy and perceived effectiveness of restaurant menu calorie labeling in the United Arab Emirates

Restaurant menu calorie labeling is regarded as a promising, cost-effective, and innovative method that will have an impact on the food environment, raise awareness among consumers, and aid in global efforts to prevent obesity. This study aimed to assess the public's calorie literacy, dining practices, and perceived effectiveness of restaurant menu labeling implementation in the United Arab Emirates (UAE). A descriptive, web-based cross-sectional study was conducted among 1279 adults in the UAE. Socio-demographic characteristics, calorie literacy, and perceived effectiveness of restaurant menu labeling among participants were investigated. Chi-square analysis was used to compare indicators across demographic characteristics. More females than males completed the online survey, (56.1% and 43.9%). Most of the participants aged < 30 years old (54.8%), The majority of participants reported eating away from home at least once per week (89.6%). 66.0% of participants were knowledgeable about calorie definition, but only 37.1% knew about average daily energy requirements. Younger participants, with a normal BMI, and higher education levels reported a significantly higher likelihood of eating at a chain restaurant with caloric information on the menu (p <0.05). The majority of participants (76.0%) preferred to see calorie information and other nutrition information on menus. To conclude, menu labeling is a welcomed policy to be implemented in food outlets. Further investigation is necessary to ascertain the most efficacious method of presenting nutrition information to consumers to facilitate informed purchasing decisions considering the potential benefits of mandating calorie declaration in obesity prevention efforts.

Complex correction of eating behaviour disorders, anthropometric and physiological indicators in patients with non-alcoholic fatty liver disease on the background of abdominal obesity

Purpose: to evaluate the effectiveness of correction of eating behaviour disorders, anthropometric, physiological indicators by impFreelementing combined non-drug treatment for patients with non-alcoholic fatty liver disease on the background of abdominal obesity. Material and methods 85 patients with non-alcoholic fatty liver disease on the background of abdominal obesity of the 1st degree were examined. All patients were divided into two clinical groups: 1st group (research) - 48 people, with average body mass index BMI=32.55±1.07 kg/m2, who underwent a course of cognitive behavioural therapy, diet therapy, and physical activity for 6 months; the control group - 37 people with average BMI=31.95±1.03 kg/m2 followed only a rational diet and physical activity, without cognitive behavioural therapy. The examination of the patients included the measurement of anthropometric and physiological indicators, questionnaires according to the DEBQ (Dutch Eating Behaviour Questionnaire). Results On the 180th day, the number of patients with normal blood pressure in the 1st group increased in 2.38 times (D=2.3511, p=0.0015), healthy eating behavior was recorded in 2.38 times more often (D=0.2215, p=0.0047) and the number of restrictive type of EB decreased in 2.0 times (D=0.4321, p=0.0031), compared to the control group. Conclusion A combined course of therapy in the form of a rational diet, aerobic exercise and cognitive behavioural therapy should be an integral component of early non-drug treatment, as a guarantee not only of the correction of anthropometric and functional indicators, but also of the modification of the eating behavior and a guarantee of long-term maintenance of the desired weight.

Disinhibition augments thirst perception from two dehydrating stimuli in men

Physiological systems controlling water and energy ingestion are coordinated. Whether maladaptive eating behavior and appetite for water are linked is unknown. Thus, we sought to investigate the association between maladaptive eating and both thirst and water drinking behavior with two dehydrating conditions. Twenty-two lean men and 20 men with obesity (mean age 32.3 ± 8.4 years and 30.0 ± 11.1 years, respectively) completed the Three-Factor Eating Questionnaire (TFEQ) and Gormally Binge Eating Scale. On separate days, volunteers were dehydrated by a 2-h hypertonic saline infusion and a 24-h water deprivation, and thirst was measured on a 100-mm visual analogue scale (VAS) during each procedure. After each dehydrating condition, ad libitum water intake was measured. In the saline infusion, higher Disinhibition on the TFEQ was associated with thirst in the lean group (β = 4.2 mm VAS, p = 0.03) but not in the group with obesity (p = 0.51). In the water-deprivation condition, higher Disinhibition was also associated with thirst in the lean group (β = 5.6 mm VAS, p = 0.01) with the strength of relationship being 3.5-fold stronger than that observed in the group with obesity (β = 1.6 mm VAS, p = 0.0003). Hunger, Restraint, and binge-eating scores were not associated with thirst in either dehydrating condition (all p > 0.05). Maladaptive eating behaviors were not associated with ad libitum water intake (all p > 0.05). Disinhibition is associated with higher thirst perception in healthy weight individuals and may be attenuated in obesity. The characteristics of disinhibition which typically includes a heightened readiness to eat, may reflect a more general phenotype that also reflects a readiness to drink.

Interoceptive sensibility and body satisfaction in pregnant and non-pregnant women with and without children

Pregnancy is a time of great physical and psychological change. As well as prominent changes in the external appearance of the body, such as the baby bump, there are also substantial changes taking place within the body. Our awareness of, and attention towards, internal bodily signals (interoception) is thought to have a direct impact on how we feel about our bodies. Therefore, understanding how our experience of these interoceptive signals might change during pregnancy may have important implications for maternal wellbeing. This study examined body satisfaction and interoceptive sensibility (subjective experience of interoception) in pregnant and non-pregnant women with and without children. Feelings towards pregnancy-specific changes in body satisfaction and interoceptive sensibility were also examined in women in their first pregnancy (primigravida) and subsequent pregnancies (multigravida). It was found that pregnancy did not directly impact levels of body satisfaction, instead pregnant and non-pregnant women with children reported less satisfaction with their bodies compared to those without children. Primigravida women were more satisfied with the appearance of pregnancy specific bodily changes compared to multigravida women. Interestingly, these differences in body satisfaction in those with children (pregnant and non-pregnant) were mediated by the extent to which women trusted their bodies (measure of interoceptive sensibility). All other pregnancy related changes in interoceptive sensibility and body satisfaction were either non-significant or had small effect sizes. These results may suggest body trust as an important factor to support during the transition to parenthood in order to improve body satisfaction in mothers.

Water intake, thirst, and copeptin responses to two dehydrating stimuli in lean men and men with obesity

OBJECTIVE

Physiological systems responsible for water homeostasis and energy metabolism are interconnected. This study hypothesized altered responses to dehydration including thirst, ad libitum water intake, and copeptin in men with obesity.

METHODS

Forty-two men (22 lean and 20 with obesity) were stimulated by a 2-hour hypertonic saline infusion and a 24-hour water deprivation. In each dehydrating condition, thirst, ad libitum water intake after dehydration, and urinary and hormonal responses including copeptin were assessed.

RESULTS

After each dehydration condition, ad libitum water intake was similar between both groups (p > 0.05); however, those with obesity reported feeling less thirsty (p < 0.05) and had decreased copeptin response and higher urinary sodium concentrations when stressed (p < 0.05). Angiotensin II, aldosterone, atrial and brain natriuretic peptides, and apelin concentrations did not differ by adiposity group and did not explain the different thirst or copeptin responses in men with obesity. However, leptin was associated with copeptin response in lean individuals during the hypertonic saline infusion (p < 0.05), but the relationship was diminished in those with obesity.

CONCLUSIONS

Diminished thirst and copeptin responses are part of the obesity phenotype and may be influenced by leptin. Adiposity may impact pathways regulating thirst and vasopressin release, warranting further investigation.

Appetitive interoception, the hippocampus and western-style diet

Obesity, Type 2 diabetes and other metabolic disorders continue to pose serious challenges to human health and well-being. An important source of these challenges is the overconsumption of saturated fats and sugar, main staples of what has been called the Western-style diet (WD). The current paper describes a theoretical model and supporting evidence that links intake of a WD to interference with a specific brain substrate that underlies processing of interoceptive signals of hunger and satiety. We review findings from rats and humans that the capacity of these signals to modulate the strength of appetitive and eating behavior depends on the functional integrity of the hippocampus and the learning memory operations it performs. Important among these operations is the use of contextual information to retrieve memories that are associated with other events. Within our framework, satiety provides an interoceptive context that informs animals that food cues and appetitive behavior will not be followed by rewarding postingestive outcomes. This serves to prevent those cues and responses from retrieving those reward memories. The findings reviewed provide evidence that consuming a WD and the high amounts of saturated fat and sugar it contains (a) is associated with the emergence of pathophysiologies to which the hippocampus appears selectively vulnerable (b) impairs hippocampal-dependent learning and memory (HDLM) and (c) weakens behavioral control by interoceptive hunger and satiety contextual stimuli. It is hypothesized that these consequences of WD intake may establish the conditions for a vicious cycle of further WD intake, obesity, and potentially cognitive decline.

Endocannabinoid signaling of homeostatic status modulates functional connectivity in reward and salience networks

RATIONALE

Endocannabinoids are well poised to regulate crosstalk between energy sensing of hunger and satiety and reward-driven motivation.

OBJECTIVES

Here, we aimed to unravel associations between plasma endocannabinoids and brain connectivity in homeostatic and reward circuits across hunger and satiety states.

METHODS

Fifteen participants (7 females) underwent two counter-balanced resting-state functional magnetic resonance imaging scans, one after overnight fasting and one after consumption of a standardized filling meal (satiety). Before each scan, we drew blood to measure plasma endocannabinoid concentrations (anandamide [AEA], anandamide-derived POEA, and 2-arachidonoylglycerol [2-AG]), analyzed with liquid chromatography tandem mass spectrometry.

RESULTS

We found that AEA levels were associated with increased connectivity between the lateral hypothalamus and the ventral striatum during satiety. Furthermore, fasting AEA levels correlated with connectivity between the ventral striatum and the anterior cingulate cortex and the insula.

CONCLUSIONS

Altogether, results suggest that peripheral AEA concentrations are sensitive to homeostatic changes and linked to neural communication in reward and salience networks. Findings may have significant implications for understanding normal and abnormal interactions between homeostatic input and reward valuation.

Fetal programming of human energy homeostasis brain networks: Issues and considerations

In this paper, we present a transdisciplinary framework and testable hypotheses regarding the process of fetal programming of energy homeostasis brain circuitry. Our model proposes that key aspects of energy homeostasis brain circuitry already are functional by the time of birth (with substantial interindividual variation); that this phenotypic variation at birth is an important determinant of subsequent susceptibility for energy imbalance and childhood obesity risk; and that this brain circuitry exhibits developmental plasticity, in that it is influenced by conditions during intrauterine life, particularly maternal-placental-fetal endocrine, immune/inflammatory, and metabolic processes and their upstream determinants. We review evidence that supports the scientific premise for each element of this formulation, identify future research directions, particularly recent advances that may facilitate a better quantification of the ontogeny of energy homeostasis brain networks, highlight animal and in vitro-based approaches that may better address the determinants of interindividual variation in energy homeostasis brain networks, and discuss the implications of this formulation for the development of strategies targeted towards the primary prevention of childhood obesity.

Food Consciousness Intervention Improves Interoceptive Sensitivity and Expression of Exteroception in Women

The perception of the body’s internal state (interoception) and the perception and processing of environmental sensory stimuli (exteroception) act together to modulate adaptive behaviour, including eating behaviour, and are related to bodyweight control. This study evaluated the impact of the Food and Nutrition Education Program with Sensory and Cognitive Exercises on interoceptive sensitivity and on the expression of exteroceptive perception in women who experienced difficulty in controlling their body weight. Thirty-seven women were randomized into two groups and evaluated at two moments: before and after the intervention or before and after a 3- to 4-week waiting period. A heartbeat tracking task was used for interoception evaluation. Participants were asked to write a text describing three foods after tasting them for exteroception evaluation. After the intervention, the participants showed an increase in interoceptive sensitivity, and an increase in the expression of exteroceptive stimuli perception through a semantic assessment of their writing related to the tasting experience. In addition, the results point to a possible connection between the mechanisms governing interoception and exteroception. This work brings important contributions to the search for strategies capable of promoting the perception and integration of physiological and environmental stimuli in food consumption.

Facial Emotion Recognition in Obesity and in Fibromyalgia: A Systematic Review

Facial emotion recognition (FER) is extensively investigated in psychological sciences in healthy individuals and clinical conditions. In this paper, we analyzed those studies in which FER was assessed in the case of obesity or fibromyalgia, in relation to the levels of alexithymia. Crucially, these two conditions frequently co-occur; however, no study has explored FER considering both fibromyalgia and obesity. Studies were identified using the electronic search engine of PubMed. The last research was run on 23 July 2021. Two independent lists were generated for the two clinical conditions. Six records were reviewed about obesity, while three records about fibromyalgia. The evidence relative to FER in obesity was not conclusive, whereas the evidence about an altered FER in fibromyalgia seemed more straightforward. Moreover, the role of alexithymia on FER in these clinical conditions was not extensively investigated. In our discussion, we highlighted those factors that should be carefully addressed in investigating FER in these clinical conditions. Moreover, we underlined methodological criticisms that should be overcome in future research.

Greater within-person weight variability during infancy predicts future increases in z-BMI

OBJECTIVE

This study tested the hypothesis that greater weight variability (WV; measured as root mean square error [RMSE]) during the first year of life predicts weight gain at year two and greater WV during the second year of life predicts greater weight gain at year three.

METHODS

This was a prospective study using mother and offspring data from the Avon Longitudinal Study of Parents and Children. Infant z-BMI (BMI z score) and WV scores were calculated separately during years one and two. Maternal demographic, weight, and nursing-related measures were also used in analyses.

RESULTS

Sample sizes in year-one and year-two analyses were 814 (448 male; 366 female) and 783 (432 male; 351 female), respectively. RMSE in year one significantly predicted z-BMI change in year two (β [SE]: 0.32 [0.12]; p = 0.01; adjusted R² = 0.07), controlling for z-BMI change in year one and z-BMI at birth. Similar significant prediction was found using year-two RMSE for year-three z-BMI (β [SE]: 0.33 [0.14]; p = 0.02; adjusted R² = 0.10). Maternal characteristics were not related to RMSE in year one or year two.

CONCLUSIONS

Previous findings that WV predicts subsequent increases in body mass in adults were, for the first time, extended to infants.

Problem-solving therapy-induced amygdala engagement mediates lifestyle behavior change in obesity with comorbid depression: a randomized proof-of-mechanism trial

BACKGROUND

Depression hinders obesity treatment; elucidating mechanisms may enable treatment enhancements.

OBJECTIVES

The aim was to investigate whether changes in neural targets in the negative affect circuit following psychotherapy mediate subsequent changes in weight and behaviors.

METHODS

Adults (n = 108) with obesity and depression were randomly assigned to usual care or an intervention that delivered problem-solving therapy (PST) for depression over 2 mo. fMRI for brain imaging was performed at baseline and 2 mo. BMI, physical activity, and diet were measured at baseline and 12 mo. Mediation analysis assessed between-group differences in neural target changes using t test and correlations between neural target changes and outcome changes (simple and interaction effect) using ordinary least-squares regression.

RESULTS

Compared with usual care, PST led to reductions in left amygdala activation (-0.75; 95% CI: -1.49, -0.01) and global scores of the negative affect circuit (-0.43; -0.81, -0.06), engaged by threat stimuli. Increases in amygdala activation and global circuit scores at 2 mo correlated with decreases in physical activity outcomes at 12 mo in the usual-care group; these relations were altered by PST. In relation to change in leisure-time physical activity, standardized β-coefficients were -0.67 in usual care and -0.01 in the intervention (between-group difference: 0.66; 0.02, 1.30) for change in left amygdala activation and -2.02 in usual care and -0.11 in the intervention (difference: 1.92; 0.64, 3.20) for change in global circuit scores. In relation to change in total energy expenditure, standardized β-coefficients were -0.65 in usual care and 0.08 in the intervention (difference: 0.73; 0.29, 1.16) for change in left amygdala activation and -1.65 in usual care and 0.08 in the intervention (difference: 1.74; 0.85, 2.63) for change in global circuit scores. Results were null for BMI and diet.

CONCLUSIONS

Short-term changes in the negative affect circuit engaged by threat stimuli following PST for depression mediated longer-term changes in physical activity. This trial was registered at www.clinicaltrials.gov as NCT02246413 (https://clinicaltrials.gov/ct2/show/NCT02246413).

A Conceptual Framework for Multi-Dimensional Measurements of Food Related Pleasure-The Food Pleasure Scale

In modern times, the majority of food intake is believed to be driven by hedonic processes, rather than homeostatic ones. Various factors have been found to influence the hedonic eating experience and thereby influence eating behaviour, and each factor can be regarded a piece that contributes to parts of the total picture of the hedonic response to food. As a result, the literature on the hedonic response to food-related experiences is comprehensive, but at the same time rather fragmented; and importantly, it is not clear how individuals/segments differ in key drivers of their hedonic experience and the extent to which food pleasure is perceived. In this paper, we present a conceptual framework for the development of a scale (self-report questionnaire) to measure the qualitative and quantitative aspects of food-related pleasure, the Food Pleasure Scale. We introduce the concept of (an)hedonia and scales developed in the past for its measurement, identify the spectrum of characteristics influencing food-related pleasure and explain the relevance of developing such a scale. Based on this theoretical framework, a strategy for the development of the Food Pleasure Scale is proposed.

Diseases, Disorders, and Comorbidities of Interoception

Interoception, the sense of the body's internal physiological state, underpins homeostatic reflexes, motivational states, and sensations contributing to emotional experiences. The continuous nature of interoceptive processing, coupled to behavior, is implicated in the neurobiological construction of the sense of self. Aberrant integration and control of interoceptive signals, originating in the brain and/or the periphery, can perturb the whole system. Interoceptive abnormalities are implicated in the pathophysiology of psychiatric disorders and in the symptomatic expression of developmental, neurodegenerative, and neurological disorders. Moreover, interoceptive mechanisms appear central to somatic disorders of brain-body interactions, including functional digestive disorders, chronic pain, and comorbid conditions. The present article provides an overview of disorders of interoception and suggests future directions for better understanding, diagnosis, and management of these disorders.

Relationship between Anthropometric Parameters and Sensory Processing in Typically Developing Brazilian Children with a Pediatric Feeding Disorder

In this study, we aimed to relate anthropometric parameters and sensory processing in typically developing Brazilian children diagnosed with a pediatric feeding disorder (PFD). This was a retrospective study of typically developing children with a PFD. Anthropometric data were collected and indices of weight-for-age, length/height-for-age, and body mass index-for-age (BMI-for-age) were analyzed as z-scores. Sensory profile data were collected for auditory, visual, tactile, vestibular, and oral sensory processing. We included 79 medical records of children with a PFD. There were no statistically significant (p > 0.05) relationships between the anthropometric variables (weight-, length/height-, or BMI-for-age) and the sensory variables (auditory, visual, tactile, vestibular, or oral sensory processing). In conclusion, we found no relationship between anthropometric parameters and sensory processing in the sample of typically developing Brazilian children diagnosed with a PFD under study.

Short-Term Fasting and Ingestion of Caloric Drinks Affect Heartbeat-Evoked Potentials and Autonomic Nervous System Activity in Males

Central nervous systems receive and process information from the internal and external environment to maintain homeostasis. This includes interoceptive awareness of the organism’s nutritional state. Whenever food supply is required, feelings of hunger initiate the search for and the consumption of appropriate amounts of nutrients. How this is physiologically regulated in humans has been subjected to research into interoceptive awareness of body states during fasting and food consumption. However, there is no research on the distinct effects of carbohydrate or protein intake on interoception. Therefore, we aimed to investigate the impact of fasting and consumption of standardized carbohydrate and protein shakes on interoception in a repeated-measures cross-over design in a sample of 37 healthy, normal weight males. As a physiological correlate of interoception, we measured heartbeat-evoked potentials (HEPs), which are suggested to reflect the cortical representation of cardiac signals, during eight-minutes resting state EEG-recordings. After a 16-hour fasting period, the HEP amplitudes were lower over right central and parietal electrodes and increased after ingestion of the nutritional shake. Exploratory analyses indicated that the difference between fasting and satiety was more prominent at carbohydrate compared protein testing days. Correlation analyses with heart rate variability (HRV) suggested that high cardiac sympathetic activity is related to lower HEP amplitudes. Furthermore, cardiac sympathetic activity and stress indices decreased from before to after the intervention, whereas HRV increased. Together, this study shows for the first time that fasting and the intake of a nutritional shake affects cardiac measures of autonomic nervous system functioning and the neural correlates of cardiac interoception. These findings could be relevant for diets and psychosomatic disorders, including eating disorders.

Individual differences in sensory and expectation driven interoceptive processes: a novel paradigm with implications for alexithymia, disordered eating and obesity

Those with disordered eating and/or obesity often express difficulties in sensing or interpreting what is happening in the body (interoception). However, research is hindered by conceptual confusion, concerns surrounding domain specificity, and an inability to distinguish sensory (bottom-up) and expectation driven (top-down) interoceptive processes. A paradigm was therefore developed from an active inference perspective. Novel indices were computed and examined in those with alexithymia: a personality associated with interoceptive deficits and disordered eating. The paradigm successfully identified individuals driven by sensations rather than expectations: alexithymia was characterized by attenuated prior precision (a larger divergence between pre-prandial and post-prandial satiety, and low expectation confidence), and increased prediction error (a higher correlation between changes in hunger and blood glucose, and greater rebound hunger after a sensory incongruent drink). In addition, those with a higher BMI were less confident and had a larger anticipated satiety divergence. These findings demonstrate the need to move beyond existing paradigms such as the Satiety Quotient and Heartbeat Counting Task which may have limited our understanding of eating behaviour.

Systematic review and meta-analysis of the relationship between the heartbeat-evoked potential and interoception

The Heartbeat Evoked Potential (HEP) has been proposed as a neurophysiological marker of interoceptive processing. Despite its use to validate interoceptive measures and to assess interoceptive functioning in clinical groups, the empirical evidence for a relationship between HEP amplitude and interoceptive processing, including measures of such processing, is scattered across several studies with varied designs. The aim of this systematic review and meta-analysis was to examine the body of HEP-interoception research, and consider the associations the HEP shows with various direct and indirect measures of interoception, and how it is affected by manipulations of interoceptive processing. Specifically, we assessed the effect on HEP amplitude of manipulating attention to the heartbeat; manipulating participants' arousal; the association between the HEP and behavioural measures of cardiac interoception; and comparisons between healthy and clinical groups. Following database searches and screening, 45 studies were included in the systematic review and 42 in the meta-analyses. We noted variations in the ways individual studies have attempted to address key confounds, particularly the cardiac field artefact. Meta-analytic summaries indicated there were moderate to large effects of attention, arousal, and clinical status on the HEP, and a moderate association between HEP amplitude and behavioural measures of interoception. Problematically, the reliability of the meta-analytic effects documented here remain unknown, given the lack of standardised protocols for measuring the HEP. Thus, it is possible effects are driven by confounds such as cardiac factors or somatosensory effects.

Emotion perception and theory of mind in obesity: a systematic review on the impact of social cognitive deficits on dysfunctional eating behaviors

The aim of this paper was to summarize our current understanding of emotion perception and Theory of Mind (ToM) in obesity and how they relate to dysfunctional eating behaviors (DEB), frequently found in candidates for bariatric surgery. The literature was searched using the electronic databases PsychInfo, Medline, and Web of Science databases, and by additional hand searches through reference lists and specialist eating disorders journals. Relevant studies were included if they were written in English, included participants suffering from obesity and evaluation with tasks assessing social cognition, such as emotion recognition and perception, as well as ToM. Twelve studies analyzed for this systematic review suggest that deficits in such social cognitive domains may lie behind many emotional and social difficulties present in people with obesity, be they bariatric or not, which usually favor DEB. Our review suggests that people with obesity of all ages score significantly less than controls on instruments assessing emotion recognition and ToM, justifying a possible relationship between social cognitive impairments and dysfunctional eating behaviors, such as binges, emotional eating, and addition to food, frequently seen in people with obesity. These findings have important implications for our understanding of the social cognitive foundations of eating behavior in individuals with obesity. They can help not only the presurgical behavioral assessment, but also guide postoperative follow-up of this population.

Interoception and Its Role for Eating, Obesity, and Eating Disorders

Abstract. The importance of the sense of ourselves from within for understanding adaptive behavior and psychopathology has been increasingly recognized during the last decades. Interoception builds the foundation of our embodied self and dysfunctional interoception lies at the core of many psychosomatic disorders. Eating is fundamental for survival with consequences for health and well-being. It is deeply grounded in homoeostatic and allostatic psychophysiological needs and is driven by interoceptive signals of the body. This narrative review summarizes a selection of empirical findings and draws conclusions on the role of interoception in eating behavior, body weight, and eating disorders. Beyond disordered eating behavior, eating disorders are characterized by impairment of the sense of self, with dysfunctional interoception at its core. Predictive coding accounts are addressed to integrate conclusions and to underline the relevance of interventions to modify interoception.

Time Processing, Interoception, and Insula Activation: A Mini-Review on Clinical Disorders

Time processing is a multifaceted skill crucial for managing different aspects of life. In the current work, we explored the relationship between interoception and time processing by examining research on clinical models. We investigated whether time processing deficits are associated with dysfunction of the interoceptive system and/or insular cortex activity, which is crucial in decoding internal body signaling. Furthermore, we explored whether insular activation predicts the subjective experience of time (i.e., the subjective duration of a target stimulus to be timed). Overall, our work suggests that alteration of the interoceptive system could be a common psychophysiological hallmark of mental disorders affected by time processing deficits.

Using pre-prandial blood glucose to assess eating in the absence of hunger in free-living individuals

Our ability to understand and intervene on eating in the absence of hunger (EAH) as it occurs in peoples' natural environments is hindered by biased methods that lack ecological validity. One promising indicator of EAH that does not rely on self-report and is easily assessed in free-living individuals is glucose. Here, we hypothesize that elevated pre-prandial blood glucose concentrations (PPBG), which reflect a source of readily-available, short-term energy, are a biological indicator of EAH. This was a 7-day observational study of N = 41, 18-24 year old men and women with BMI < 25 kg/m² (60%) or BMI ≥ 25 kg/m² (40%). We collected data using ecological momentary assessment from people in their natural environments. We defined EAH by self-report (perceived EAH) and by PPBG thresholds using two methods (standardized, PPBG < 85 mg/dl; personalized, PPBG < individual fasting levels). Multilevel modeling was used to analyze the data. N = 963 eating events were reported. There were significantly (p < .05) fewer perceived EAH events (25%) as compared to standardized (62%) and personalized PPBG-defined EAH events (51%). Consistent with published literature, perceived EAH was more likely to occur at a higher PPBG (p < .01), particularly among participants with a BMI ≥ 25 kg/m² (p_int < .01). Additionally, discordance between perceived EAH and PPBG-defined EAH, indicating a perception of hunger at an eating event when PPBS was elevated, was less likely among participants with a BMI < 25 kg/m² vs. those with a BMI ≥ 25 kg/m² (p_int < .01) as well as at snacks vs. meals (p_int < .01). These findings provide preliminary support for using PPBG as a biological indicator of EAH in free-living individuals.

Somatic symptoms and binge eating in women's daily lives

OBJECTIVE

The present study aimed to determine whether the momentary severity of women's somatic symptoms was concurrently and prospectively associated with their engagement in binge eating in naturalistic settings.

METHOD

Thirty women (M_age = 34.13, SD = 13.92) who had engaged in binge eating at least once over the month prior to study entry completed a 14-day ecological momentary assessment (EMA) protocol. During each of the 14 days, participants received five semi-random surveys via text message that assessed momentary somatic symptom severity (i.e., headaches, stomachaches/pain, chest/heart pain, faintness/dizziness, shortness of breath, fatigue) and disordered eating behaviors. Generalized estimating equations were used to determine whether momentary somatic symptoms were concurrently and prospectively (i.e., by participants' next assessment) associated with the occurrence of binge eating behavior, while controlling for age and body mass index.

RESULTS

At the within-person level, more severe stomachaches/pain, faintness/dizziness, shortness of breath, and fatigue were concurrently associated with an increased likelihood of engaging in binge eating. Further, at the between-person level, more severe stomachaches/pain, chest/heart pain, shortness of breath, and fatigue in general were associated with binge eating across the EMA protocol. Momentary stomachache/pain severity also prospectively predicted women's engagement in binge eating behavior at the next assessment.

CONCLUSIONS

The present results provide initial evidence that multiple somatic symptoms may serve as momentary correlates or proximal antecedents of binge eating behavior in women's daily lives. Somatic symptoms may consequently prove useful to target in eating disorder treatments, perhaps via interoceptive exposure interventions.

Overeating Risk in Overweight Young Women Is Divided into Two Types According to Appetite and Eating Behavior

Background: The problem of obesity in young women leads to future chronic diseases, effects on reproductive health, and next-generation obesity. Thus, it is necessary to provide effective support for these women's behavioral change. The purpose of this study was to evaluate dietary-related indicators to clarify the appetite and eating behavior problems among young women. Methods: Healthy women 18-39 years of age were enrolled. Interoceptive awareness (IA) was quantified using a heartbeat perception task score. Eating behavior was examined in three ways: Three-Factor Eating Questionnaire (TFEQ), visual analog scales of subjective appetite sensations, and a food consumption test. Results: In all, 15 participants who were overweight and 50 with normal weight were analyzed. The overweight women were clustered into two groups according to the heartbeat perception task score: a low-score group (women with overweight who have low IA [OW-LOW]) and high-score group (women with overweight who have high IA [OW-HIGH]). The OW-LOW group had significantly smaller intermeal changes in hunger score compared with women with normal weight. The disinhibition score on the TFEQ for the OW-HIGH group was significantly higher than the normal-weight women, and the prospective consumption score in the fasting condition was significantly higher in women with normal weight and a high heartbeat perception task score. Conclusions: Overweight young women were characterized into two groups with different appetite and eating behavior, which is connected to the risk of overeating. An appetite characteristic is associated with a high risk of obesity among the normal-weight population. Individualized interventions tailored to the IA levels may help in improving and preventing obesity.

Stimulation of the vagus nerve reduces learning in a go/no-go reinforcement learning task

When facing decisions to approach rewards or to avoid punishments, we often figuratively go with our gut, and the impact of metabolic states such as hunger on motivation are well documented. However, whether and how vagal feedback signals from the gut influence instrumental actions is unknown. Here, we investigated the effect of non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) vs. sham (randomized cross-over design) on approach and avoidance behavior using an established go/no-go reinforcement learning paradigm in 39 healthy human participants (23 female) after an overnight fast. First, mixed-effects logistic regression analysis of choice accuracy showed that taVNS acutely impaired decision-making, p = .041. Computational reinforcement learning models identified the cause of this as a reduction in the learning rate through taVNS (∆α = -0.092, p_boot = .002), particularly after punishment (∆α_Pun = -0.081, p_boot = .012 vs. ∆α_Rew =-0.031, p_boot = .22). However, taVNS had no effect on go biases, Pavlovian response biases or response time. Hence, taVNS appeared to influence learning rather than action execution. These results highlight a novel role of vagal afferent input in modulating reinforcement learning by tuning the learning rate according to homeostatic needs.

Post-Ingestive Sensations Driving Post-Ingestive Food Pleasure: A Cross-Cultural Consumer Study Comparing Denmark and China

Culture is one of the main factors that influence food assessment. This cross-cultural research aimed to compare Chinese and Danish consumers in their post-ingestive drivers of Post-Ingestive Food Pleasure (PIFP). We define PIFP as a “subjective conscious sensation of pleasure and joy experienced after eating”. We conducted two in-country consumer studies in Denmark (n = 48) and in China (n = 53), measuring post-ingestive sensations and PIFP using visual analogue scale, for three hours following consumption of a breakfast meal. Key results revealed perceived Satisfaction, Mental, Overall and Physical wellbeing to be highly influential on PIFP in both countries. Moreover, Danish consumers perceived appetite-related sensations such as Satiety, Hunger, Desire-to-eat and In-need-of-food to be influential on PIFP, which was not the case in China. In China, more vitality-related sensations such as Energized, Relaxation and Concentration were found to be drivers of PIFP. These results suggest similarities but also distinct subtleties in the cultural constructs of PIFP in Denmark and in China. Focusing on Food Pleasure as a post-ingestive measure provides valuable output, deeper insights into what drives Food Pleasure, and, importantly, takes us beyond the processes only active during the actual eating event.

Subjective Sensations related to Food as Determinants of Snack Choice

Comprehending the complexity and determinants of food choices can help understand facets of the growing obesity epidemic. Focusing on consumers' subjective sensations as determinants of food choices can provide essential insights into eating behaviors. We explored subjective sensations linked to appetite, desire, wellbeing and energy. This study aims to 1) quantify subjective temporal sensations, and 2) study the effects of these sensations on snack choice. Two-hundred and fifty-three participants (mean age 20.5) evaluated subjective sensations using a visual analogue scale. The choice of one of six snacks was offered to the participants; choices were recorded as implicit choice measures. The results demonstrated that especially sensory specific desire sensations (Salty, Fatty, Sweet desire) affected, either positively or negatively, snack choice. Furthermore, wellbeing sensations (Overall, Mental, Physical wellbeing) also showed significant effects for snack choice. Health-conscious females chose healthy snacks, and males chose unhealthy snacks. Importantly, this research indicates the relevance of subjective sensations in consumer studies that focus on diverse determinants of food choice. Sensory specific desires and wellbeing sensations were notably shown to be important determinants of snack choice. The contribution of different sensations to food choice is imperative, and helps us to understand aspects of snacking behavior. This could have broader implications concerning public health issues and obesity.

What Difference Does it Make? Risk-Taking Behavior in Obesity after a Loss is Associated with Decreased Ventromedial Prefrontal Cortex Activity

Altered activity in decision-making neural circuitry may underlie the maladaptive food choices found in obesity. Here, we aimed to identify the brain regions purportedly underpinning risk-taking behavior in individuals with obesity. Twenty-three adult women with obesity and twenty-three healthy weight controls completed the Risky Gains Task during functional magnetic resonance imaging (fMRI). This task allows participants to choose between a safe option for a small, guaranteed monetary reward and risky options with larger rewards. fMRI analyses comparing losing trials to winning trials found that participants with obesity presented decreased activity in the left anterior insula in comparison to controls (p < 0.05, AlphaSim corrected). Moreover, left insula activation during losses vs. wins was negatively correlated with UPPS-P questionnaire sensation seeking scores. During safe vs. risky trials following a loss, the control group exhibited increased activation in the ventromedial prefrontal cortex (vmPFC) (p < 0.05, AlphaSim corrected) in comparison to the OB group. Moreover, vmPFC response in the obesity group during post-loss trials was negatively correlated with risky choices on the task overall. As a whole, our findings support that diminished tuning of the insula towards interoceptive signals may lead to a lack of input to the vmPFC when weighing the costs and benefits of risky choices.

Dynamic Changes in Post-Ingestive Sensations after Consumption of a Breakfast Meal High in Protein or Carbohydrate

The obesity epidemic urges exploration of several parameters that play an important role in our eating behaviours. Post-ingestive sensations can provide a more comprehensive picture of the eating experience than mere satiety measurements. This study aimed to (1) quantify the dynamics of different post-ingestive sensations after food intake and (2) study the effect of protein and carbohydrate on hedonic and post-ingestive responses. Forty-eight participants (mean age 20.4) were served a breakfast meal high in protein (HighPRO) or high in carbohydrate (HighCHO) on two separate days using a randomised controlled crossover design. Post-ingestive sensations were measured every 30 min, for 3 h post intake using visual analogue scale (VAS). Results showed a significant main effect of time for all post-ingestive sensations. HighCHO induced higher hedonic responses compared to HighPRO, as well as higher ratings for post-ingestive sensations such as Satisfaction, Food joy, Overall wellbeing and Fullness. HighPRO, on the other hand, induced higher ratings for Sweet desire post intake. The development of sensations after a meal might be important for consumers’ following food choices and for extra calorie intake. More detailed knowledge in this area could elucidate aspects of overeating and obesity.

A multimodal investigation of impulsivity as a moderator of the relation between momentary elevations in negative internal states and subsequent dietary lapses

Suboptimal outcomes from behavioral weight loss (BWL) treatments are partially attributable to accumulated instances of non-adherence to dietary prescriptions (i.e., dietary lapses). Results identifying negative internal triggers for dietary lapses are inconsistent, potentially due to individual differences that impact how individuals respond to cues. Impulsivity is one factor that likely influences reactivity to internal states. We examined three dimensions of impulsivity (delay discounting, inhibitory control, and negative urgency) as moderators of the relation between affective and physical states and subsequent dietary lapses at the beginning of BWL. Overweight/obese adults (n = 189) completed behavioral and self-reported measures of impulsivity at baseline of BWL and an ecological momentary assessment (EMA) protocol across the first two weeks of treatment to report on affective/physical states and instances of dietary lapses. Results indicated that baseline negative urgency, but not delay discounting or inhibitory control, was positively associated with overall lapse risk. Moderation analyses indicated that poorer inhibitory control strengthened the relation between momentary increases in stress and subsequent dietary lapse, and higher negative urgency strengthened the relation between increases in loneliness and dietary lapse. Negative urgency also moderated the impact of momentary hunger on subsequent dietary lapse risk in an unexpected direction, such that higher negative urgency weakened the relation between hunger and subsequent lapse. Results lend partial and tentative support for the moderating role of impulsivity on the relation between internal states and lapse likelihood. With replication, the development and testing of personalized treatment components based on baseline impulsivity level may be warranted.

Decision Making Deficits in Relation to Food Cues Influence Obesity: A Triadic Neural Model of Problematic Eating

In this review article we propose a model of the brain systems, the deficiency of which may underlie problematic eating. This integrative model is based on studies that have focused on discrete brain components involved in problematic eating, combined with insights from studies on the neurocognitive basis of other addictive and problematic behaviors. The model includes: (a) a hyper-functioning reward anticipation and processing system (amygdala-striatum dependent) in response to food-related cues; (b) a hypo-functioning reflective and inhibitory control system (prefrontal cortex dependent), that fails to anticipate and properly weigh future outcomes; and (c) an altered interoceptive awareness system (insular cortex dependent) that translates homeostatic violation signals into a strong consumption desire that hijacks the inhibitory system and excites the reward system. We posit that when the abovementioned systems are imbalanced in such a way that the dopamine axis is hyperactive in relation to food cues and the inhibitory system is weak, and this is further aggravated by an altered interoceptive awareness system, people may experience loss of control or inability to resist tempting/rewarding foods. This loss of control over food consumption can explain, at least in part, the development of excess weight and contribute to the obesity epidemic.