Applying psycho-behavioural phenotyping in obesity characterization

Abstract

Individual differences in obesity, beyond being explained by metabolic and medical complications, are understood by alterations in eating behaviour which underlie psychological processes. From this psychological perspective, studies have identified several potential characteristic features at the psycho-behavioural level that could additionally explain the maintenance of chronic excess weight or the unsuccessful results of current treatments. To date, despite the growing evidence, the heterogeneity of the psychological evidence associated with obesity has made it challenging to generate consensus on whether these psycho-behavioural phenotypes can be a complement to improve outcomes of existing interventions. For this reason, this narrative review is an overview focused on summarizing studies describing the psycho-behavioural phenotypes associated with obesity. Based on the literature, three psychological constructs have emerged: reward dependence, cognitive control, and mood and emotion. We discuss the clinical implications of stratifying and identifying these psycho-behavioural profiles as potential target for interventions which may ensure a better response to treatment in individuals with obesity. Our conclusions pointed out a considerable overlap between these psycho-behavioural phenotypes suggesting bidirectional interactions between them. These findings endorse the complexity of the psycho-behavioural features associated with obesity and reinforce the need to consider them in order to improve treatment outcomes.

White adipose tissue distribution and amount are associated with increased white matter connectivity

“…The ultimate goal of uncovering the complex relationship between brain structure and function and body composition is to pave the way for the development of effective and accessible intervention strategies for obesity. It is important to note that there is no one-size-fitsall treatment for obesity (Li et al, 2023) (Camacho-Barcia et al, 2023). In future studies, it is essential to prioritize a comprehensive assessment of fat distribution and quantity.…”

“…To address this complexity, it is crucial to evaluate different obesity phenotypes, such as normal weight obesity, metabolically obese normal weight, metabolically healthy obese, and metabolically unhealthy obese individuals. Furthermore, psycho‐behavioral phenotypes based on individual reward sensitivity, cognitive control abilities, and mood and emotion regulation can help identify individual biomarkers for preventive measures (Camacho‐Barcia et al, 2023 ). In future studies, it is essential to prioritize a comprehensive assessment of fat distribution and quantity.…”

The interplay between white adipose tissue, adipokines, and structural gray matter changes

“…The observed link between abdominal obesity, adipokines, and Alzheimer's disease and cognitive decline further emphasizes the broader implications of adipokines, extending beyond energy homeostasis. Exploring psycho‐behavioral phenotypes can further help identify individual biomarkers, potentially enhancing the precision of preventive measures (Camacho‐Barcia et al, 2023 ). This comprehensive approach may enhance our understanding of obesity's multifaceted impact on brain health.…”

Unveiling the Interrelationship between Eating Patterns and Metabolic Syndrome

“…Implementing individualspecific psychological strategies is crucial for ensuring and sustaining weight loss. High reward sensitivity, preference for unhealthy foods, and overeating in patients with binge eating disorder and obesity underscore the need for interventions that strengthen self-control and conscientiousness, as well as developing emotion regulation skills [76]. Furthermore, non-invasive deep magnetic brain stimulation has shown promise in reducing impulse-related behaviors linked to obesity.…”

“…Furthermore, non-invasive deep magnetic brain stimulation has shown promise in reducing impulse-related behaviors linked to obesity. Mindfulness-based interventions have demonstrated positive outcomes in treating obesity by altering eating behaviors leading to mindful eating [76,77]. According to many studies cognitivebehavioral weight-management treatment leads to improvements in measures of self-regulation, selfefficacy and mood with development of abilities to redirect attention, and the management of the physiological consequences of the emotions [76,[78][79][80][81].…”