Interoceptive sensitivity, body weight and eating behavior in children: a prospective study

Abstract

Previous research indicates that interindividual differences in the ability to perceive one's own bodily signals (interoceptive sensitivity, IS) are associated with disordered eating behavior and weight problems. But representative and prospective data in children are lacking and therefore, the exact nature of these observed associations remains unclear. Data on IS measured by heartbeat perception ability in 1657 children between 6 and 11 years of age were collected on the basis of two measurement points with a year distance in time. Stability of the construct and its prospective association with different food approach behaviors [assessed via parent questionnaires (Children's Eating Behavior Questionnaire and Dutch Eating Behavior Questionnaire)] as well as with weight status were analyzed via structural equation modeling. Main results were that only in overweight children external and emotional eating behavior were predictive for later IS, whereas no such relation was found in normal weight children. There was no direct relation between IS and body mass index. For the first time, we could show that eating behavior and IS in middle childhood are prospectively related to each other. But surprisingly, our data indicate that altered interoceptive processes rather follow than precede non-adaptive eating behavior patterns in overweight children. This suggests a possible crucial role of faulty learning mechanisms in eating behavior early in life, undermining the later confidence in one's body.

Multimodal Body Representation of Obese Children and Adolescents before and after Weight-Loss Treatment in Comparison to Normal-Weight Children

“…Our observation of no group differences in heartbeat detection accuracy contradicts previous claims that a diminished perception of the inner status of the body might contribute to overweight [20]. Interestingly, in a large sample of children (n>1500) aged 6 to 11 years, no differences were observed between overweight and normal-weight children at a first assessment, whereas differences between the groups were evident one year later [9]. Our observations suggest that diminished heartbeat perception is likely not a general symptom of obesity.…”

“…In this sense, it has been suggested that a lack of awareness of the own body size or indifference towards own weight status contribute to overweight, as they hamper motivation for weight loss [5–7]. In addition, it has been suggested that a disturbed interoceptive processing, as indicated by poor heartbeat detection accuracy, might contribute to an excessive food intake [8, 9]. As yet, no study has comprehensively investigated different types of body representation in obese children and adolescents.…”

“…Heartbeat detection accuracy has been observed to be diminished in adults with high BMI [20] and it is associated with healthier eating behavior and better physical fitness in children [9, 21]. Also, studies in adults indicate that participants with high BMI might have difficulties in estimating the size of an object touching their skin (tactile size estimation), possibly reflecting a disturbed sense of the own size [22–24].…”

Interoceptive contributions to healthy eating and obesity

“…They observed that normal weight participants exhibited better heartbeat interoceptive sensitivity as compared to overweight and obese participants, and that the overweight and obese participants’ BMI was negatively correlated with interoceptive sensitivity. A separate study from this same research group using the same task failed to observe a relationship between heartbeat interoception and BMI in children [67]. These mixed findings should be interpreted cautiously, as the validity of the heartbeat counting task as a measure of interoceptive sensitivity has recently come into question [68].…”

The Adult Eating Behaviour Questionnaire in a bariatric surgery‐seeking sample: Factor structure, convergent validity, and associations with BMI

“…The Adult Eating Behaviour Questionnaire (AEBQ) is an age‐upward extension of a widely used and well‐validated measure of individual differences in food approach (enjoyment of eating, eating in response to food cues in the environment, and eating in response to negative affect) and avoidance (responsiveness to satiety, slow pace of eating, undereating in response to negative affect, and picky/“fussy” eating) in children (Hunot et al, ; Wardle, Guthrie, Sanderson, & Rapoport, ). The Child Eating Behaviour Questionnaire (CEBQ) scales are concurrently and prospectively associated with adiposity in children (e.g., Antoniou et al, ; Boswell, Byrne, & Davies, ; Koch & Pollatos, ; Llewellyn & Fildes, ). The AEBQ shares seven of the original CEBQ scales (excluding a scale measuring desire to drink and including a newly added scale measuring subjective hunger).…”