OBJECTIVE
To test the relationship of anxiety to caloric intake and food cue perception in women and men.
METHODS
Fifty-five twins (26 complete, 3 incomplete pairs; 51% women) underwent 2 functional magnetic resonance imaging (fMRI) scans (before and after a standardized meal) and then ate at an ad libitum buffet to objectively assess food intake. State and trait anxiety were assessed using the State-Trait Anxiety Inventory. During the fMRI scans, participants viewed blocks of fattening and non-fattening food images, and non-food objects.
RESULTS
In women, higher trait anxiety was associated with a higher body mass index (BMI) (r=0.40, P=0.010). Trait anxiety was positively associated with kilocalories consumed at the buffet (r=0.53, P=0.005) and percent kilocalories consumed from fat (r=0.30, P=0.006), adjusted for BMI. In within-pair models, which control for shared familial and genetic factors, higher trait anxiety remained associated with kilocalories consumed at the buffet (ρ=0.66, P=0.014), but not with BMI. In men, higher state anxiety was related to macronutrient choices, but not to total caloric intake or BMI. FMRI results revealed that women with high trait anxiety did not suppress activation by fattening food cues across brain regions associated with satiety perception after eating a standardized meal (mean difference low anxiety: −15.4, P<0.001; high anxiety: −1.53, P=0.82, adjusted for BMI).
CONCLUSIONS
In women, trait anxiety may promote excess caloric consumption through altered perception of high-calorie environmental food cues, placing women with genetic predispositions toward weight gain at risk of obesity.