The Rise and Fall of Physiological Theories of the Control of Human Eating Behavior

Levitsky, David A.; Barre, Laura; Michael, John Jeshurun; Zhong, Yingyi; He, Yitong; Mizia, Alyse; Kaila, Sahib

doi:10.3389/fnut.2022.826334

Cited by 4 publications

(4 citation statements)

References 69 publications

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“…Body energy homeostasis is a highly regulated process that matches energy intake to energy expenditure over time. 5,6 While historically both a glucostatic theory as well as a lipostatic theory have been proposed, 7 it is still not clear what is actually regulated, e.g. total body energy stores, body fat mass or body weight.…”

Section: Homeostatic Regulation Of Energy Balance and Eating Behaviourmentioning

confidence: 99%

The ‘Behavioral Balance Model’: A new perspective on the aetiology and therapy of obesity

Schultes,

Ernst,

Hallschmid

et al. 2023

Diabetes Obesity Metabolism

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Obesity is a debilitating disease of global proportions that necessitates refined, concept‐driven therapeutic approaches. Policy makers, the public and even health care professionals, but also individuals with obesity harbour many misconceptions regarding this disease, which leads to prejudice, negative attitudes, stigmatization, discrimination, self‐blame, and failure to provide and finance adequate medical care. Decades of intensive, successful scientific research on obesity have only had a very limited effect on this predicament. We propose a science‐based, easy‐to‐understand conceptual model that synthesizes the complex pathogenesis of obesity including biological, psychological, social, economic and environmental aspects with the aim to explain and communicate better the nature of obesity and currently available therapeutic modalities. According to our integrative ‘Behavioral Balance Model’, ‘top‐down cognitive control’ strategies are implemented (often with limited success) to counterbalance the increased ‘bottom‐up drive’ to gain weight, which is triggered by biological, psycho‐social and environmental mechanisms in people with obesity. Besides offering a deeper understanding of obesity, the model also highlights why there is a strong need for multimodal therapeutic approaches that may not only increase top‐down control but also reduce a pathologically increased bottom‐up drive.

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Section: Homeostatic Regulation Of Energy Balance and Eating Behaviourmentioning

confidence: 99%

The ‘Behavioral Balance Model’: A new perspective on the aetiology and therapy of obesity

Schultes,

Ernst,

Hallschmid

et al. 2023

Diabetes Obesity Metabolism

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show abstract

“…Another study shows hypoglycemia-related increases in food intake in healthy adults without diabetes are due to an increased consumption of foods high in fat content and low glycemic index 18. These findings are inconsistent with the notion of increased preference for carbohydrates triggered automatically by hypoglycemia, and are aligned with critique of the glucostatic theory of appetite control 19. Instead, nutritional knowledge, individual food preferences, and learned eating habits may also be at play in an individual’s behavioral response to hypoglycemia.…”

Section: Introductionmentioning

confidence: 96%

“… 18 These findings are inconsistent with the notion of increased preference for carbohydrates triggered automatically by hypoglycemia, and are aligned with critique of the glucostatic theory of appetite control. 19 Instead, nutritional knowledge, individual food preferences, and learned eating habits may also be at play in an individual’s behavioral response to hypoglycemia.…”

Section: Introductionmentioning

confidence: 99%

Preference for high-carbohydrate foods does not change for children and adolescents in insulin-induced hypoglycemia

Sauchelli

Rogers

Fry

et al. 2022

BMJ Open Diab Res Care

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IntroductionHypoglycemia elicits coordinated counter-regulatory neuroendocrine responses. The extent to which this process involves an increased drive to eat, together with greater preference for foods high in carbohydrate content, is unclear. Our objective was to examine this effect in children and adolescents (age 5–19 years) without diabetes and no prior known experience of hypoglycemic episodes.Research design and methodsWe administered a computerised task designed to examine preference for high-carbohydrate foods (sweet and savory) to pediatric patients (n=26) undergoing an insulin tolerance test as part of the routine clinical assessment of pituitary hormone secretory capacity. The task was completed at baseline and three time points after intravenous infusion of insulin (approximately 7, 20 and 90 min).ResultsAlthough all patients reached insulin-induced hypoglycemia (mean venous glucose at nadir=1.9 mmol/L), there was moderate evidence of no effect on preference for high-carbohydrate foods (moderate evidence for the null hypothesis) compared with euglycemia. Patients also did not display an increase in selection of foods of high compared with low energy density. Sensitivity of the task was demonstrated by decreased preference for sweet, high-carbohydrate foods after consumption of sweet food and drink.ConclusionsResults support the view that acute hypoglycemia does not automatically prompt the choice of high-carbohydrate foods for rapid glucose restoration, and further stresses the importance that people and families with children vulnerable to hypoglycemic episodes ensure that ‘rapidly absorbed glucose rescue therapy’ is always available.

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“…However, within the last decade convincing evidence has accumulated to demonstrate clear associations. Many researchers point to the work of Brobeck [ 2 , 3 ] and Kennedy [ 4 , 5 ] in the 1940s and 1950s as the starting point for investigations of the control of food intake (see [ 6 ] for an account of the early theories of appetite control). These classic studies on the hyperphagia produced by hypothalamic lesions established a line of thinking that linked the brain's control of food intake with body weight.…”

Section: Introductionmentioning

confidence: 99%

Fat-free mass and resting metabolic rate are determinants of energy intake: implications for a theory of appetite control

Hopkins

Gibbons

Blundell

2023

Phil. Trans. R. Soc. B

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Any explanation of appetite control should contain a description of physiological processes that could contribute a drive to eat alongside those that inhibit eating. However, such an undertaking was largely neglected until 15 years ago when a series of independent research programmes investigated the physiological roles of body composition and appetite. These outcomes demonstrated that fat-free mass (FFM), but not fat mass, was positively associated with objectively measured meal size and energy intake (EI). These findings have been accompanied by demonstrations that resting metabolic rate (RMR) is also positively associated with EI, with the influence of FFM largely mediated by RMR. These findings re-introduce the role of drive into models of appetite control and indicate how this can be integrated with processes of inhibition. The determinants of EI fit into an evolutionary perspective in which the energy demands of high metabolic rate organs and skeletal tissue constitute a need state underlying a tonic drive to eat. This approach should lead to the development of integrated models of appetite that include components of body composition (FFM) and energy expenditure (RMR) as tonic biological signals of appetite alongside other traditional tonic (adipose tissue derived) and episodic signals (gastrointestinal tract derived). This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.

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The Rise and Fall of Physiological Theories of the Control of Human Eating Behavior

Cited by 4 publications

References 69 publications

The ‘Behavioral Balance Model’: A new perspective on the aetiology and therapy of obesity

The ‘Behavioral Balance Model’: A new perspective on the aetiology and therapy of obesity

Preference for high-carbohydrate foods does not change for children and adolescents in insulin-induced hypoglycemia

Fat-free mass and resting metabolic rate are determinants of energy intake: implications for a theory of appetite control

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