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Evidence for behavioral susceptibility theory of obesity
By Helen Albert
15 July 2008
Am J Clin Nutr 2008; 88: 22-29

MedWire News: Higher body mass index (BMI) and waist circumference are associated with lower satiety responsiveness and higher food cue responsiveness in young children, report investigators.

"Obesogenic modern environments have caused marked increases in mean population weights over the past few decades, but there is still tremendous variability in weight within populations," comment Susan Carnell and Jane Wardle, from University College London in the UK.

They add that "the mechanisms that cause some persons to eat more than their metabolic requirement and gain weight, while others stay slim, remain poorly understood."

The investigators tested the behavioral susceptibility theory of obesity in children, namely, that variation in appetite characteristics can explain some of the variation in obesity of the general population.

Parents of two groups of children, 572 aged 3-5 years from a community sample and 10,364 aged 8-11 years from a population-based twin cohort in the UK, were asked to complete two scales from the Child Eating Behavior Questionnaire for their children. These included the Satiety Responsiveness-Slowness in Eating (SR-SE) scale (six items) and the full Enjoyment of Food (EF) scale (four items).

For the 8-11 year group, parents were also asked to weigh and measure their children's height and waist circumference, whereas for the younger group weights and heights were measured by trained researchers in the children's schools.

As reported in the American Journal of Clinical Nutrition, the researchers found that in both groups higher BMI standard deviation scores were associated with reduced satiety responsiveness and higher food cue responsiveness providing evidence in favor of the behavioral susceptibility theory of obesity. For the older group, increased waist circumference was also linked to reduced satiety responsiveness and higher food cue responsiveness.

When the groups were analyzed according to weight categories, the children with highest weight and waist circumference had the lowest satiety responsiveness and highest responsiveness to food cues across both groups.

The researchers comment: "If the association between appetite and adiposity is causal, it raises the question of the origins and consequences of differences in appetite," adding that "future studies could examine associations with particular genes, eg, the fat mass and obesity-associated gene."

They conclude: "A greater understanding of the determinants of appetite could help persons, clinicians, and policy makers develop a more informed approach to achieving healthy weight."

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