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The association between obesity severity and food reward in adolescents with obesity: a one-stage individual participant data meta-analysis

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Abstract

Background

Food reward and cue reactivity have been linked prospectively to problematic eating behaviours and excess weight gain in adults and children. However, evidence to date in support of an association between degree of adiposity and food reward is tenuous. A non-linear relationship between reward sensitivity and obesity degree has been previously proposed, suggesting a peak is reached in mild obesity and decreases in more severe obesity in a quadratic fashion.

Objective

To investigate and characterise in detail the relationship between obesity severity, body composition, and explicit and implicit food reward in adolescents with obesity.

Methods

Data from seven clinical trials in adolescents with obesity were aggregated and analysed in an independent participant data meta-analysis. Linear and curvilinear relationships between the degree of obesity and explicit and implicit reward for sweet and high fat foods were tested in fasted and fed states with BMI-z score as a continuous and discrete predictor using clinically recognised partitions.

Results

Although positive associations between obesity severity and preference for high-fat (i.e. energy dense) foods were observed when fasted, none reached significance in either analysis. Conversely, adiposity was reliably associated with lower reward for sweet, particularly when measured as implicit wanting (p = 0.012, ηp2 = 0.06), independent of metabolic state. However, this significant association was only observed in the linear model. Fat distribution was consistently associated with explicit and implicit preference for high-fat foods.

Conclusions

A limited relationship was demonstrated between obesity severity and food reward in adolescents, although a lower preference for sweet could be a signal of severe obesity in a linear trend. Obesity is likely a heterogenous condition associated with multiple potential phenotypes, which metrics of body composition may help define.

Clinical trial registrations

NCT02925572: https://classic.clinicaltrials.gov/ct2/show/NCT02925572. NCT03807609: https://classic.clinicaltrials.gov/ct2/show/NCT03807609. NCT03742622: https://classic.clinicaltrials.gov/ct2/show/NCT03742622. NCT03967782: https://classic.clinicaltrials.gov/ct2/show/NCT03967782. NCT03968458: https://classic.clinicaltrials.gov/ct2/show/NCT03968458. NCT04739189: https://classic.clinicaltrials.gov/ct2/show/NCT04739189. NCT05365685: https://www.clinicaltrials.gov/study/NCT05365685?tab=history.

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Data availability

Relevant data described in the manuscript will be made available upon reasonable request pending approval from relevant stakeholders.

Notes

  1. Note that dopaminergic tone and binding potential are inversely related.

  2. For sensitivity analyses involving models with BMI-z as a categorical predictor, see section S1 of the supplementary materials.

Abbreviations

BMI:

Body mass index

CDC:

Centers for disease control and prevention

DXA:

Dual-energy X-ray absorptiometry

FM:

Fat mass

FFM:

Fat-free mass

LFPQ:

Leeds food preference questionnaire

VAS:

Visual analogue scale

IDP:

Individual participant data

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Authors and Affiliations

  1. EA 3533, Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont Auvergne University, 3 Rue de La Chebarde, 63170, Clermont-Ferrand, Aubière, France

    Halim Moore, Alicia Fillon & David Thivel

  2. Observatoire National de l’Activité Physique et de la Sédentarité (ONAPS), Faculty of Medicine, Clermont Auvergne University, Clermont-Ferrand, France

    Alicia Fillon & David Thivel

  3. Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK

    Kristine Beaulieu & Graham Finlayson

  4. Nutrition Obesity Clincal Center UGECAM, Clermont-Ferrand, France

    Julie Masurier

  5. Laboratoire CIAMS Complexité, Innovation, Activités Motrices et Sportives, Fédération SAPRéM, 2 Allée du Château, 45062, Orléans Cedex 2, France

    Maud Miguet

  6. International Research Chair Health in Motion, Clermont Auvergne University Foundation, Clermont-Ferrand, France

    David Thivel

  7. Unit of Biostatistics (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France

    Bruno Pereira

  8. Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden

    Maud Miguet

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  1. Halim Moore
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Contributions

HM and DT designed the analysis; DT, AF, MM, and JM conducted the research; DT provided essential reagents, or provided essential materials; HM and BP analysed the data; HM wrote the paper; GF and KB reviewed the paper and provided essential feedback; HM had primary responsibility for the final content. All authors have read and approved the final manuscript.

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Correspondence to Halim Moore.

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The authors declare that they have no conflict of interest.

Ethics statement

The primary clinical trials that produced the data for the present study received ethics approval by independent university review board and were conducted in accordance with the principles laid out by the 1964 Declaration of Helsinki and its later amendments. All parents or guardians provided their informed consent prior to their children being included in each study.

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Moore, H., Pereira, B., Fillon, A. et al. The association between obesity severity and food reward in adolescents with obesity: a one-stage individual participant data meta-analysis. Eur J Nutr (2024). https://doi.org/10.1007/s00394-024-03348-4

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