Identifying behavioral phenotypes for childhood obesity

Abstract

Existing programs which aim to prevent and treat childhood obesity often do not take into account individual variation and the underlying mechanisms that impact child eating behavior. Individual differences in children's appetitive traits have been shown to appear as early as during infancy and become more pronounced as children grow older and become more exposed to the obesogenic food environment. Differences in genetic predispositions interacting with factors in children's early environment account in part for individual differences in appetitive traits. It is very likely that obesogenic eating phenotypes manifest themselves before the onset of childhood obesity. If so, identifying these phenotypes early is expected to move primary prevention strategies in a new direction and holds great potential to significantly enhance our ability to prevent childhood obesity. The aim of this narrative review is to discuss the role of behavioral phenotyping as an innovative approach for the development of more personalized obesity prevention and treatment interventions that are tailored to children's individual predispositions. We describe several examples of appetitive traits which have been linked to overeating and excess weight gain in children and thus may represent modifiable risk factors for future interventions. The review concludes with a comprehensive synthesis of opportunities for future human ingestive behavior research on identifying behavioral phenotypes for childhood obesity.

A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research

“…The intervention strategies have been developed mainly from knowledge about risk or predictive factors and/or speculations about processes in the development of OW/OB. However, consistent with the literature in development science (see below), the value of designing intervention and prevention strategies from an evidence base of process in the development of OW/OB has been recognized …”

“…Similar reasoning was recently used by Stanhope et al who argued that calories from any food have the potential to increase the risk for obesity, but that there is a need to identify the mechanisms or pathways associated with this risk, and this, they argued, might lead to new intervention strategies. Similarly, Kral et al argued that it is important to identify the underlying mechanisms associated with the development of OW/OB in childhood. Moving from risk and prediction to an understanding of developmental processes over time should contribute to the efficacy of interventions through a better targeting of strategies to the processes that contribute to the development of OW/OB in different children or families.…”

Disordered Eating Attitudes and Behaviors in Youth with Overweight and Obesity: Implications for Treatment

“…Food-seeking appetitive traits and poor self-regulation, including lack of satiety responsiveness, motivation to eat, impulsivity, and faster eating rates, have been observed in children with obesity at greater rates than normal-weight peers [36, 37]. Increasing endorsement of these traits may present a cumulative risk for excess calorie consumption and weight gain [36, 37].…”

“…Food-seeking appetitive traits and poor self-regulation, including lack of satiety responsiveness, motivation to eat, impulsivity, and faster eating rates, have been observed in children with obesity at greater rates than normal-weight peers [36, 37]. Increasing endorsement of these traits may present a cumulative risk for excess calorie consumption and weight gain [36, 37]. The association between lack of satiety responsiveness and impulsivity with binge eating has also been highlighted [36] and other research suggests certain appetitive traits may be more severe in individuals with both obesity and BED [38].…”

Longitudinal associations between eating and drinking engagement during mealtime and eating in the absence of hunger in low income toddlers

“…Yet, Asta and colleagues’ study did not examine individual differences in EAH or continuity in EAH across time. It is important to consider these issues, as understanding whether EAH is a stable construct can inform our understanding of when best to intervene to reduce EAH as an effort to prevent childhood obesity (Kral et al, 2018). In addition, Asta and colleagues’ study focused largely on associations between demographics and child affect with EAH, and did not consider how other aspects of toddler eating and drinking behavior may relate to EAH.…”