The development of interoceptive hunger signals

Stevenson, Richard J.; Bartlett, Johanna; Wright, Madeline; Hughes, Alannah; Hill, Brayson J.; Saluja, Supreet; Francis, Heather

doi:10.1002/dev.22374

Cited by 6 publications

(1 citation statement)

References 49 publications

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“…The literature using carer‐reports to investigate interoception in young children in relation to disordered eating is scarce. However, it has been hypothesized that loss of control eating, understood as a precursor to BED, as well as restrictive eating are linked to poor interoception (Stevenson et al, 2023). Furthermore, articles using carer‐reports focusing on exteroception in relation to disordered eating in children show similar findings to ours.…”

Section: Discussionmentioning

confidence: 99%

Sensory processing across eating disorders: A systematic review and meta‐analysis of self‐report inventories

Cobbaert,

Hay,

Mitchell

et al. 2024

Intl J Eating Disorders

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ObjectiveThis review investigated the extant literature regarding the relationship between eating disorder diagnoses and sensory processing as measured by validated and reliable self‐report inventories. Increasing evidence highlights the role of sensory processing in cognitive functions. Sensory processing is implicated in mental‐ill health, including eating disorders (ED) and body image disturbances. However, the pathophysiological underpinnings of sensory processing, encompassing exteroception and interoception, in relation to ED remain underexplored.MethodWe included studies involving participants aged 15 years or older with an eating disorder diagnosis confirmed by semi‐structured or structured interviews. We further limited inclusion to articles using validated and reliable self‐report instruments to measure sensory processing. Our meta‐analysis focused on studies using the interoceptive awareness subscale from the second version of the Eating Disorder Inventory. We used the Critical Appraisal checklist for quasi‐experimental studies to assess the quality of included articles.ResultsThere were 19 studies that met our inclusion criteria. Most studies showed moderate‐to‐high quality. Anorexia nervosa (AN) and bulimia nervosa (BN) were associated with heightened exteroception. Moreover, people with AN reported a heightened sense of taste compared to those with BN. Our meta‐analysis comprising 10 studies, 19 samples, and 6382 participants revealed that AN (binge‐purge subtype) and BN were associated with increased interoceptive difficulties compared to AN (restrictive subtype) or binge‐eating disorder.DiscussionOverall, this review emphasizes the need for a deeper investigation into sensory processing, spanning both exteroception and interoception, in relation to ED. This may prove important for individualizing person‐centered care.Public significanceHow people process internal, for example, hunger, and external, for example, taste and sensations is known to influence cognition and mental‐ill health, including ED and body image disturbances. However, the ways in which sensory processing may contribute to ED are incompletely understood. We found that individuals with AN or BN experienced heightened exteroception, while people with an eating disorder characterized by purging reported increased interoceptive difficulties. These patterns could inform the development of more personalized treatments.

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Section: Discussionmentioning

confidence: 99%

Sensory processing across eating disorders: A systematic review and meta‐analysis of self‐report inventories

Cobbaert,

Hay,

Mitchell

et al. 2024

Intl J Eating Disorders

View full text Add to dashboard Cite

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The development of interoceptive hunger signals

Stevenson

Bartlett

Wright

et al. 2023

Developmental Psychobiology

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Hunger is often reported when people experience certain internal sensations (e.g., fatigue) or when they anticipate that a food will be good to eat. The latter results from associative learning, while the former was thought to signal an energy deficit. However, energy-deficit models of hunger are not well supported, so if interoceptive hungers are not "fuel gauges," what are they? We examined an alternate perspective, where internal states signaling hunger, which are quite diverse, are learned during childhood. A basic prediction from this idea is offspring-caregiver similarity, which should be evident if caregivers teach their child the meaning of internal hunger cues. We tested 111 university student offspring-primary caregiver pairs, by having them complete a survey about their internal hunger states, alongside other information that may moderate this relationship (i.e., gender, body mass index, eating attitudes, and beliefs about hunger). We observed substantial similarity between offspring-caregiver pairs (Cohen's ds from 0.33 to 1.55), with the main moderator being beliefs about an energyneeds model of hunger, which tended to increase similarity. We discuss whether these findings may also reflect heritable influences, the form that any learning might take, and the implications for child feeding practices.

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Caregivers’ Attention Toward, and Response to, Their Child's Interoceptive Hunger and Thirst Cues

Stevenson,

Serebro,

Mruk

et al. 2024

Developmental Psychobiology

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People can use their internal state to determine if they are hungry or thirsty. Although the meaning of some interoceptive cues may be innate (e.g., pain), it is possible that others—including those for hunger and thirst—are acquired. There has been little exploration of this idea in humans. Consequently, we conducted a survey among child caregivers to determine if the basic conditions necessary for interoceptive learning were present. Two‐hundred and thirty‐five caregivers of children aged 1–12 years were asked if they had recently noticed stomach rumbling, hunger‐related irritability, and a dry mouth in their child. They were also asked how they would respond. The impact of several moderating variables, especially caregiver beliefs about the causes of hunger, fullness, and thirst, was also explored. Fifteen percent of caregivers had recently noticed stomach rumbling in their child, 28% hunger‐related irritability, and 14% a dry mouth. Forty‐four percent of caregivers had noticed at least one of these three cues. Noticing hunger cues was significantly moderated by caregiver beliefs about their cause, by child age, and in one case by temporal context (around vs. outside mealtimes). Key caregiver responses were providing the need (e.g., offer food) and/or asking the child if they had a need (e.g., hungry?). Each type of response could potentially support a different form of interoceptive learning. In conclusion, we suggest the necessary conditions for children to learn interoceptive hunger and thirst cues, are present in many caregiver–offspring dyads.

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The development of interoceptive hunger signals

Cited by 6 publications

References 49 publications

Sensory processing across eating disorders: A systematic review and meta‐analysis of self‐report inventories

Sensory processing across eating disorders: A systematic review and meta‐analysis of self‐report inventories

The development of interoceptive hunger signals

Caregivers’ Attention Toward, and Response to, Their Child's Interoceptive Hunger and Thirst Cues

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