Effect of a 10-month residential multidisciplinary weight loss intervention on food reward in adolescents with obesity.

While multidisciplinary weight loss (WL) programs have been suggested to improve the sensitivity of appetite control system, this study examined for the first time the effect of a specific multidisciplinary intervention on the hedonic aspects of food intake in adolescents with obesity. Twenty-four adolescents (11-15 years) with obesity (mean BMI: 35.7 ± 4.5 kg/m2; BMI percentile: 98.7 ± 0.5) took part in a 10-month inpatient WL program, which included physical activity, nutritional education and psychological support. Height, weight, body composition, food reward (pre- and post-meal), ad libitum energy intake, appetite sensations and eating behavior traits were assessed at baseline, 5 months and at the end of the 10-month intervention. Analyses were conducted with linear mixed models and paired t-tests. The mean WL was 8.9 ± 6.9 kg. Appetite sensations and pre-meal hedonic ratings of liking for all food categories (HF: high-fat; LF: low-fat; SA: savory; SW: sweet) increased after 5 months (fasting hunger, p = 0.02; fasting desire to eat, p = 0.01; daily hunger, p = 0.001; pre-meal liking for HFSA, p = 0.03; LFSA, p = 0.04; HFSW, p = 0.009; LFSW, p = 0.005). In contrast, appetite sensations (fasting and daily), emotional eating (p < 0.001), uncontrolled eating (p = 0.009), and pre-meal explicit liking (for all food categories) decreased between months 5 and 10. Post-meal liking for HFSA (p < 0.001), LFSA (p = 0.002), HFSW (p = 0.02) and LFSW (p < 0.001) decreased between baseline and month 5 and remained unchanged between months 5 and 10. These findings suggest that adaptive mechanisms to WL occurring in the short-to-medium term are attenuated in the longer term with the persistence of WL. These results indicate improvements in the reward response to food in adolescents with obesity and may contribute to the beneficial effect of multicomponent WL interventions in this population. Future studies are required to confirm these findings and elucidate underlying mechanisms.

Miguet M ，Beaulieu K ，Fillon A ，Khammassi M ，Masurier J ，Lambert C ，Duclos M ，Boirie Y ，Finlayson G ，Thivel D ... -  《-》

Cognitive restriction accentuates the increased energy intake response to a 10-month multidisciplinary weight loss program in adolescents with obesity.

Multidisciplinary interventions have shown some merits in weight reduction strategies in youth, however, their impact on subsequent daily energy intake remains largely unknown. The aim of the present study was to evaluate the nutritional responses to a 10-month multidisciplinary intervention among adolescents with obesity, in relation to their eating behavior characteristics. Thirty-five adolescents (mean age: 13.4 ± 1.2 years) with obesity took part in a 10-month residential multidisciplinary weight loss program. Anthropometric measurements, body composition (dual-energy X-ray absorptiometry), 24-h ad libitum energy intake (weighted), eating behaviors (Dutch Eating Behavior Questionnaire) and appetite sensations (Visual Analogue Scales) were assessed on three occasions: at their arrival in the institution (T0), after 5 months (T1), and at the end of the 10-month program (T2). The mean weight loss reached 11% of the adolescents' initial body weight, with an important inter-individual variability (-25% to +3% of their initial body weight). Results revealed sex differences change, with boys showing a higher decrease in fat mass percent and increase in fat-free mass compared with girls. Weight loss was accompanied by a significant decrease in emotional (-8.3%, p < 0.05) and external (-14.8%, p < 0.001) eating scores and a significant increase in 24-h ad libitum energy intake (+246 kcal, p < 0.001). The observed subsequent increased 24-h ad libitum energy intake at T2 compared to T0 was significantly higher in cognitively restrained eaters (+492 kcal) compared to unrestrained eaters (+115 kcal, p = 0,015). Dietary restraint score at baseline was inversely correlated with the percentage of weight loss (r = -0.44, p = 0.010). A 10-month multidisciplinary weight loss intervention induced an increase in 24-h ad libitum energy intake compared to baseline, especially in cognitively restrained eaters. Moreover, initially cognitively restrained eaters tended to lose less body weight compared to unrestrained ones. These findings suggest that cognitive restriction may be a useful eating behavior characteristic to consider as a screening tool for identifying adverse responders to weight loss interventions in youth.

Miguet M ，Masurier J ，Chaput JP ，Pereira B ，Lambert C ，Dâmaso AR ，Courteix D ，Duclos M ，Boirie Y ，Thivel D ... -  《-》

Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead To Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women with Overweight and Obesity.

Continuous energy restriction (CER) is purported to be problematic because of reductions in fat-free mass (FFM), compensatory motivation to overeat, and weakened satiety. Intermittent energy restriction (IER) is an alternative behavioral weight loss (WL) strategy that may mitigate some of these limitations. The objective of the DIVA study was to compare the effects of CER and IER on appetite when the degree of WL (≥5%) is matched. Women with overweight/obesity (BMI 25.0-34.9 kg/m2; age 18-55 y) were recruited for this controlled-feeding RCT via CER (25% daily energy restriction) or IER (alternating ad libitum and 75% energy restriction days). Probe days were conducted at baseline and post-intervention to assess body composition, ad libitum energy intake and subjective appetite in response to a fixed-energy breakfast, and eating behavior traits. After baseline measurements, participants were allocated to CER (n = 22) or IER (n = 24). Per protocol analyses (≥5% WL within 12 wk) were conducted with use of repeated measures ANOVA. Thirty of 37 completers reached ≥5% WL [CER (n = 18): 6.3 ± 0.8% in 57 ± 16 d, IER (n = 12): 6.6 ± 1.1% in 67 ± 13 d; % WL P = 0.43 and days P = 0.10]. Fat mass [-3.9 (95% CI: -4.3, -3.4) kg] and FFM [-1.3 (95% CI: -1.6, -1.0) kg] were reduced post-WL (P < 0.001), with no group differences. Self-selected meal size decreased post-WL in CER (P = 0.03) but not in IER (P = 0.19). Hunger AUC decreased post-WL (P < 0.05), with no group differences. Satiety quotient remained unchanged and was similar in both groups. Both interventions improved dietary restraint, craving control, susceptibility to hunger, and binge eating (P < 0.001). Controlled ≥5% WL via CER or IER did not differentially affect changes in body composition, reductions in hunger, and improvements in eating behavior traits. This suggests that neither CER nor IER lead to compensatory adaptations in appetite in women with overweight/obesity. This trial was registered at clinicaltrials.gov as NCT03447600.

Beaulieu K ，Casanova N ，Oustric P ，Turicchi J ，Gibbons C ，Hopkins M ，Varady K ，Blundell J ，Finlayson G ... -  《-》

Effect of exercise-meal timing on energy intake, appetite and food reward in adolescents with obesity: The TIMEX study.

The present study manipulated the delay between exercise and test meal to investigate its effect on energy intake, appetite sensations and food reward in adolescents with obesity. Fifteen adolescents with obesity randomly completed 3 experimental sessions: i) rest without exercise (CON); ii) 30 min of exercise 180 min before lunch (EX-180); iii) 30 min of exercise 60 min before lunch (EX-60). Ad libitum energy intake was assessed at lunch and dinner, and food reward (LFPQ) assessed before and after lunch. Appetite sensations were assessed at regular intervals. Absolute energy intake was not different between conditions despite a 14.4% lower intake in EX-60 relative to CON. Lunch relative energy intake (REI: energy intake - exercise-induced energy expenditure) was higher in CON compared with EX-60 (p < 0.001). Lunch fat intake was lower in EX-60 compared with CON (p = 0.01) and EX-180(p = 0.02). Pre-lunch hunger in CON was lower than EX-180 (p = 0.02). Pre-lunch prospective food consumption and desire to eat were lower in CON compared with both exercise conditions (p = 0.001). A significant condition effect was found for explicit liking for high-fat relative to low-fat foods before lunch (p = 0.03) with EX-60 being significantly lower than EX-180 (p = 0.001). The nutritional and food reward adaptations to exercise might be dependent on the timing of exercise, which is of importance to optimize its effect on energy balance in adolescents with obesity. CLINICAL TRIAL REFERENCE: NCT03807609.

Fillon A ，Mathieu ME ，Masurier J ，Roche J ，Miguet M ，Khammassi M ，Finlayson G ，Beaulieu K ，Pereira B ，Duclos M ，Boirie Y ，Thivel D ... -  《-》

The energy content of meals with a similar macronutrient distribution may have a greater impact on appetite sensations than food preferences in adolescents with obesity: A secondary analysis.

Moore H ，Siroux J ，Pereira B ，Miguet M ，Fillon A ，Dionnet C ，Julian V ，Duclos M ，Boirie Y ，Finlayson G ，Isacco L ，Thivel D ... -  《-》