Interoceptive sensitivity, body weight and eating behavior in children: a prospective study

Abstract

Previous research indicates that interindividual differences in the ability to perceive one's own bodily signals (interoceptive sensitivity, IS) are associated with disordered eating behavior and weight problems. But representative and prospective data in children are lacking and therefore, the exact nature of these observed associations remains unclear. Data on IS measured by heartbeat perception ability in 1657 children between 6 and 11 years of age were collected on the basis of two measurement points with a year distance in time. Stability of the construct and its prospective association with different food approach behaviors [assessed via parent questionnaires (Children's Eating Behavior Questionnaire and Dutch Eating Behavior Questionnaire)] as well as with weight status were analyzed via structural equation modeling. Main results were that only in overweight children external and emotional eating behavior were predictive for later IS, whereas no such relation was found in normal weight children. There was no direct relation between IS and body mass index. For the first time, we could show that eating behavior and IS in middle childhood are prospectively related to each other. But surprisingly, our data indicate that altered interoceptive processes rather follow than precede non-adaptive eating behavior patterns in overweight children. This suggests a possible crucial role of faulty learning mechanisms in eating behavior early in life, undermining the later confidence in one's body.

Keywords: body weight; children; eating behavior; heartbeat perception; interoceptive sensitivity; overweight.

Figure 1

Heartbeat perception scores for both measurement points (T1 and T2) contrasting overweight and normal weight group. Error bars represent standard error of means. ^*p < 0.05.

Figure 2

Structural model for reciprocal time-lagged effects between heartbeat perception (HBP) and body mass index standard deviation score (BMI-SDS). Controlled for age, sex, and educational attainment of the mother. Displayed are standardized estimates. ^***p < 0.001.

Figure 3

Results of multi-group structural equation analysis evaluating the reciprocal effects between heartbeat perception and eating behavior across normal weight and overweight children. Model fit: χ²_{(df = 1040)} = 1987.08, p < 0.001, CFI = 0.94, RMSEA = 0.04, SRMR = 0.05. Controlled for age, sex, educational attainment of the mother and cross sectional relations. For the sake of clarity, only significant standardized estimates of path coefficients over time are presented. See the text for further information on the exact measurement model. Standardized coefficients for overweight children are reported outside parentheses and standardized coefficients for normal weight children are reported inside parentheses. ^***p < 0.001, ^**p < 0.01, ^*p < 0.05