Getting to the heart of the matter: Does aberrant interoceptive processing contribute towards emotional eating?

Hayley A Young,Amy Owens,Aimee E Pink,Claire Williams,Gary Freegard,David Benton,Clemens Fürnsinn

doi:10.1371/journal.pone.0186312

Abstract

According to estimates from Public Health England, by 2034 70% of adults are expected to be overweight or obese, therefore understanding the underpinning aetiology is a priority. Eating in response to negative affect contributes towards obesity, however, little is known about the underlying mechanisms. Evidence that visceral afferent signals contribute towards the experience of emotion is accumulating rapidly, with the emergence of new influential models of ‘active inference’. No longer viewed as a ‘bottom up’ process, new interoceptive facets based on ‘top down’ predictions have been proposed, although at present it is unclear which aspects of interoception contribute to aberrant eating behaviour and obesity. Study one examined the link between eating behaviour, body mass index and the novel interoceptive indices; interoceptive metacognitive awareness (IAw) and interoceptive prediction error (IPE), as well as the traditional measures; interoceptive accuracy (IAc) and interoceptive sensibility (IS). The dissociation between these interoceptive indices was confirmed. Emotional eaters were characterised by a heightened interoceptive signal but reduced meta-cognitive awareness of their interoceptive abilities. In addition, emotional eating correlated with IPE; effects that could not be accounted for by differences in anxiety and depression. Study two confirmed the positive association between interoceptive accuracy and emotional eating using a novel unbiased heartbeat discrimination task based on the method of constant stimuli. Results reveal new and important mechanistic insights into the processes that may underlie problematic affect regulation in overweight populations.

Highlights

Deficits in emotion regulation are a commonly used explanation for the development and maintenance of obesity [1], the exact process by which emotions affect eating behaviour remains an unanswered question
Self-confidence and depression have been associated with interoception [21], as well as emotional eating [32], we considered whether the interoception–eating behaviour associations might be explained by individual differences in anxiety, depression and self-confidence
The present results indicated that a complex pattern of interoceptive processing underlies aberrant eating behaviour

Summary

Introduction

Deficits in emotion regulation are a commonly used explanation for the development and maintenance of obesity [1], the exact process by which emotions affect eating behaviour remains an unanswered question. Interoception and eating behaviour signals are pertinent to the emotional experience (a process referred to as interoception: the perception and interpretation of bodily signals) has shed new light on the mechanisms surrounding emotional disorders [2,3,4,5,6] and has the potential to enhance our understanding of obesity. Interoception is no longer considered a unitary construct and it is unclear which aspects of interoception contribute to aberrant eating behaviour and obesity: a more complete understanding of the inter-relations between interoception, obesity and emotion is required

Objectives

Methods

Results

Discussion

Conclusion