Behavior, Psychology and Sociology

Role of appetitive phenotype trajectory groups on child body weight during a family-based treatment for children with overweight or obesity

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Emerging evidence suggests that individual appetitive traits may usefully explain patterns of weight loss in behavioral weight loss treatments for children. The objective of this study was to identify trajectories of child appetitive traits and the impact on child weight changes over time.


Secondary data analyses of a randomized noninferiority trial conducted between 2011 and 2015 evaluated children’s appetitive traits and weight loss. Children with overweight and obesity (mean age = 10.4; mean BMI z = 2.0; 67% girls; 32% Hispanic) and their parent (mean age = 42.9; mean BMI = 31.9; 87% women; 31% Hispanic) participated in weight loss programs and completed assessments at baseline, 3, 6,12, and 24 months. Repeated assessments of child appetitive traits, including satiety responsiveness, food responsiveness and emotional eating, were used to identify parsimonious grouping of change trajectories. Linear mixed-effects models were used to identify the impact of group trajectory on child BMIz change over time.


One hundred fifty children and their parent enrolled in the study. The three-group trajectory model was the most parsimonious and included a high satiety responsive group (HighSR; 47.4%), a high food responsive group (HighFR; 34.6%), and a high emotional eating group (HighEE; 18.0%). Children in all trajectories lost weight at approximately the same rate during treatment, however, only the HighSR group maintained their weight loss during follow-ups, while the HighFR and HighEE groups regained weight (adjusted p-value < 0.05).


Distinct trajectories of child appetitive traits were associated with differential weight loss maintenance. Identified high-risk subgroups may suggest opportunities for targeted intervention and maintenance programs.

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We want to thank and acknowledge all of the families and children who participated in this study. The families that participated were reimbursed for time and effort, and the interventionists who worked at the University of California, San Diego Center for Healthy Eating and Activity Research were compensated for their work. In 2017, our group had the following published in JAMA Pediatrics [18].

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Correspondence to Kerri N. Boutelle.

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Boutelle, K.N., Kang Sim, D.E., Manzano, M. et al. Role of appetitive phenotype trajectory groups on child body weight during a family-based treatment for children with overweight or obesity. Int J Obes 43, 2302–2308 (2019) doi:10.1038/s41366-019-0463-4

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