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Clinical Research

Sex as an independent variable in the measurement of satiation: a retrospective cohort study




Satiation is a key component of food intake regulation as it brings an eating episode to an end. The effect of sex on satiation measurement has not been characterized.


To assess the effects of biological variables on satiation.


Retrospective cohort study. We included 959 participants (mean age 39 [SD 12] years; 70.7% female, and BMI 33 kg/m2 [8]) who had measurements of satiation with a nutrient-drink test to assess volume to fullness (VTF) and maximum tolerated volume (MTV), and/or an ad libitum meal test to assess calories consumed to fullness (CTF). We performed univariate and multiple regression analyses to estimate the contribution of sex to VTF, MTV, and CTF, compared to other biological variables, such as age, weight, height, BMI, waist-to-hip circumference (W/H), and lean mass percentage (LM%), that are known to affect these parameters.


Females had higher BMI, W/H, and LM%. VTF, MTV, and CTF were lower in females: 704 [323] vs. 783 [328] mL, p = 0.001; 1226 [384] vs. 1419 [410] mL, p < 0.001; and 871 [291] vs. 1086 [326] kcal, p < 0.001; respectively. Sex was a strong and independent predictor of VTF, MTF and CTF: parameter estimate [PE] = −80.8, p = 0.006; PE = −124.2, p = 0.0007; and PE = −110, p = 0.001; respectively.


Sex has a strong effect on satiation measured by VTF, MTV, and CTF, even after adjusting for other biological factors known to affect these parameters. Females seem to integrate intra-meal inhibition signals to consume fewer calories unrelated to body size or composition.

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Fig. 1: Satiation Meadurements by Sex.

Data availability

Data collected for the study, including individual de-identified participant data, as well as study protocol, and informed consent will be available to interested parties with publication, after signing of a data access agreement. Data may be requested by contacting Dr. Andres Acosta M.D, Ph.D., at


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We thank participants in the studies, the nurses, the staff of the Mayo Clinic Clinical Research Trials Unit (supported by Mayo Clinic Center for Clinical and Translational Science [CCaTS] grant UL1-TR000135), and Michael Ryks and Deborah Rhoten for their excellent technical support.


Dr. Acosta is supported by NIH (NIH K23-DK114460), Mayo Clinic Center for Individualized Medicine – Gerstner Career Development Award. Dr. Camilleri receives funding related to obesity from the National Institutes of Health (NIH RO1-DK67071). Dr. Kapoor is supported by the NIA grant U54 AG044170. The funding source was not involved in the study design, in collection, analysis, and interpretation of the data, in writing the report, or in the decision to submit the paper for publication. The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data, the accuracy of the data analysis, and the decision to submit for publication.

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MDH: designed research, analyzed data or performed statistical analysis and wrote paper; LC: conducted research, analyzed data or performed statistical analysis, wrote paper; AC: conducted research, wrote paper; AK, SF, DDH and MC: wrote paper; AA: designed research, analyzed data or performed statistical analysis, and wrote paper. MDH and AA had primary responsibility for final content. All authors read and approved the final manuscript.

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Correspondence to Andres Acosta.

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Competing interests

Dr. Acosta is a stockholder in Gila Therapeutics, Phenomix Sciences; he serves as a consultant for Rhythm Pharmaceuticals, General Mills. Dr. Camilleri is a stockholder in Phenomix Sciences and Enterin and serves as a consultant to Takeda, Allergan, Rhythm, Kallyope, and Arena with compensation to his employer, Mayo Clinic. Dr. Kapoor serves as a consultant for Mithra and Astellas Pharmaceuticals. She is also a consultant for the company Womaness. The rest of the authors have nothing to disclose.

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Hurtado, M.D., Cifuentes, L., Campos, A. et al. Sex as an independent variable in the measurement of satiation: a retrospective cohort study. Int J Obes 46, 2156–2162 (2022).

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