Do appetitive traits impact success in tier three weight management services?

Introduction: Appetitive traits are stable, genetically determined predispositions towards food, which can be influenced by people’s environments. Understanding the appetitive traits of people engaged in weight management, and whether these traits are associated with weight loss success, could contribute to the development of tailored interventions. Method: A mixed-methods design explored: 1) the appetitive traits of adults accessing a Specialist Weight Management Tier Three Service; 2) whether appetitive traits were related to a weight loss of 5% of total body weight or more; and 3) participants’ own experiences of their appetitive traits during weight management. Participants (n=74) completed the Adult Eating Behaviour Questionnaire (AEBQ) and provided demographic and weight history data. Baseline and follow-up weight measurements were obtained from medical records. Logistic regression analyses explored relationships between five AEBQ appetitive traits and whether 5% weight loss was achieved. Interviews were conducted with 22 participants and data was analysed using reflexive thematic analysis. Results: Participants who were more satiety responsive, and those with a slower speed of eating were more likely to achieve 5% weight loss or more (OR 3.15; 95% CI [1.38,7.17] and OR 1.93; 95% CI [1.02,3.68] respectively). Interview data suggested that slower speed of eating may reflect the successful management of other appetitive traits. Interviewees shared their experiences of enjoyment of food, emotional eating, and stigma as important in their weight management attempts. Discussion: This is the first study to explore the appetitive traits of people accessing a U.K. weight management service. Results must be interpreted cautiously given the small sample, but findings suggest greater responsiveness to satiety and a slower speed of eating may be determinants of weight loss success. Future research should further explore the influence of appetitive traits on weight management, including the potential for tailored interventions to support individuals with more avid appetites.