Associations between Eating Behaviours and Psychological Characteristics with Body Mass Index Change and Appetite-Related Changes during Incretin-Based Therapy

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Abstract
Introduction: The aim of this study was to examine associations between psychological and behavioural factors and body weight, appetite, satiety, and food cravings in individuals with obesity receiving incretin therapy. Methods: Between January and February 2025, 411 adults completed an online survey. They provided data using the Weight Efficacy Lifestyle Questionnaire – Short Form, the Three-Factor Eating Questionnaire, and the Salzburg Emotional Eating Scale, and rated their perceptions of satiety, appetite, and food cravings. Multivariable linear and logistic regression analyses were used to assess associations between psychological factors and these outcomes, adjusting for relevant confounders. Results: The sample was mainly female (71.8%), with a median age of 40 years (Q1–Q3: 33–47). Participants had a median treatment duration of 43 weeks (Q1–Q3: 30–58) and a median body mass index (BMI) difference of 5.9 kg/m2 (Q1–Q3: 4.0–7.4). In fully adjusted models, higher self-efficacy was associated with lower BMI values (β = −0.22; p < 0.001) and greater satiety (adjusted odds ratio [AOR] = 1.46; p < 0.001). Emotional eating in response to happiness was related to higher BMI (β = 0.46; p < 0.001) but also to higher satiety and lower cravings (AOR = 1.31–1.41; p < 0.05). Conclusion: Eating self-efficacy and emotion-related eating patterns were linked to body weight, appetite, satiety, and cravings. Considering these psychological profiles may help tailor behavioural support, improve adherence, and enhance the effectiveness of incretin-based therapy.

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