Multidimensional Characterisation of Eating Behaviour in Genetic Obesity: A Systematic Review.

Area of Science:

• Endocrinology
• Genetics
• Behavioral Science

Background:

• Monogenic (MO) and syndromic (SO) obesity are severe genetic conditions characterized by early-onset weight gain due to disrupted central appetite regulation.
• Key pathways like the leptin-melanocortin axis are implicated, leading to significant hyperphagia and complex eating behaviors.
• Current clinical characterization of these eating behaviors is limited, hindering early diagnosis and tailored interventions.

Purpose of the Study:

• To systematically review and describe multidimensional eating behavior profiles in individuals with genetically confirmed obesity (MO and SO).
• To explore the variability of these eating behaviors across different genetic etiologies.
• To evaluate existing assessment tools for their suitability in clinical and research settings for these populations.

Main Methods:

• A systematic review adhering to PRISMA guidelines was conducted, analyzing 162 studies of individuals with genetically confirmed SO or MO.
• Eating behaviors were categorized into nine dimensions, including food preoccupation, food-seeking, hunger/satiety, oral behaviors, nutritional quality, preferences, acceptability, loss of control eating, and restraint.
• Assessment tools and methodologies used in the included studies were systematically reviewed.

Main Results:

• Hyperphagia is a consistent finding across genetic obesity types, though definitions and measures vary.
• Prader-Willi syndrome (PWS) exhibits early-onset hyperphagia, increased hunger, food preoccupation, compulsive food-seeking, and specific food preferences.
• Similar traits are observed in other SO and MO conditions; existing tools like HQ and FRPQ are insufficient for the full spectrum of behaviors or diverse cognitive profiles.

Conclusions:

• This review provides the first comprehensive multidimensional map of eating behaviors in rare genetic obesity.
• A shared feature is disrupted appetite regulation, underscoring the need for standardized, multidimensional assessment tools.
• Improved behavioral characterization is crucial for developing targeted therapies and enhancing outcome monitoring for individuals with genetic obesity.