Weight-dependent associations between food responsiveness, appetite interoception, and binge eating in daily life

Food responsiveness and impaired sensitivity to internal appetite signals have been implicated in binge-eating disorder (BED), yet little is known about how these processes interact in daily life or whether their associations with binge eating differ by weight status. This study examined how real-world dynamics among food responsiveness, appetite interoception, and binge-eating symptoms varied by weight using ecological momentary assessment (EMA). Adults with BED or subthreshold BED (N=46) with healthy to overweight body mass index (BMI) completed a 14-day EMA protocol. Individual differences in food responsiveness were operationalized as person-specific momentary associations between palatable food cue exposure and craving. Generalized linear mixed models examined main and interactive effects of BMI, food responsiveness, and within- and between-person hunger and satiety sensitivity on binge-eating symptoms. Individuals with lower satiety sensitivity reported higher binge-eating symptoms, and a significant three-way interaction emerged between within-person satiety sensitivity, BMI, and food responsiveness predicting binge-eating symptoms. Among individuals with lower BMI (within the healthy range), greater momentary satiety sensitivity was associated with lower binge-eating symptoms regardless of food responsiveness. In contrast, among individuals with higher BMI (within the overweight range), elevated food responsiveness attenuated the association between satiety sensitivity and binge-eating symptoms. No significant effects emerged for hunger sensitivity prior to eating episodes. Findings suggest that heightened food responsiveness may undermine the regulatory influence of satiety signaling on binge-eating symptoms among individuals with higher BMI, highlighting the importance of targeting cue-driven eating in interventions for BED.