Genetic clues to emotional hunger could reshape obesity care

A genetic risk score may offer a new way to identify emotional hunger in people living with obesity, according to new research that adds weight to calls for more personalised and psychologically informed obesity care.

Emotional hunger, in which eating is driven by distress rather than physical need, is increasingly recognised as a contributor to weight gain and poor treatment outcomes, yet it is often difficult to identify outside formal psychological assessment.

In this study, emotional hunger was defined as a score of seven or above on the anxiety or depression components of the Hospital Anxiety and Depression Scale. Researchers explored whether a genetic risk score could predict emotional hunger in people living with obesity, potentially allowing its assessment in settings where reported mental health data is unavailable.

The team calculated an emotional hunger genetic risk score using data from 483 participants. The score incorporated variants in genes involved in anxiety- and depression-related neurotransmitter pathways, including HTR2A, TPH2, DRD2 and ANKK1, alongside participant height. These pathways are known to influence emotional regulation and reward, both central to eating behaviour.

The model was then tested using independent datasets from earlier research, including a test cohort of 57 individuals and a validation cohort of 48 individuals. Predictive performance improved across these datasets. The area under the curve was 0.69 in the training dataset, rising to 0.72 in the test dataset and 0.85 in the validation dataset, suggesting good discrimination in the latter group.

Researchers also examined whether specific eating behaviour measures could improve prediction. In a subgroup of 137 participants who had completed a questionnaire, individual items were analysed. Two questions linked to loneliness significantly enhanced model performance, increasing the area under the curve by 0.04, underlining the importance of social and emotional factors in obesity-related eating behaviours.

The authors suggest the genetic risk score could be particularly valuable in biobanks, retrospective studies and other research contexts where Hospital Anxiety and Depression Scale data are not available. It may also enable researchers to explore how emotional hunger influences response to different obesity therapies.