Department of Physical Medicine and Rehabilitation, The University of Miami Miller School of Medicine, Miami, FL, USA; Miami Project to Cure Paralysis, Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
Appetite. 2024 Jan 1;192:107110. doi: 10.1016/j.appet.2023.107110. Epub 2023 Nov 7.
Overeating associated with neurogenic obesity after spinal cord injury (SCI) may be related to how persons with SCI experience satiation (processes leading to meal termination), their eating frequency, and the context in which they eat their meals. In an online, cross-sectional study, adults with (n = 688) and without (Controls; n = 420) SCI completed the Reasons Individuals Stop Eating Questionnaire-15 (RISE-Q-15), which measures individual differences in the experience of factors contributing to meal termination on five scales: Physical Satisfaction, Planned Amount, Decreased Food Appeal, Self-Consciousness, and Decreased Priority of Eating. Participants also reported weekly meal and snack frequency and who prepares, serves, and eats dinner with them at a typical dinner meal. Analysis revealed that while Physical Satisfaction, Planned Amount, and Decreased Food Appeal were reported as the most frequent drivers of meal termination in both groups, scores for the RISE-Q-15 scales differed across the groups. Compared to Controls, persons with SCI reported Physical Satisfaction and Planned Amount as drivers of meal termination less frequently, and Decreased Food Appeal and Decreased Priority of Eating more frequently (all p < 0.001). This suggests that persons with SCI rely less on physiological satiation cues for meal termination than Controls and instead rely more on hedonic cues. Compared to Controls, persons with SCI less frequently reported preparing and serving dinner meals and less frequently reported eating alone (all p < 0.001), indicating differences in meal contexts between groups. Individuals with SCI reported consuming fewer meals than Controls but reported a higher overall eating frequency due to increased snacking (p ≤ 0.015). A decrease in the experience of physical fullness, along with a dependence on a communal meal context and frequent snacking, likely contribute to overeating associated with neurogenic obesity after SCI.
脊髓损伤（SCI）后与神经性肥胖相关的暴食可能与 SCI 患者的饱腹感体验（导致进食结束的过程）、他们的进食频率以及他们进食的环境有关。在一项在线横断面研究中，患有（n=688）和不患有（对照组；n=420）SCI 的成年人完成了《个体停止进食原因问卷-15 项》（RISE-Q-15），该问卷测量了五个量表中个体差异对进食结束的影响：生理满足感、计划进食量、食物吸引力降低、自我意识和进食优先级降低。参与者还报告了每周的进餐和零食频率，以及在典型的晚餐中谁为他们准备、供应和与他们一起吃晚餐。分析表明，尽管在两组中，生理满足感、计划进食量和食物吸引力降低被认为是最常见的进食结束驱动因素，但 RISE-Q-15 量表的评分在两组之间存在差异。与对照组相比，SCI 患者报告的生理满足感和计划进食量作为进食结束的驱动因素较少，而食物吸引力降低和进食优先级降低更为频繁（均 p<0.001）。这表明 SCI 患者比对照组更少依赖生理饱腹感信号来结束进食，而是更多地依赖享乐性信号。与对照组相比，SCI 患者较少报告准备和供应晚餐，较少报告独自进食（均 p<0.001），这表明两组之间的进餐环境存在差异。SCI 患者报告的进餐次数少于对照组，但由于增加了零食摄入，总体进食频率更高（p≤0.015）。生理饱腹感的降低，加上对集体进餐环境的依赖和频繁的零食摄入，可能导致 SCI 后神经性肥胖相关的暴食。
