Avignon Antoine, Bonnet Jean-Baptiste, Anitcheou Jean, Tournayre Sarah, Attalin Vincent, Boegner Catherine, Jalek Abdulkader, Jullien Dominique, Le Rouzic Camille, Myzia Justine, Marty Lucile, Kemba Youadigue, Sultan Ariane, Bousquet Jean
Nutrition-Diabetes Department, University Hospital of Montpellier, Montpellier, France.
Joint Research Unit (UMR) 1302, Desbrest Institute of Epidemiology and Public Health, University of Montpellier, INSERM, Montpellier, France.
Obesity (Silver Spring). 2025 May;33(5):892-902. doi: 10.1002/oby.24262. Epub 2025 Apr 3.
Obesity management requires personalized approaches. Using data from the Aviitam platform in France, this study aimed to do the following: 1) explore psychological and behavioral patterns through clustering techniques; 2) validate the robustness of these clusters; and 3) assess their association with weight-loss outcomes in severe obesity under semaglutide treatment.
Phase 1 included 989 adults with BMI ≥ 25 kg/m who completed validated questionnaires, including the Hospital Anxiety and Depression Scale (HADS) and Intuitive Eating Scale-2 (IES-2). Phase 2 validated robustness in 492 individuals. Phase 3 applied clusters to 125 individuals with BMI ≥ 40 kg/m who were treated with semaglutide 2.4 mg/week at Montpellier University Hospital, assessing weight-loss trajectories over 12 months.
The following two clusters were identified: the Intuitive Eaters Group (IEG, n = 482); and the Emotionally Driven Eaters Group (EDEG, n = 507). The IEG exhibited lower emotional distress and higher intuitive eating scores. HADS and IES-2 distinguished clusters effectively (area under the curve, 0.95). Robustness was confirmed in Phase 2. In Phase 3, the IEG demonstrated a significantly more favorable weight-loss trajectory compared to the EDEG (p = 0.03).
Psychological and behavioral clusters identified through HADS and IES-2 are associated with weight loss under semaglutide treatment, suggesting the value of integrating psychological and behavioral profiling into obesity care.
肥胖管理需要个性化方法。本研究利用法国Aviitam平台的数据，旨在实现以下目标：1）通过聚类技术探索心理和行为模式；2）验证这些聚类的稳健性；3）评估它们与司美格鲁肽治疗下重度肥胖患者体重减轻结果的关联。
第一阶段纳入了989名BMI≥25kg/m²的成年人，他们完成了经过验证的问卷，包括医院焦虑抑郁量表（HADS）和直觉饮食量表-2（IES-2）。第二阶段在492名个体中验证了稳健性。第三阶段将聚类应用于蒙彼利埃大学医院125名BMI≥40kg/m²且接受每周2.4mg司美格鲁肽治疗的个体，评估其12个月内的体重减轻轨迹。
识别出以下两个聚类：直觉饮食者组（IEG，n = 482）；以及情绪驱动饮食者组（EDEG，n = 507）。IEG表现出较低的情绪困扰和较高的直觉饮食得分。HADS和IES-2有效地区分了聚类（曲线下面积为0.95）。第二阶段证实了稳健性。在第三阶段，与EDEG相比，IEG的体重减轻轨迹明显更有利（p = 0.03）。
通过HADS和IES-2识别出的心理和行为聚类与司美格鲁肽治疗下的体重减轻相关，这表明将心理和行为剖析纳入肥胖护理具有价值。
