I’ve gut a feeling : relevance and trainability of gastric interoception in the context of eating behavior
PSPE
- Tiemann, Aline ORCID Université de Fribourg
- Fribourg (Switzerland), [2025]
1 ressource en ligne (181 pages) ; 1 fichier pdf
PhD: Université de Fribourg. Université du Luxembourg., 17.10.2025
Troubles du comportement alimentaire
Intéroception
Eating disorders
Interoception
Gastric Biofeedback
English
disorders (EDs) are associated with high morbidity, mortality, and chronicity, yet
treatment efficacy has plateaued under current approaches. Disordered and maladaptive eating
behaviors often precede the onset of eating disorders, and targeting underlying factors may offer
a promising approach. Interoception, defined as the sensing of internal bodily signals, has been
proposed as one such underlying factor contributing to disordered eating. Interoception is
multidimensional, including the sensing, interpretation, and integration of internal bodily
signals. In particular, the sensing of signals originating from the stomach (i.e., gastric
interoception), such as hunger, satiety, and fullness are highly relevant for eating behavior.
However, gastric interoception remains understudied in its multidimensional aspects (including
physiological, behavioral and self-report measures), with most research focusing solely on selfreport.
The goal of Study 1 was to examine the relevance of multidimensional gastric
interoception for maladaptive eating behavior in a sample comprising healthy individuals,
individuals with bulimia nervosa (BN) and binge-eating disorder (BED). Results indicated that
multidimensional gastric interoception, assessed through physiological, behavioral, and selfreport
measures, was the strongest predictor of maladaptive eating behavior (emotional,
external and restrained eating). Notably, the gastric attribution of interoceptive sensations (i.e.,
negative affect after water ingestion) emerged as the most significant predictor for emotional,
external and restrained eating.
Additionally, gastric motility has been proposed as a key mediator of hunger and satiety,
with individuals with EDs exhibiting altered gastric motility patterns. Interventions aimed at
regulating gastric motility, such as gastric biofeedback using electrogastrogram (EGG), hold
promise in the context of gastric interoception and eating behaviors. However, this approach
remains largely understudied, with only one known study to date (Stern et al., 2004). Therefore,
the aim of Study 2 was to develop a novel EGG-based gastric biofeedback paradigm. We
assessed its feasibility, effectiveness, and subjective experience in a healthy sample. We
compared three groups: a virtual reality (VR) group, a 2D screen-based group, and a control
group (CG). Results demonstrated technical feasibility and positive evaluations of the gastric
biofeedback paradigm. In Study 3, we examined the downstream effects of the gastric
biofeedback paradigm between the VR, 2D and CG. We assessed the effects of gastric
biofeedback on multidimensional cardiac and gastric interoception (physiological, behavioral,
and self-report), general self-reported interoception, eating behavior (emotional, external,
restrained, and intuitive eating), and ED symptoms. Results indicated promising effects of the
2D condition on satiation and fullness perception, body listening, and intuitive eating. Overall,
the findings of this thesis suggest that gastric interoception plays a key role in eating behavior
and that gastric biofeedback is both feasible and well accepted. The 2D condition, in particular,
appears promising for enhancing satiation and fullness perception, body listening, and intuitive
eating. It also offers a potentially accessible option for home-based use and early intervention.
Future research should further develop gastric biofeedback and evaluate its clinical utility in
populations with EDs.
treatment efficacy has plateaued under current approaches. Disordered and maladaptive eating
behaviors often precede the onset of eating disorders, and targeting underlying factors may offer
a promising approach. Interoception, defined as the sensing of internal bodily signals, has been
proposed as one such underlying factor contributing to disordered eating. Interoception is
multidimensional, including the sensing, interpretation, and integration of internal bodily
signals. In particular, the sensing of signals originating from the stomach (i.e., gastric
interoception), such as hunger, satiety, and fullness are highly relevant for eating behavior.
However, gastric interoception remains understudied in its multidimensional aspects (including
physiological, behavioral and self-report measures), with most research focusing solely on selfreport.
The goal of Study 1 was to examine the relevance of multidimensional gastric
interoception for maladaptive eating behavior in a sample comprising healthy individuals,
individuals with bulimia nervosa (BN) and binge-eating disorder (BED). Results indicated that
multidimensional gastric interoception, assessed through physiological, behavioral, and selfreport
measures, was the strongest predictor of maladaptive eating behavior (emotional,
external and restrained eating). Notably, the gastric attribution of interoceptive sensations (i.e.,
negative affect after water ingestion) emerged as the most significant predictor for emotional,
external and restrained eating.
Additionally, gastric motility has been proposed as a key mediator of hunger and satiety,
with individuals with EDs exhibiting altered gastric motility patterns. Interventions aimed at
regulating gastric motility, such as gastric biofeedback using electrogastrogram (EGG), hold
promise in the context of gastric interoception and eating behaviors. However, this approach
remains largely understudied, with only one known study to date (Stern et al., 2004). Therefore,
the aim of Study 2 was to develop a novel EGG-based gastric biofeedback paradigm. We
assessed its feasibility, effectiveness, and subjective experience in a healthy sample. We
compared three groups: a virtual reality (VR) group, a 2D screen-based group, and a control
group (CG). Results demonstrated technical feasibility and positive evaluations of the gastric
biofeedback paradigm. In Study 3, we examined the downstream effects of the gastric
biofeedback paradigm between the VR, 2D and CG. We assessed the effects of gastric
biofeedback on multidimensional cardiac and gastric interoception (physiological, behavioral,
and self-report), general self-reported interoception, eating behavior (emotional, external,
restrained, and intuitive eating), and ED symptoms. Results indicated promising effects of the
2D condition on satiation and fullness perception, body listening, and intuitive eating. Overall,
the findings of this thesis suggest that gastric interoception plays a key role in eating behavior
and that gastric biofeedback is both feasible and well accepted. The 2D condition, in particular,
appears promising for enhancing satiation and fullness perception, body listening, and intuitive
eating. It also offers a potentially accessible option for home-based use and early intervention.
Future research should further develop gastric biofeedback and evaluate its clinical utility in
populations with EDs.
- Faculty
- Faculté des lettres et des sciences humaines
- Department
- Département de Psychologie
- Language
-
- English
- Classification
- Psychology
- Notes
-
- Thèse cumulative en co-tutelle
- Bibliographie
- License
-
CC BY
- Open access status
- diamond
- Identifiers
-
- SWISSCOVERY 991172821574905501
- DOI 10.51363/unifr.lth.2026.061
- URN urn:nbn:ch:rero-002-123581
- Persistent URL
- https://folia.unifr.ch/unifr/documents/334412
Statistics
Document views: 23
File downloads:
- phd_Tiemanna.pdf: 15