A Pragmatic Outpatient Framework for Appetite-Related Phenotyping in Obesity.

Background: Previous obesity phenotyping models have been proposed; however, current protocols rely on complex physiological assessments that are difficult to implement in routine outpatient care. Aim: To describe and apply a pragmatic outpatient framework for appetite-related phenotyping integrating standardized satiety testing and emotional eating assessment. Methods: In this observational study, adults with overweight or obesity underwent a standardized mixed-meal satiety test using visual analogue scales together with emotional eating assessment using the Emotional Eating Questionnaire. Exploratory thresholds were derived from a normal-weight reference group. Participants were classified into appetite-related phenotypes: impaired early satiety, impaired late satiety, emotional eating, overlap, and no dominant phenotype. Results: A total of 129 adults with overweight or obesity were included. Impaired early satiety was identified in 48.1% of participants, impaired late satiety in 35.7%, and normal satiety responses in 16.3%. Severe emotional eating was present in 12.4% of participants. Overlap between emotional eating and altered satiety-test responses was identified in 11% of participants. Conclusions: Most participants exhibited at least one appetite-related phenotype, supporting the relevance of assessing both homeostatic (satiety) and emotional dimensions of eating behavior in clinical practice. Future studies should evaluate reproducibility and potential implications for phenotype-guided obesity treatment.