Listening to children with obesity: lived experiences of hunger, cravings, and satiety.

BACKGROUND

Appetite regulation is central to childhood obesity, yet little is known about how children themselves experience and interpret sensations of hunger, cravings, and satiety. This study aimed to explore how children living with overweight or obesity describe these sensations and how they respond to them in everyday life.

METHODS

This qualitative study included 32 children (17 girls, 15 boys) aged 8-10 years who were interviewed four years after enrolling in a randomized controlled obesity treatment trial in Stockholm, Sweden. At follow-up (mean age 9.4 years, SD 0.8), the majority had overweight or obesity (mean BMI z-score 2.4, SD 0.6). Individual semi-structured interviews were conducted and analyzed using thematic analysis.

RESULTS

Two overarching themes were identified. The first, Experiences of hunger, cravings, and satiety, comprised three subthemes: Hunger - powerful bodily sensations, multiform and situational; Cravings - a sensory and emotional drive for something specific; and Satiety - recognizable bodily signals along a spectrum. The second theme, Responses and strategies for managing appetite, also included three subthemes: Self-regulation; External rules and structures; and Impulsive or emotionally driven eating. Children described hunger as embodied and sometimes overwhelming, cravings as distinct from hunger and often cue-triggered, and satiety as ranging from comfortable to distressing fullness. Responses varied across contexts and included distraction, portion control shaped by adults, and socially motivated eating. Appetite-related experiences were typically described without moral judgment or self-blame.

CONCLUSIONS

These findings position appetite regulation in middle childhood as dynamic, embodied, and context-dependent. Attending to children's own language may inform developmentally sensitive, child-centered obesity treatment and support integration of behavioral and emerging pharmacological approaches.