Introduction and Objective: Homeostatic and hedonic mechanisms regulate food intake. Four obesity phenotypes have been identified: abnormal satiation (AS), abnormal postprandial satiety (APS), emotional eating (EE), and abnormal resting energy expenditure (low REE). Ultra-processed foods (UPF; NOVA group 4) have been linked to obesity and metabolic disease, but whether UPF intake differs by obesity phenotype remains unclear. Methods: We retrospectively analyzed adults with obesity (BMI 30) from a lifestyle intervention trial. Participants underwent physiological and behavioral phenotyping. Of 152 participants, 43 were excluded due to missing baseline dietary recall data and 73 due to absent or multiple phenotypes, leaving 36 participants for analysis. UPF intake was quantified and compared across phenotypes using ANOVA for comparisons involving more than two groups and Student’s t-test for two-group comparisons. Results: Participants had a mean age of 46 ± 12 years, 77% were female, and mean baseline BMI was 38 ± 7 kg/m². There were no significant differences in age, gender distribution, or baseline BMI across phenotype groups. Mean total caloric intake was 1,710 ± 655 kcal/day, and mean UPF proportion was 55.9% ± 24.8%. UPF intake differed significantly across phenotypes (p = 0.03). The low REE phenotype had the highest UPF proportion (68.7% ± 23.8), while AS had the lowest (41.5% ± 18.9; p = 0.004). UPF-derived calories were also higher in low REE compared with AS (1,381 ± 837 vs 812 ± 405 kcal/day; p = 0.03), with EE and APS showing intermediate values. Conclusion: UPF intake differs by obesity phenotype, with highest consumption in participants with abnormal REE phenotype. Future studies should evaluate phenotype-tailored interventions and reduction in UPF intake. Disclosure L.E. Sefried: None. J. Villamarin: None. A.N. McRae: None. J.M. Garcia Cordova: None. J.D. Pazmino Zurita: None. M.M. Schaefer: None. J. Stutzman: None. T. Quezada: None. M.D. Hurtado Andrade: Research Support; Current; Eli Lilly and Company. Advisory Panel; Ended; Novo Nordisk. Other - I support Novo Nordisk with publications, data generation. I am paid to present these data at meetings; Current; Novo Nordisk. Research Support; Current; Endogenex. Research Support; Ended; Phenomix Sciences. Advisory Panel; Ended; Roche Pharmaceuticals. Consultant; Ended; Verge Genomics. A. Acosta: Other - Licensed Patent / Technology; Current; Phenomix Sciences, Gila Therapeutics. Advisory Panel; Current; Boehringer Ingelheim International GmbH, Structure Therapeutics. Research Support; Ended; Novo Nordisk. Research Support; Current; Rhythm Pharmaceuticals, Inc., Regeneron Pharmaceuticals Inc. D.D. Hensrud: None. M. Romanos: None. T.W. Fredrick: None. S. Kumar: Consultant; Current; Rhythm Pharmaceuticals, Inc.
Sefried et al. (Fri,) studied this question.