Sensitization of the reinforcing value of food is associated with greater BMI percentile in lower income adolescents

Sensitization, or the increase in the reinforcing value of high energy density snack food (RV_FOOD) after repeated daily intake, is associated with weight and weight change in adolescents. The purpose of this study was to examine the relationships among reinforcer sensitization, delay discounting (DD), and BMI percentile in a lower income sample who experience higher rates of food insecurity (FI). We hypothesized that the relationship between sensitization and BMI percentile is moderated by FI and DD. We conducted an observational cohort study in 118, 11–14 year old adolescents from lower income households. The RV_FOOD of a preferred HED food was assessed at baseline and after 2 weeks of daily intake. We also assessed DD and household and adolescent reported FI. Sensitization, but not baseline RV_FOOD, was positively associated with BMI percentile, but this effect was not moderated by household or adolescent FI or by DD. Both adolescent and household FI were associated with higher baseline RV_FOOD, creating a potential ceiling effect and suggesting that adolescents who are FI may enter the study “pre-sensitized” to the snack foods. This study replicates and extends our prior findings showing that sensitization is related to higher BMI percentile in lower income adolescents, but these effects were not moderated by FI. Food insecurity, in particular when reported by the adolescent, was related to DD and baseline RV_FOOD which can impact food intake, diet, and weight status.