Clustering of intuitive eating and psychological health identifies subgroups associated with weight loss following semaglutide.

OBJECTIVE: Obesity management requires personalized approaches. Using data from the Aviitam platform in France, this study aimed to do the following: 1) explore psychological and behavioral patterns through clustering techniques; 2) validate the robustness of these clusters; and 3) assess their association with weight-loss outcomes in severe obesity under semaglutide treatment. METHODS: Phase 1 included 989 adults with BMI ≥ 25 kg/m who completed validated questionnaires, including the Hospital Anxiety and Depression Scale (HADS) and Intuitive Eating Scale-2 (IES-2). Phase 2 validated robustness in 492 individuals. Phase 3 applied clusters to 125 individuals with BMI ≥ 40 kg/m who were treated with semaglutide 2.4 mg/week at Montpellier University Hospital, assessing weight-loss trajectories over 12 months. RESULTS: The following two clusters were identified: the Intuitive Eaters Group (IEG, n = 482); and the Emotionally Driven Eaters Group (EDEG, n = 507). The IEG exhibited lower emotional distress and higher intuitive eating scores. HADS and IES-2 distinguished clusters effectively (area under the curve, 0.95). Robustness was confirmed in Phase 2. In Phase 3, the IEG demonstrated a significantly more favorable weight-loss trajectory compared to the EDEG (p = 0.03). CONCLUSIONS: Psychological and behavioral clusters identified through HADS and IES-2 are associated with weight loss under semaglutide treatment, suggesting the value of integrating psychological and behavioral profiling into obesity care.