Stress modulates gastric interoception depending on eating traits and emotion regulation: evidence from the magic table

www.nature.com/scientificreports OPEN Stress modulates gastric interoception depending on eating traits and emotion regulation: evidence from the magic table Miriam Kipping1, André Schulz2 & Olga Pollatos1 The high prevalence of obesity and low treatment response in eating disorders highlight the need for a better understanding of eating regulation. Gastric interoception – the perception of signals such as hunger and satiation – plays a key role in aligning food intake with physiological needs. This study investigated how acute stress, emotion regulation difficulties, and eating traits influence gastric interoceptive sensitivity. Ninety-four fasting participants completed both a stress and control task in counterbalanced order across two laboratory sessions. Gastric interoceptive sensitivity was assessed using a novel method, the Magic Table (MT), in which participants ate yogurt from a self-refilling bowl until satiation and fullness. Multi-level modeling evaluated stress effects and moderation by self-reported eating traits and emotion regulation. For validation, 61 participants also completed the established Two-step Water Load Test (WLT-II) and free food consumption. Medium to strong correlations between MT indices, WLT-II, and food intake supported the validity of the MT. While stress had no overall effect on gastric interoception, cross-level interactions showed reduced fullness sensitivity under stress in individuals with high emotion regulation difficulties, restrained, and uncontrolled eating. These findings suggest that this group may be at risk for interoceptive desensitization under stress and inform studies on interoception-focused interventions. Keywords Satiation perception, Gastric interoception, Eating, Stress, Emotion regulation The prevalence of obesity is increasing globally1. In 2022, over 16% of adults worldwide were living with obesity, and more than 43% were overweight2, 3. This trend is alarming given the long-term consequences, such as type 2 diabetes and arteriosclerosis, which contribute to disability, reduced life expectancy, and diminished quality of life2, 4. Additionally, eating disorders often co-occur with obesity or underweight, are linked to somatic and mental health comorbidities, reduced quality of life, and higher mortality and suicide risk compared to the general population5, 6. Available treatments show only low to moderate response rates7, 8, underlining the need for a better understanding of the mechanisms underlying eating behavior to develop more effective prevention or treatment approaches. Stress is a key factor in food intake regulation. Physiologically, acute stress triggers the sympathetic adrenal medullary (SAM) axis, which supports energy mobilization for a fight-or-flight response and inhibits behaviors such as eating9. However, empirical findings are mixed: experimental and correlational studies and a meta-analysis show that stress in particular increases the consumption of sweet or high-fat foods10–20. In contrast, a recent study and two meta-analyses reported no or only minimal changes in eating behavior under stress or negative emotions21, 22–23. These inconsistencies may stem from between-person differences. For example, among female students, 19% reported no change in appetite under stress, 51% reported an increase, and 30% a decrease24. Such variability has been linked to individual traits, life stress, and physiological stress responses12, 25–33. One study found that high emotional eaters reported less reduction in hunger after eating under stress than low emotional eaters, suggesting reduced gastric interoception under stress34. Yet, no study has directly assessed whether stress alters gastric interoceptive sensitivity (a typical behavioral indicator of interoception in the gastric domain, assessing the perception threshold of satiation). While interoception is often studied as a stable trait, little research has examined it under different psychophysiological states, like stress. However, in the cardiac 1Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 45, 89081 Ulm, Germany. 2Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, 11, Porte des Sciences, Esch-sur-Alzette 4366, Luxembourg. email: Scientific Reports | (2026) 16:14969 | https://doi.org/10.1038/s41598-026-48641-w 1 modality, some evidence suggests that acute stress affects interoceptive accuracy (i.e., the correct perception of one’s heartbeat35, possibly due to stronger organ signaling and neural representation36–39. These findings raise the possibility that stress might also alter gastric interoception and thereby influence stress-related eating. Research on interoception and dysregulated eating showed reduced interoception in overweight and obese individuals, as well as in patients with eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder40–43. Eating disorders are severe mental health conditions characterized by persistent and clinically significant disturbances in eating behavior (e.g., severe dietary restriction or recurrent binge eating episodes), body image, and weight regulation that cause substantial physical and psychosocial impairment44. In contrast, in healthy individuals, elevated BMIs, binge eating, and emotional, uncontrolled, or restrictive eating, and emotional regulation difficulties can be observed as subclinical traits. Interoceptive deficits are also linked to these dysfunctional traits (e.g., higher body mass index (BMI), binge eating, emotional eating, and emotion regulation difficulties) in subclinical and healthy samples45–50. Although eating disorders are qualitatively distinct conditions from dysfunctional eating traits and emotion regulation difficulties, these traits were identified as risk factors for or symptoms of eating disorders44, 51, 52. Therefore, examining these traits in a healthy sample, along with interoception, allows investigation of the mechanisms that may contribute to dysregulated eating. So far, research has linked dysregulated eating mainly to cardiac interoceptive accuracy or general interoceptive sensibility (i.e., bodily perceptions assessed with self-report questionnaires)53. However, gastric interoception is likely more directly relevant to eating behavior regulation54. For instance, hunger/satiety-specific interoceptive sensibility has been found to relate more strongly to disordered eating symptoms than general interoceptive sensibility55. Few studies have examined gastric interoception using behavioral methods. One reported increased gastric interoceptive sensitivity (i.e., drinking less water until fullness) in women with anorexia nervosa56, while others found reduced sensitivity (i.e., drinking more until satiation and fullness perception) for patients with bulimia nervosa and binge eating disorder as compared t (...truncated)