Listening to your stomach: Effects of gastric biofeedback training on interoception, eating behavior and eating disorder symptoms

Gastric interoception, the sensing of signals from the stomach, plays a central role in regulating hunger, satiety, and fullness and is closely linked to eating behaviors and symptoms of eating disorders (EDs). Gastric motility has been identified as a key mediator of hunger and satiety, with altered gastric rhythms being observed in individuals with EDs. Enhancing gastric interoception by targeting gastric rhythms may therefore offer a promising intervention strategy. This study examined the effects of a novel electrogastrography (EGG)-based gastric biofeedback training delivered using virtual reality (VR) or a two-dimensional (2D) display, compared with a control condition. A sample of predominantly healthy university students (N = 94) participated in four biofeedback sessions over two weeks. We assessed cardiac, gastric, and general interoception, along with self-report measures of eating behavior (emotional, external, restrained, and intuitive eating) and ED symptoms. We expected biofeedback training to improve interoception, eating behaviors, and to reduce ED symptoms, with the strongest effects in the VR group, followed by the 2D group, and the weakest effects in the control group. Linear mixed model analyses revealed that the 2D condition was the most effective, showing the greatest improvements in gastric and general interoception (specifically satiation and fullness sensing, and body listening), as well as intuitive eating. These findings suggest that 2D gastric biofeedback may be an effective and accessible approach to interoception training which can potentially be applied in home settings. Future research should explore its clinical utility in populations with EDs.