{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:15:13Z","timestamp":1790111713702,"version":"4.0.1"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Obes"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Experiencing ostracism (i.e., social exclusion) may impact self-regulatory eating behaviors, particularly in youths with excess weight. Yet, research in pediatric patients with obesity is lacking. Hence, we examined the effect of Virtual Reality(VR)-based ostracism on motivation for food in children and adolescents with BMI \u226597<jats:sup>th<\/jats:sup> percentile.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In a randomized experimental between-subject design, forty-one patients (M<jats:sub>age<\/jats:sub>\u2009=\u200913.37 years, 46% female) with a diagnosis of obesity (ICD-10: E66) were randomized to a social exclusion or inclusion condition in a VR-Cyberball-paradigm. Patients\u2019 salivary cortisol, heart rate and heart rate variability were assessed. Furthermore, we measured patients\u2019 motivation to consume high-calorie food, their prosocial behavior, their self-reported urge to eat and subjective stress.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Results indicate that the experience of social exclusion in youths with obesity leads to a blunted salivary cortisol response; in contrast, no effects of social exclusion on the sympathetic nervous system were observed. Social exclusion was associated with an increased perceived threat to fundamental social needs. Similarly, ostracized participants demonstrated heightened self-regulatory behaviors regarding their motivation for high-calorie food intake, selecting fewer grams of sweets following social exclusion. Furthermore, ostracism tended to increase helping behavior post-exclusion, although this effect was not significant. Self-reported urge to eat and stress levels during the experiment showed no significant effect.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Ostracism-induced reduction of motivation for food suggests that affiliative behaviors like increasing compliance regarding eating behaviors may play a role in youths with obesity with BMI \u226597<jats:sup>th<\/jats:sup> percentile in the context of social stress. Future research should explore the broader social context, including family and friends, to better understand the dynamics between social stress, physiological reactivity, and self-regulatory behaviors in treating obesity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical trial registration<\/jats:title>\n            <jats:p>As this study does not constitute a clinical trial, the study design and analyses plans were not preregistered.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41366-025-01824-3","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T03:12:26Z","timestamp":1758683546000},"page":"2117-2124","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ostracism, cortisol reactivity, and motivation for high-calorie food in children and adolescents with obesity"],"prefix":"10.1038","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0081-7489","authenticated-orcid":false,"given":"Anna","family":"Felnhofer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8994-964X","authenticated-orcid":false,"given":"Andreas","family":"Goreis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4605-2503","authenticated-orcid":false,"given":"Helmuth","family":"Haslacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3692-8754","authenticated-orcid":false,"given":"Charlotte","family":"Nigmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Skacel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1772-6695","authenticated-orcid":false,"given":"Rodrig","family":"Marculescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4333-1494","authenticated-orcid":false,"given":"Paul L.","family":"Plener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3706-8370","authenticated-orcid":false,"given":"Susanne","family":"Greber-Platzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oswald D.","family":"Kothgassner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"1824_CR1","unstructured":"World Health Organization. BMI-for-age (5-19 years). WHO-Website. 2025. https:\/\/www.who.int\/tools\/growth-reference-data-for-5to19-years\/indicators\/bmi-for-age."},{"key":"1824_CR2","unstructured":"Wabitsch M, Moss A. S3-Leitlinie Therapie und Pr\u00e4vention der Adipositas im Kindes- und Jugendalter [S3 guideline therapy and prevention of obesity in childhood and adolescence]. Arbeitsgemeinschaft Adipositas im Kindes und Jugendalter (AGA). 2019. https:\/\/register.awmf.org\/de\/leitlinien\/detail\/050-002."},{"key":"1824_CR3","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1159\/000519284","volume":"96","author":"C Kappes","year":"2023","unstructured":"Kappes C, Stein R, K\u00f6rner A, Merkenschlager A, Kiess W. Stress, stress reduction and obesity in childhood and adolescence. Horm Res Paediatr. 2023;96:88\u201396. https:\/\/doi.org\/10.1159\/000519284.","journal-title":"Horm Res Paediatr"},{"key":"1824_CR4","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s41043-021-00279-2","volume":"40","author":"SK Roy","year":"2021","unstructured":"Roy SK, Jahan K, Alam N, Rois R, Ferdaus A, Israt S, et al. Perceived stress, eating behavior, and overweight and obesity among urban adolescents. J Health Popul Nutr. 2021;40:54. https:\/\/doi.org\/10.1186\/s41043-021-00279-2.","journal-title":"J Health Popul Nutr"},{"key":"1824_CR5","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.appet.2010.11.140","volume":"56","author":"SJ Salvy","year":"2011","unstructured":"Salvy SJ, Bowker JC, Nitecki LA, Kluczynski MA, Germeroth LJ, Roemmich JN. Impact of simulated ostracism on overweight and normal-weight youths\u2019 motivation to eat and food intake. Appetite. 2011;56:39\u201345. https:\/\/doi.org\/10.1016\/j.appet.2010.11.140.","journal-title":"Appetite"},{"key":"1824_CR6","doi-asserted-by":"publisher","first-page":"101353","DOI":"10.1016\/j.copsyc.2022.101353","volume":"47","author":"KD Williams","year":"2022","unstructured":"Williams KD, Nida SA. Ostracism and social exclusion: implications for separation, social isolation, and loss. Curr Opin Psychol. 2022;47:101353. https:\/\/doi.org\/10.1016\/j.copsyc.2022.101353.","journal-title":"Curr Opin Psychol"},{"key":"1824_CR7","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1111\/j.1751-9004.2007.00004.x","volume":"1","author":"KD Williams","year":"2007","unstructured":"Williams KD. Ostracism: the kiss of social death. Soc Personal Psychol Compass. 2007;1:236\u201347. https:\/\/doi.org\/10.1111\/j.1751-9004.2007.00004.x.","journal-title":"Soc Personal Psychol Compass"},{"key":"1824_CR8","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1016\/j.jesp.2003.11.006","volume":"40","author":"L Zadro","year":"2004","unstructured":"Zadro L, Williams KD, Richardson R. How low can you go? Ostracism by a computer is sufficient to lower self-reported levels of belonging, control, self-esteem, and meaningful existence. J Exp Soc Psychol. 2004;40:560\u20137. https:\/\/doi.org\/10.1016\/j.jesp.2003.11.006.","journal-title":"J Exp Soc Psychol"},{"key":"1824_CR9","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1093\/jpepsy\/jsr066","volume":"37","author":"SJ Salvy","year":"2012","unstructured":"Salvy SJ, Bowker JC, Nitecki LA, Kluczynski MA, Germeroth LJ, Roemmich JN. Effects of ostracism and social connection-related activities on adolescents\u2019 motivation to eat and energy intake. J Pediatr Psychol. 2012;37:23\u201332. https:\/\/doi.org\/10.1093\/jpepsy\/jsr066.","journal-title":"J Pediatr Psychol"},{"key":"1824_CR10","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1037\/0022-3514.88.4.589","volume":"88","author":"RF Baumeister","year":"2005","unstructured":"Baumeister RF, DeWall CN, Ciarocco NJ, Twenge JM. Social exclusion impairs self-regulation. J Pers Soc Psychol. 2005;88:589\u2013604. https:\/\/doi.org\/10.1037\/0022-3514.88.4.589.","journal-title":"J Pers Soc Psychol"},{"key":"1824_CR11","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1521\/jscp.2008.27.5.471","volume":"27","author":"M Oaten","year":"2008","unstructured":"Oaten M, Williams KD, Jones A, Zadro L. The effects of ostracism on self\u2013regulation in the socially anxious. J Soc Clin Psychol. 2008;27:471\u2013504. https:\/\/doi.org\/10.1521\/jscp.2008.27.5.471.","journal-title":"J Soc Clin Psychol"},{"key":"1824_CR12","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/j.copsyc.2021.10.005","volume":"44","author":"LM Sisk","year":"2022","unstructured":"Sisk LM, Gee DG. Stress and adolescence: vulnerability and opportunity during a sensitive window of development. Curr Opin Psychol. 2022;44:286\u201392. https:\/\/doi.org\/10.1016\/j.copsyc.2021.10.005.","journal-title":"Curr Opin Psychol"},{"key":"1824_CR13","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1093\/her\/cym052","volume":"23","author":"RM Puhl","year":"2008","unstructured":"Puhl RM, Moss-Racusin CA, Schwartz MB, Brownell KD. Weight stigmatization and bias reduction: perspectives of overweight and obese adults. Health Educ Res. 2008;23:347\u201358. https:\/\/doi.org\/10.1093\/her\/cym052.","journal-title":"Health Educ Res"},{"key":"1824_CR14","doi-asserted-by":"publisher","first-page":"104494","DOI":"10.1016\/j.appet.2019.104494","volume":"145","author":"VP Senese","year":"2020","unstructured":"Senese VP, Pezzella M, Pasquariello L, Ali S. Effects of social exclusion and maternal rejection on Children\u2019s high-caloric food consumption. Appetite. 2020;145:104494. https:\/\/doi.org\/10.1016\/j.appet.2019.104494.","journal-title":"Appetite"},{"key":"1824_CR15","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-020-02145-2","volume":"20","author":"VV Thaker","year":"2020","unstructured":"Thaker VV, Osganian SK, deFerranti SD, Sonneville KR, Cheng JK, Feldman HA, et al. Psychosocial, behavioral and clinical correlates of children with overweight and obesity. BMC Pediatr. 2020;20:291. https:\/\/doi.org\/10.1186\/s12887-020-02145-2.","journal-title":"BMC Pediatr"},{"key":"1824_CR16","doi-asserted-by":"publisher","first-page":"303","DOI":"10.3390\/children8040303","volume":"8","author":"WR Black","year":"2021","unstructured":"Black WR, Borner KB, Beauchamp MT, Davis AM, Dreyer Gillette ML, Sweeney B, et al. Health-related quality of life across recent pediatric obesity classification recommendations. Children. 2021;8:303. https:\/\/doi.org\/10.3390\/children8040303.","journal-title":"Children"},{"key":"1824_CR17","doi-asserted-by":"publisher","first-page":"113205","DOI":"10.1016\/j.physbeh.2020.113205","volume":"228","author":"OD Kothgassner","year":"2021","unstructured":"Kothgassner OD, Goreis A, Glenk LM, Kafka JX, Beutl L, Kryspin-Exner I, et al. Virtual and real-life ostracism and its impact on a subsequent acute stressor. Phys Behav. 2021;228:113205. https:\/\/doi.org\/10.1016\/j.physbeh.2020.113205.","journal-title":"Phys Behav"},{"key":"1824_CR18","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1159\/000119004","volume":"28","author":"C Kirschbaum","year":"1993","unstructured":"Kirschbaum C, Pirke KM, Hellhammer DH. The \u2018Trier Social Stress Test\u2019\u2013a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology. 1993;28:76\u201381. https:\/\/doi.org\/10.1159\/000119004.","journal-title":"Neuropsychobiology"},{"key":"1824_CR19","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-020-0729-6","volume":"10","author":"B Herhaus","year":"2020","unstructured":"Herhaus B, Ullmann E, Chrousos G, Petrowski K. High\/low cortisol reactivity and food intake in people with obesity and healthy weight. Transl Psychiatry. 2020;10:40. https:\/\/doi.org\/10.1038\/s41398-020-0729-6.","journal-title":"Transl Psychiatry"},{"key":"1824_CR20","doi-asserted-by":"publisher","first-page":"3654","DOI":"10.3390\/nu13103654","volume":"13","author":"K Wijnant","year":"2021","unstructured":"Wijnant K, Klosowska J, Braet C, Verbeken S, De Henauw S, Vanhaecke L, et al. Stress responsiveness and emotional eating depend on youngsters\u2019 chronic stress level and overweight. Nutrients. 2021;13:3654. https:\/\/doi.org\/10.3390\/nu13103654.","journal-title":"Nutrients"},{"key":"1824_CR21","doi-asserted-by":"publisher","unstructured":"Kothgassner OD, Felnhofer A. Does virtual reality help to cut the Gordian knot between ecological validity and experimental control? Ann Int Commun Assoc. 2020. https:\/\/doi.org\/10.1080\/23808985.2020.1792790.","DOI":"10.1080\/23808985.2020.1792790"},{"key":"1824_CR22","doi-asserted-by":"publisher","unstructured":"Parsons TD. Virtual reality for enhanced ecological validity and experimental control in the clinical, affective and social neurosciences. Front Hum Neurosci. 2015;9. https:\/\/doi.org\/10.3389\/fnhum.2015.00660.","DOI":"10.3389\/fnhum.2015.00660"},{"key":"1824_CR23","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1037\/0022-3514.92.1.56","volume":"92","author":"JM Twenge","year":"2007","unstructured":"Twenge JM, Baumeister RF, DeWall CN, Ciarocco NJ, Bartels JM. Social exclusion decreases prosocial behavior. J Pers Soc Psychol. 2007;92:56\u201366. https:\/\/doi.org\/10.1037\/0022-3514.92.1.56.","journal-title":"J Pers Soc Psychol"},{"key":"1824_CR24","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.chb.2016.12.059","volume":"70","author":"OD Kothgassner","year":"2017","unstructured":"Kothgassner OD, Griesinger M, Kettner K, Wayan K, V\u00f6lkl-Kernstock S, Hlavacs H, et al. Real-life prosocial behavior decreases after being socially excluded by avatars, not agents. Comput Hum Behav. 2017;70:261\u20139. https:\/\/doi.org\/10.1016\/j.chb.2016.12.059.","journal-title":"Comput Hum Behav"},{"key":"1824_CR25","doi-asserted-by":"publisher","first-page":"174","DOI":"10.3758\/BF03192765","volume":"38","author":"KD Williams","year":"2006","unstructured":"Williams KD, Jarvis B. Cyberball: a program for use in research on interpersonal ostracism and acceptance. Behav Res Methods. 2006;38:174\u201380. https:\/\/doi.org\/10.3758\/BF03192765.","journal-title":"Behav Res Methods"},{"key":"1824_CR26","doi-asserted-by":"publisher","DOI":"10.1038\/srep02027","volume":"3","author":"S Cacioppo","year":"2013","unstructured":"Cacioppo S, Frum C, Asp E, Weiss RM, Lewis JW, Cacioppo JT, et al. A quantitative meta-analysis of functional imaging studies of social rejection. Sci Rep. 2013;3:2027. https:\/\/doi.org\/10.1038\/srep02027.","journal-title":"Sci Rep"},{"key":"1824_CR27","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.neuroimage.2017.02.050","volume":"153","author":"N Vijayakumar","year":"2017","unstructured":"Vijayakumar N, Cheng TW, Pfeifer JH. Neural correlates of social exclusion across ages: a coordinate-based meta-analysis of functional MRI studies. NeuroImage. 2017;153:359\u201368. https:\/\/doi.org\/10.1016\/j.neuroimage.2017.02.050.","journal-title":"NeuroImage"},{"key":"1824_CR28","doi-asserted-by":"publisher","unstructured":"Kothgassner OD, Hlavacs H, Beutl L, Glenk LM, Palme R, Felnhofer A, et al. Two experimental virtual paradigms for stress research: developing avatar-based approaches for interpersonal and evaluative stressors. In: Entertainment computing-ICEC 2016: 15th IFIP TC 14 international conference. Vienna, Austria: Springer International Publishing; 2016. https:\/\/doi.org\/10.1007\/978-3-319-46100-7_5.","DOI":"10.1007\/978-3-319-46100-7_5"},{"key":"1824_CR29","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1089\/cyber.2012.0113","volume":"15","author":"MP Kassner","year":"2012","unstructured":"Kassner MP, Wesselmann ED, Law AT, Williams KD, et al. Virtually ostracized: studying ostracism in immersive virtual environments. Cyberpsychol Behav Soc Netw. 2012;15:399\u2013403. https:\/\/doi.org\/10.1089\/cyber.2012.0113.","journal-title":"Cyberpsychol Behav Soc Netw"},{"key":"1824_CR30","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1192\/bjp.177.6.534","volume":"177","author":"R Goodman","year":"2000","unstructured":"Goodman R, Ford T, Simmons H, Gatward R, Meltzer H. Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry. 2000;177:534\u20139. https:\/\/doi.org\/10.1192\/bjp.177.6.534.","journal-title":"Br J Psychiatry"},{"key":"1824_CR31","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1002\/eat.20362","volume":"40","author":"M Tanofsky-Kraff","year":"2007","unstructured":"Tanofsky-Kraff M, Theim KR, Yanovski SZ, Bassett AM, Burns NP, Ranzenhofer LM, et al. Validation of the emotional eating scale adapted for use in children and adolescents (EES-C). Int J Eat Disord. 2007;40:232\u201340. https:\/\/doi.org\/10.1002\/eat.20362.","journal-title":"Int J Eat Disord"},{"key":"1824_CR32","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-0875-9","volume":"16","author":"EM Klein","year":"2016","unstructured":"Klein EM, Br\u00e4hler E, Dreier M, Reinecke L, M\u00fcller KW, Schmutzer G, et al. The German version of the Perceived Stress Scale\u2014psychometric characteristics in a representative German community sample. BMC Psychiatry. 2016;16:159. https:\/\/doi.org\/10.1186\/s12888-016-0875-9.","journal-title":"BMC Psychiatry"},{"key":"1824_CR33","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1016\/j.psyneuen.2007.04.010","volume":"32","author":"V Rouach","year":"2007","unstructured":"Rouach V, Bloch M, Rosenberg N, Gilad S, Limor R, Stern N, et al. The acute ghrelin response to a psychological stress challenge does not predict the post-stress urge to eat. Psychoneuroendocrinology. 2007;32:693\u2013702. https:\/\/doi.org\/10.1016\/j.psyneuen.2007.04.010.","journal-title":"Psychoneuroendocrinology"},{"key":"1824_CR34","doi-asserted-by":"publisher","unstructured":"Williams KD. Ostracism: a temporal need-threat model. Adv Exp Soc Psychol. 2009. https:\/\/doi.org\/10.1016\/S0065-2601(08)00406-1.","DOI":"10.1016\/S0065-2601(08)00406-1"},{"key":"1824_CR35","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1111\/j.1467-8624.1998.tb06161.x","volume":"69","author":"G Downey","year":"1998","unstructured":"Downey G, Lebolt A, Rinc\u00f3n C, Freitas AL. Rejection sensitivity and children\u2019s interpersonal difficulties. Child Dev. 1998;69:1074\u201391. https:\/\/doi.org\/10.1111\/j.1467-8624.1998.tb06161.x.","journal-title":"Child Dev"},{"key":"1824_CR36","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1111\/j.1532-7795.2007.00531.x","volume":"17","author":"B London","year":"2007","unstructured":"London B, Downey G, Bonica C, Paltin I. Social causes and consequences of rejection sensitivity. J Res Adolesc. 2007;17:481\u2013506. https:\/\/doi.org\/10.1111\/j.1532-7795.2007.00531.x.","journal-title":"J Res Adolesc"},{"key":"1824_CR37","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1038\/nn.3086","volume":"15","author":"NI Eisenberger","year":"2012","unstructured":"Eisenberger NI, Cole SW. Social neuroscience and health: neurophysiological mechanisms linking social ties with physical health. Nat Neurosci. 2012;15:669\u201374. https:\/\/doi.org\/10.1038\/nn.3086.","journal-title":"Nat Neurosci"},{"key":"1824_CR38","doi-asserted-by":"publisher","unstructured":"Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Task Force of the European Society of Cardiology, Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation. 1996. https:\/\/doi.org\/10.1161\/01.CIR.93.5.1043.","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"1824_CR39","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","volume":"41","author":"F Faul","year":"2009","unstructured":"Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149\u201360. https:\/\/doi.org\/10.3758\/BRM.41.4.1149.","journal-title":"Behav Res Methods"},{"key":"1824_CR40","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.obhdp.2012.04.004","volume":"120","author":"D Balliet","year":"2013","unstructured":"Balliet D, Ferris DL. Ostracism and prosocial behavior: a social dilemma perspective. Organ Behav Hum Decis Process. 2013;120:298\u2013308. https:\/\/doi.org\/10.1016\/j.obhdp.2012.04.004.","journal-title":"Organ Behav Hum Decis Process"},{"key":"1824_CR41","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1038\/s41366-019-0447-4","volume":"44","author":"JR Doom","year":"2020","unstructured":"Doom JR, Lumeng JC, Sturza J, Kaciroti N, Vazquez DM, Miller AL. Longitudinal associations between overweight\/obesity and stress biology in low-income children. Int J Obes. 2020;44:646\u201355. https:\/\/doi.org\/10.1038\/s41366-019-0447-4.","journal-title":"Int J Obes"},{"key":"1824_CR42","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1007\/s12529-018-9720-5","volume":"25","author":"TJ Williamson","year":"2018","unstructured":"Williamson TJ, Thomas KS, Eisenberger NI, Stanton AL. Effects of social exclusion on cardiovascular and affective reactivity to a socially evaluative stressor. Int J Behav Med. 2018;25:410\u201320. https:\/\/doi.org\/10.1007\/s12529-018-9720-5.","journal-title":"Int J Behav Med"},{"key":"1824_CR43","doi-asserted-by":"publisher","first-page":"e60433","DOI":"10.1371\/journal.pone.0060433","volume":"8","author":"U Weik","year":"2013","unstructured":"Weik U, Kuepper Y, Hennig J, Deinzer R. Effects of pre-experience of social exclusion on hypothalamus-pituitary-adrenal axis and catecholaminergic responsiveness to public speaking stress. PLoS ONE. 2013;8:e60433. https:\/\/doi.org\/10.1371\/journal.pone.0060433.","journal-title":"PLoS ONE"},{"key":"1824_CR44","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1016\/j.psyneuen.2010.02.019","volume":"35","author":"C Z\u00f6ller","year":"2010","unstructured":"Z\u00f6ller C, Maroof P, Weik U, Deinzer R. No effect of social exclusion on salivary cortisol secretion in women in a randomized controlled study. Psychoneuroendocrinology. 2010;35:1294\u20138. https:\/\/doi.org\/10.1016\/j.psyneuen.2010.02.019.","journal-title":"Psychoneuroendocrinology"},{"key":"1824_CR45","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.psyneuen.2007.11.004","volume":"33","author":"BM Elzinga","year":"2008","unstructured":"Elzinga BM, Roelofs K, Tollenaar MS, Bakvis P, van Pelt J, Spinhoven P. Diminished cortisol responses to psychosocial stress associated with lifetime adverse events: a study among healthy young subjects. Psychoneuroendocrinology. 2008;33:227\u201337. https:\/\/doi.org\/10.1016\/j.psyneuen.2007.11.004.","journal-title":"Psychoneuroendocrinology"},{"key":"1824_CR46","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.jpsychires.2020.07.014","volume":"130","author":"S Metz","year":"2020","unstructured":"Metz S, Duesenberg M, Hellmann-Regen J, Wolf OT, Roepke S, Otte C, et al. Blunted salivary cortisol response to psychosocial stress in women with posttraumatic stress disorder. J Psychiatry Res. 2020;130:112\u20139. https:\/\/doi.org\/10.1016\/j.jpsychires.2020.07.014.","journal-title":"J Psychiatry Res"},{"key":"1824_CR47","doi-asserted-by":"publisher","first-page":"S112","DOI":"10.1016\/j.domaniend.2016.03.004","volume":"56","author":"SD Hewagalamulage","year":"2016","unstructured":"Hewagalamulage SD, Lee TK, Clarke IJ, Henry BA. Stress, cortisol, and obesity: a role for cortisol responsiveness in identifying individuals prone to obesity. Domest Anim Endocrinol. 2016;56:S112\u201320. https:\/\/doi.org\/10.1016\/j.domaniend.2016.03.004.","journal-title":"Domest Anim Endocrinol"},{"key":"1824_CR48","unstructured":"Centers for Disease Control and Prevention. International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). National Center for Health Statistics. 2024. https:\/\/www.cdc.gov\/nchs\/icd\/icd-10-cm\/?CDC_AAref_Val=https:\/\/www.cd."},{"key":"1824_CR49","unstructured":"Obesity Medicine Association. New ICD-10 codes for obesity treatment: advancements in accurate diagnosis and care. 2024. https:\/\/obesitymedicine.org\/blog\/new-icd-10-codes-for-obesity-treatment-advancements-in-accurate-diagnosis-and-care\/.c.gov\/nchs\/icd\/icd-10-cm.htm."},{"key":"1824_CR50","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1177\/0963721419837685","volume":"28","author":"G Altheimer","year":"2019","unstructured":"Altheimer G, Urry HL. Do emotions cause eating? The role of previous experiences and social context in emotional eating. Curr Dir Psychol Sci. 2019;28:234\u201340. https:\/\/doi.org\/10.1177\/0963721419837685.","journal-title":"Curr Dir Psychol Sci"},{"key":"1824_CR51","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1002\/eat.22864","volume":"51","author":"AB Goldschmidt","year":"2018","unstructured":"Goldschmidt AB, Smith KE, Crosby RD, Boyd HK, Dougherty E, Engel SG, et al. Ecological momentary assessment of maladaptive eating in children and adolescents with overweight or obesity. Int J Eat Disord. 2018;51:549\u201357. https:\/\/doi.org\/10.1002\/eat.22864.","journal-title":"Int J Eat Disord"},{"key":"1824_CR52","doi-asserted-by":"publisher","first-page":"715","DOI":"10.3390\/children9050715","volume":"9","author":"RA Kitani","year":"2022","unstructured":"Kitani RA, Letsou K, Kokka I, Kanaka-Gantenbein C, Bacopoulou F. Difference in hair cortisol concentrations between obese and non-obese children and adolescents: a systematic review. Children. 2022;9:715. https:\/\/doi.org\/10.3390\/children9050715.","journal-title":"Children"}],"container-title":["International Journal of Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41366-025-01824-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41366-025-01824-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41366-025-01824-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T09:15:13Z","timestamp":1760606113000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41366-025-01824-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":52,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["1824"],"URL":"https:\/\/doi.org\/10.1038\/s41366-025-01824-3","relation":{},"ISSN":["0307-0565","1476-5497"],"issn-type":[{"value":"0307-0565","type":"print"},{"value":"1476-5497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]},"assertion":[{"value":"24 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no conflict of interest with regards to this study. In addition, PLP declares that he is an advisor for Boehringer-Ingelheim and received speaker honoraria from GLK, Janssen, InfectoPharm and Oral B.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All procedures were performed in compliance with relevant laws and institutional guidelines and have been approved by the ethics committee of the Medical University of Vienna (vote no. 2170\/2019).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}