AppetiteCheck: Feasibility of Momentary Vagus Nerve Stimulation as an Implicit Intervention for Eating Behavior

Abstract: Overeating and emotional eating are common health issues that affect people even without an eating disorder. The vagus nerve plays a critical role in the gut-brain axis, and implanted vagus nerve stimulators have been associated with reduced appetite. In this paper, we propose transcutaneous cervical vagus nerve stimulation (tcVNS) as a ubiquitous system to provide immediate, low-effort intervention during an eating episode. In a study with 24 participants, we evaluated a mobile, handheld tcVNS device during a single episode of distracted snacking. We found that participants ate 9.6% less and 23.6% more slowly during vagus nerve stimulation than during sham stimulation. Post-snacking satiety was the same in both conditions, while heart rate was lower during vagus nerve stimulation. The stimulation was described as subtle and barely noticeable. Overall, these results provide evidence for the feasibility of non-invasive vagus nerve stimulation as a low-attention intervention for managing eating behavior -- one that can be packaged inside ubiquitous interactive systems. As such, we extend the design space of implicit interfaces toward physiological intervention, motivating future ubiquitous systems that pair eating-related sensing with low-attention interventions.