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Identifying the mechanisms through which behavioral weight-loss treatment improves food decision-making in obesity.

ABSTRACT: OBJECTIVES:Behavioral weight loss (BWL) programs are the recommended treatment for obesity, yet it is unknown whether these programs change one's ability to use self-control in food choices and what specific mechanisms support such change. Using experimental economics methods, we investigated whether changes in dietary behavior in individuals with obesity following BWL are driven by one or more of the following potential mechanisms: changes in the perception of the 1) health or 2) taste of food items, and/or 3) shifting decision weights for health versus taste attributes. Therefore, we compared these mechanisms between obese participants and lifetime normal weight controls (NW) both before and after BWL. METHODS:Females with obesity (N = 37, mean BMI = 33.2) completed a food choice task involving health ratings, taste ratings, and decision-making pre- and post-standard BWL intervention. NW controls (N = 30, BMI = 22.4) completed the same task. RESULTS:Individuals with obesity exhibited increased self-control (selecting healthier, less tasty food choices) post-treatment. However, their rates of self-control remained significantly lower than NW. We found no differences in initial health perceptions across groups, and no changes with treatment. In contrast, taste ratings and the relative value of taste versus health decreased following treatment. Although, post-treatment participants continued to perceive unhealthy foods as tastier and used less self-control than NW controls, they showed significant improvements in these domains following a BWL intervention. CONCLUSIONS:To help individuals improve dietary decisions, additional research is needed to determine how to make greater changes in taste preferences and/or the assignment of value to taste versus health attributes in food choices.

SUBMITTER: Demos KE

PROVIDER: S-EPMC5477769 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Identifying the mechanisms through which behavioral weight-loss treatment improves food decision-making in obesity.

Demos Kathryn E KE McCaffery Jeanne M JM Thomas J Graham JG Mailloux Kimberly A KA Hare Todd A TA Wing Rena R RR

Appetite 20170315

<h4>Objectives</h4>Behavioral weight loss (BWL) programs are the recommended treatment for obesity, yet it is unknown whether these programs change one's ability to use self-control in food choices and what specific mechanisms support such change. Using experimental economics methods, we investigated whether changes in dietary behavior in individuals with obesity following BWL are driven by one or more of the following potential mechanisms: changes in the perception of the 1) health or 2) taste ...[more]

PMID: 28315419

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Project description:BACKGROUND:Behavioural approaches to weight loss are often initially successful but less so in the longer term, as some people maintain the necessary behaviour changes while others do not. This study aimed to derive possible explanations for this using a qualitative approach with a view to improving intervention effectiveness. METHODS:Thirty-six participants in a development and feasibility study for a weight loss and maintenance intervention (called SkiM) were interviewed three times over 18?months regarding their experiences before, during and after the intervention. Data were analysed thematically. The accounts of those who were more and less successful in terms of longer term weight loss were compared, and a conceptual model linking the main analytic themes was developed. RESULTS:Five interpretative themes were generated: encountering and managing key situations; the impact of emotion; the source of control; personal values; and acquiring knowledge and skills. These themes were linked through a model of decision-making during key situations. In this model, behavioural decisions emerge from a dynamic interplay between several drivers: emotional state and needs, perceived control, personal values, the individual's knowledge and skills, and their existing habits. The individual's response in key situations generates experiential learning that can influence decisional dynamics in similar situations in future. These dynamics appeared to differ between participants, and between those who were more and less successful in weight management. CONCLUSIONS:Our analysis and model of decision-making during weight-management have implications for the development and delivery of behavioural weight management interventions. By helping individuals to identify the drivers of their decision-making in key situations, and equipping them to manage these drivers, programmes may enhance their capacity to sustain the behaviour changes needed for long-term weight loss.

Project description:BackgroundBehavioral weight loss interventions can lead to an average weight loss of 5%-10% of initial body weight, however there is wide individual variability in treatment response. Although built, social, and community food environments can have potential direct and indirect influences on body weight (through their influence on physical activity and energy intake), these environmental factors are rarely considered as predictors of variation in weight loss.ObjectiveEvaluate the association between built, social, and community food environments and changes in weight, moderate-to-vigorous physical activity (MVPA), and dietary intake among adults who completed an 18-month behavioral weight loss intervention.MethodsParticipants included 93 adults (mean ± SD; 41.5 ± 8.3 years, 34.4 ± 4.2 kg/m2, 82% female, 75% white). Environmental variables included urbanicity, walkability, crime, Neighborhood Deprivation Index (includes 13 social economic status factors), and density of convenience stores, grocery stores, and limited-service restaurants at the tract level. Linear regressions examined associations between environment and changes in body weight, waist circumference (WC), MVPA (SenseWear device), and dietary intake (3-day diet records) from baseline to 18 months.ResultsGrocery store density was inversely associated with change in weight (β = -0.95; p = 0.02; R 2 = 0.062) and WC (β = -1.23; p < 0.01; R 2 = 0.109). Participants living in tracts with lower walkability demonstrated lower baseline MVPA and greater increases in MVPA versus participants with higher walkability (interaction p = 0.03). Participants living in tracts with the most deprivation demonstrated greater increases in average daily steps (β = 2048.27; p = 0.02; R 2 = 0.039) versus participants with the least deprivation. Limited-service restaurant density was associated with change in % protein intake (β = 0.39; p = 0.046; R 2 = 0.051).ConclusionEnvironmental factors accounted for some of the variability (<11%) in response to a behavioral weight loss intervention. Grocery store density was positively associated with weight loss at 18 months. Additional studies and/or pooled analyses, encompassing greater environmental variation, are required to further evaluate whether environment contributes to weight loss variability.

Dataset Information

Identifying the mechanisms through which behavioral weight-loss treatment improves food decision-making in obesity.

Publications

Identifying the mechanisms through which behavioral weight-loss treatment improves food decision-making in obesity.

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