Do hunger and exposure to food affect scores on a measure of hedonic hunger? An experimental study. Appetite. 2014;74:1-5. [PMID: 24269255 DOI: 10.1016/j.appet.2013.11.010]

The Effect of Multi-Strategy Nutrition Education Programs on Hedonic Hunger and Nutrition Status in Adolescents

Objective: Increasing the awareness of adolescents about hedonic hunger, understanding the difference between homeostatic hunger and hedonic hunger, and adolescents learning to control themselves to stop excessive food consumption are extremely important for a healthy adulthood. The study aimed to evaluate the effects of the multi-strategy nutrition education programs (MSNEP) on hedonic hunger, food addiction, nutrition literacy, and nutritional status in adolescents. Methods: This study was planned using a pre-test and post-test design. The MSNEP was conducted with 132 adolescents (11-15 years; 69 boys, 63 girls) for 4 weeks (45 min-1 h/session). Data were obtained using questionnaires with face-to-face interviews at pre-education (baseline) and post-education (week 4 and week 8). The survey form included sociodemographic information, nine item short version of Children's Power of Food Scale (C-PFS-9), the Yale Food Addiction Scale for Children 2.0 (YFAS-C 2.0), the Adolescent Nutrition Literacy Scale (ANLS), anthropometric measurements, and 24-hour dietary recall. Results: A decrease in C-PFS-9 total scores was found compared to the baseline (p < 0.001). While the YFAS-C 2.0 score decreased in boys compared to the baseline (p < 0.05), no significant difference was found in girls (p > 0.05). A difference was found in the ANLS scores for girls (p = 0.01), but no difference was found in the scores for boys during the study (p > 0.05). At week 4, the consumption of dairy products, legumes, vegetables and fruits, bread and grains, nuts, and hard-shelled seeds increased compared to the baseline (p < 0.05). Also, daily protein and fiber intake increased (p < 0.05). Accordingly, a higher YFAS-C 2.0 score predicted greater hedonic hunger. A lower ANLS score was a predictor for higher food taste and food available scores. Conclusions: In conclusion, the MSNEP was found to have positive effects on hedonic hunger, food addiction, nutritional literacy, and healthy eating behaviors. The study revealed differences between girls and boys. In order to maintain healthy body weights in adolescents, it is recommended that the MSNEP be provided in schools.

Relationship of perceived depression, stress, anxiety levels and hedonic hunger

BACKGROUND

This study was designed to explore relationship of perceived depression, anxiety and stress (DAS) levels and hedonic hunger in adults.

METHODS

A cross-sectional survey included questions about some socio-demographic characteristics, Power of Food Scale (PFS-Tr) and Depression Anxiety Stress Scales (DASS-21) was sent via an online platform. Self-reported weight and height were also questioned. A total of 4112 adult volunteers between the ages of 18-65 years participated in this study. 72.3% of them were female.

RESULTS

The prevalence of moderate to extremely severe depression, anxiety, and stress was reported as 31%, 34% and 13% respectively. Hedonic hunger and perceived DAS levels were higher in females (p < 0.001). Hedonic hunger was positively correlated with perceived DAS (p < 0.001). While body mass index (BMI) was positively associated with PFS-Tr total score, food available and food present; negatively associated with food tasted. Body mass index was negatively correlated with perceived DAS. Hedonic hunger and perceived DAS levels decreased with increasing age. Females were more prone to both hedonic hunger and perceived DAS. About one in three participants reported moderate to extremely severe levels of depression and anxiety. Greater perceived DAS levels are associated with hedonic hunger. Underweight individuals had higher levels of perceived DAS.

CONCLUSION

To our knowledge, this is the first study to examine the prevalence and predictors of perceived DAS levels and hedonic hunger in the Turkish adult population. The findings of the study suggest that the predictors such as age, sex and BMI are a part of psychological well-being and hedonic hunger.

Overlapping and distinct relationships between hedonic hunger, uncontrolled eating, food craving, and the obesogenic home food environment during and after a 12-month behavioral weight loss program

Hedonic hunger, reward-driven eating outside of biological need, is a newer construct in eating behavior research. During behavioral weight loss (BWL), greater improvements in hedonic hunger are associated with higher weight loss, but it remains unclear if hedonic hunger predicts weight loss independent of more well-established, similar constructs (uncontrolled eating and food craving). Research also is needed to understand how hedonic hunger interacts with contextual factors (e.g., obesogenic food environment) during weight loss. Adults (N = 283) in a 12-month randomized controlled trial of BWL were weighed at 0, 12, and 24 months, and completed questionnaires assessing hedonic hunger, food craving, uncontrolled eating, and the home food environment. All variables improved at 12 and 24 months. Decreases in hedonic hunger at 12 months were associated with higher concurrent weight loss, but not when accounting for improvements in craving and uncontrolled eating. At 24 months, reduction in craving was a stronger predictor of weight loss than hedonic hunger, but improvement in hedonic hunger was a stronger predictor of weight loss than change in uncontrolled eating. Changes to the obesogenic home food environment failed to predict weight loss, regardless of levels of hedonic hunger. This study adds novel information on the individual and contextual factors associated with short- and long-term weight control, which can help refine conceptual models and treatment strategies.

Motivation to consume palatable foods as a predictor of body image dissatisfaction: Using the Power of Food Scale in a Brazilian sample

The Power of Food Scale (PFS) is a questionnaire for self-assessing the motivation to consume palatable foods, especially in environments where food is abundant and constantly available. This study aimed to a) assess the factorial structure of the PFS in a Brazilian sample and b) examine the relationship between the power of food and body image dissatisfaction and BMI. The PFS and Body Shape Questionnaire (BSQ) were applied to a sample of 300 adults. Data were analysed using confirmatory factor analysis. Composite reliability (CR) was used to verify factor reliability. A partial least squares structural equation model was used to verify the effect of the PFS score on body image dissatisfaction. The PFS had an adequate factorial structure in this Brazilian sample, showing three well-defined factors: food available (CR = 0.91), food tasted (CR = 0.84), and food present (CR = 0.87). The BSQ showed one reliable factor (CR = 0.97). The power of the food aggregate factor significantly predicted body mass index (β = 0.16; p = .01) and body image dissatisfaction (β = 0.46; p < .001). The effect size was small for body mass index (f² = 0.02) and medium for body image dissatisfaction (f² = 0.26). The food present factor also had a slightly higher average among the three PFS factors. Women had higher PFS scores than men. Understanding the role that this motivation plays in physical and psychological outcomes such as body dissatisfaction can contribute to developing treatment strategies and support health professionals' performance in clinical settings.

Associations between hedonic hunger and BMI during a two-year behavioural weight loss trial

Objective

Prospective studies on relationships between hedonic hunger and BMI (Body Mass Index) during weight management are lacking. This study examined if hedonic hunger reduced during a behavioural weight management programme, and if hedonic hunger predicted future BMI.

Methods

Participants were 594 community-dwelling, UK-based adults(396 female; age 56.43 years, s.d. = 12.50, range 20–83 years); 490 participants (82.5%) had obesity. Participants were randomised to a 12- or 52-week behavioural weight management intervention (WW12 or WW52, respectively) or a brief self-help intervention (BI). Relationships between hedonic hunger and BMI over 24 months (baseline, 3, 12, 24 months) were analysed using an autoregressive cross-lagged model.

Results

Hedonic hunger scores decreased from 2.71 (s.d. = .91) at baseline to 2.41 (s.d. = .88) at 3 months (p < .001, CI .22 to .38), remained reduced to 24 months, and were not affected by intervention arm at any time point (p’s>.05). Baseline hedonic hunger scores predicted 3-month scores (B = .76, SE = .03, p < .001, CI .71 to .82), 3-month scores predicted 12-month scores (B = .76, SE = .03, p < .001 CI .72 to .80), and 12-month scores predicted 24-month scores (B = .72, SE = .03, p < .001, CI .64 to .77). Higher hedonic hunger at 3 months predicted higher BMI at 12 months (B = .04, SE = .02, p = .03, CI .01 to .07) but not at 24 months (p>.05). BMI at 12 months was lower in WW52 30.87kg/m², s.d. = 5.02) than WW12 (32.12 kg/m², s.d. = 5.58, p = .02, CI .16 to 2.34) and BI (32.74 kg/m², s.d. = 4.15, p = .01, CI .30 to 3.45). BMI was not affected by intervention at any other time point (p’s>.05).

Conclusion

Hedonic hunger reduced during weight management irrespective of intervention. Early reductions in hedonic hunger appear to be associated with lower BMI in the medium-term. Identifying ways to reduce hedonic hunger during weight loss could aid weight management for some people.

Validation of the Turkish version of the power of food scale in adult population

PURPOSE

The Power of Food Scale (PFS) is a tool for measuring the hedonic impact of food environments rich in palatable foods. The purpose of this study was to validate the Turkish version of PFS (PFS-Tr) in a large adult population.

METHODS

Data were obtained from 505 Turkish adults aged between 19 and 64 years. The PFS-Tr and Dutch Eating Behavior Questionnaire (DEBQ) were completed by all participants.

RESULTS

PFS-Tr compared with the original English version of PFS, items 5 and 13, which showed the highest error covariance under the food available factor. To provide general criteria, items 5 and 13 were removed. After these two items were removed, the Cronbach's alpha coefficient was 0.922 for PFS-Tr and Cronbach's alpha values for "food available", "food present", and "food taste" were found to be 0.849, 0.797, and 0.82, respectively. Besides, the Cronbach's alpha coefficient was 0.93 for DEBQ. In addition, a linear association was found between BMI and mean score of PFS-Tr with a model fit (R² = 0.02) and PFS-Tr was positively correlated with DEBQ (r 0.497 p < 0.001).

CONCLUSION

This is the first study that validates and reports the Turkish version of PFS and the results of our study show that PFS-Tr is a valid and reliable tool for determining the tendency for the hedonic hunger in Turkish adult population.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Body Mass Index and stimulus control: Results from a real-world study of eating behaviour

BACKGROUND

Evidence suggests decisions about when, what, and how much to eat can be influenced by external (location, food outlet presence, food availability) and internal (affect) cues. Although the relationship between stimulus control and obesity is debated, it is suggested that individuals with higher BMIs are more driven by cues to eating than individuals in the healthy-weight range (HWR). This study investigates the influence of stimulus control on real-world food intake, and whether stimulus control differs by BMI. It was hypothesised that, compared to those in the HWR, eating among individuals with higher BMIs would be under greater stimulus control.

METHOD

74 participants (n = 34 BMI < 24.9, n = 40 BMI > 24.9) recorded food intake for 14 days using Ecological Momentary Assessment. Participants also responded to 4-5 randomly-timed assessments per day. Known external and internal eating cues were assessed during both assessment types. Within-person logistic regression analyses were used to predict eating vs. non-eating occasions from stimulus control domains.

FINDINGS

Results support the hypothesis that eating was influenced by stimulus control: food availability, affect, time of day, and location significantly distinguished between eating and non-eating instances (AUC-ROC = 0.56-0.69, all p's < 0.001). The presence of food outlets was significantly better at distinguishing between eating and non-eating instances for those with higher BMIs (compared to individuals in the HWR).

DISCUSSION

Results support the notion of stimulus control in shaping eating decisions. Differences in levels of stimulus control between participants in the HWR compared to those with a high BMI suggest that dietary improvement interventions may be more effective when they are tailored to the individual and consider environmental influences on eating behaviour.

Psychometric properties of Power of Food Scale in Iranian adult population: gender-related differences in hedonic hunger

PURPOSE

The present study was performed to develop the Persian version of Power of Food Scale (PFS) questionnaire (PFS-P) and to assess the hedonic hunger in Iranian adult population. In addition, associations between individual differences, including sex and body mass index (BMI) and the appetitive motives measured by the PFS-P were assessed.

METHODS

Eight hundred and twenty participants were studied. The PFS-P, the International Physical Activity Questionnaire, the Three-Factor Eating Questionnaire, and a questionnaire pertaining to demographic characteristics were completed for all participants.

RESULTS

The Cronbach's alpha values for the factors "food available", "food present" and "food taste" were 0.87, 0.85, and 0.78, respectively. The intraclass correlation coefficient ranged from 0.80 to 0.97 for the factors of PFS-P. Good content, face, criterion, and construct validity were observed for the PFS-P. In addition, a good reliability was found for both aggregate score of the PFS-P and the scores of its three factors. Relatively strong associations were found between BMI and the PFS-P score (r = 0.43). The hedonic hunger was significantly higher in women than men (p < 0.001).

CONCLUSIONS

The findings of the present study provide further evidence in support of the suitability of PFS as a valid instrument to measure hedonic hunger. PFS-P can be used as a valid and reliable measure to assess hedonic hunger in Iranian populations. In addition, a moderately strong correlation was observed between BMI and hedonic hunger scores. This study revealed that women may experience hedonic hunger more than men.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Development and validation of a short form Children's power of Food Scale

OBJECTIVE

To develop and validate a shortened form of the Children's Power of Food Scale (C-PFS), which measures anticipated reward from consuming highly palatable foods (i.e., hedonic hunger). Presently, two gaps exist with the C-PFS: the need for a shorter tighter measure, and evidence to support similar item function across populations.

METHOD

Ninth grade students (N = 3277; 14.1 ± 0.4 years; 53.5% Female; 47% Hispanic) from 10 Los Angeles high schools completed the C-PFS and other surveys in class. Factor analysis, graded response modeling, and differential item functioning explored the structure of the 15 C-PFS items and identified a reduced set that parsimoniously taps hedonic hunger across the latent continuum and exhibits item-level invariance across sex, race/ethnicity, and weight status. Construct validity was examined via associations of self-reported dietary intake, impulsivity, and body mass index (BMI) to C-PFS scores.

RESULTS

Factor analytic models supported a single, primary dimension of hedonic hunger that accounted for 61% of the variance across all 15-items (α = 0.94). Adequate severity, discriminatory ability, and non-overlapping item-difficulty were observed for 11-items, of which 9-items were found to have item-level invariance across demographic and weight status groupings. Poor performing items were removed to create a 9-item scale (C-PFS-9; α = 0.93). Construct validity was demonstrated as higher C-PFS-9 scores were significantly related to greater sweet (β = 0.32, [95%CI = 0.23, 0.41], p < .001) and fatty food intake (β = 0.34, [95%CI = 0.26, 0.43], p < .001) and impulsivity resulting from positive (β = 0.11, [95%CI = 0.02, 0.21], p < .05) and negative mood (β = 0.36, [95%CI = 0.28, 0.45], p < .001). Females, relative to males, reported higher C-PFS-9 scores (β = 0.10, [95%CI = 0.02, 0.17], p < .05) and associations with BMI were mixed.

CONCLUSION

The C-PFS-9 possesses excellent psychometric properties and retains the original construct coverage of hedonic hunger without a marked decrease in information obtained.

Psychometric evaluation of the power of food scale in a diverse college sample: Measurement invariance across gender, ethnicity, and weight status

The Power of Food Scale (PFS) is an instrument designed to examine individual differences in the drive to eat for pleasure (as opposed to in response to physiological hunger) and the effect of living in an obesogenic environment. Previous research supports the validity and reliability of the PFS, however, it had yet to be validated in an ethnically diverse college sample. The purpose of the current study was to test the factor structure and measurement invariance of the PFS across gender, ethnicity, and weight status. A sample of 432 college students completed the PFS (males=113, females = 319; non-Hispanic white=181, Hispanic=251; non-overweight=302, overweight=130). Confirmatory factor analysis was used to test a second-order, 3-factor (food available, food present, food tasted) structure of the PFS in each group separately (males, females, Hispanic, non-Hispanic white, non-overweight, and overweight) and tests of measurement invariance were conducted to test the equivalency of the measure across gender, ethnicity, and weight status. Results supported the measure's original factor structure (second-order, 3-factor model) and indicated that the measure is equivalent across each of these groups, respectively. Although the small, unbalanced groups may impact the stability of the findings, the results nonetheless suggest that the PFS is a psychometrically valid measure in a diverse college sample, and that mean comparisons on this measure are meaningful across gender, ethnicity, and weight status. Given the measurement invariance of the PFS, there is support for use of the PFS among diverse college students in future work.

Dietary Motivation and Hedonic Hunger Predict Palatable Food Consumption: An Intensive Longitudinal Study of Adolescents

Background

Understanding interactions between stable characteristics and fluctuating states underlying youth's food choices may inform methods for promoting more healthful food intake.

Purpose

This study examined dietary motivation and hedonic hunger as interacting predictors of adolescents' consumption of palatable foods.

Methods

Intensive longitudinal data were collected from 50 adolescents (aged 13-18) over 20 days. Participants completed a measure of dietary motivation at baseline and reported on hedonic hunger and palatable food consumption via a smartphone app at the end of each day.

Results

Results indicated that 66.7% of the variability in hedonic hunger was between-person (BP) and 33.3% was within-person (WP). BP hedonic hunger was positively associated with fatty food consumption (β = 0.28, p < .05), and WP hedonic hunger was positively associated with starchy food consumption (β = 0.38, p < .0001). Autonomous motivation was negatively associated with consumption of fast foods (β = -0.14, p < .05). Significant cross-level interactions were found: WP hedonic hunger and controlled motivation were positively associated with starchy food consumption, and WP hedonic hunger and autonomous motivation were negatively associated with fast food consumption.

Conclusions

Findings indicated that hedonic hunger has the potential to fluctuate, and conceptualization of the variable as both trait and state may be most appropriate. Adolescents with controlled dietary motivation may be vulnerable to the influence of hedonic hunger and prone to eating higher quantities of starchy foods. Adolescents with autonomous dietary motivation may be less vulnerable to hedonic hunger and less likely to consume fast food.

Uncontrolled eating: a unifying heritable trait linked with obesity, overeating, personality and the brain

Many eating-related psychological constructs have been proposed to explain obesity and overeating. However, these constructs, including food addiction, disinhibition, hedonic hunger, emotional eating, binge eating and the like all have similar definitions, emphasizing loss of control over intake. As questionnaires measuring the constructs correlate strongly (r > 0.5) with each other, we propose that these constructs should be reconsidered to be part of a single broad phenotype: uncontrolled eating. Such an approach enables reviewing and meta-analysing evidence obtained with each individual questionnaire. Here, we describe robust associations between uncontrolled eating, body mass index (BMI), food intake, personality traits and brain systems. Reviewing cross-sectional and longitudinal data, we show that uncontrolled eating is phenotypically and genetically intertwined with BMI and food intake. We also review evidence on how three psychological constructs are linked with uncontrolled eating: lower cognitive control, higher negative affect and a curvilinear association with reward sensitivity. Uncontrolled eating mediates all three constructs' associations with BMI and food intake. Finally, we review and meta-analyse brain systems possibly subserving uncontrolled eating: namely, (i) the dopamine mesolimbic circuit associated with reward sensitivity, (ii) frontal cognitive networks sustaining dietary self-control and (iii) the hypothalamus-pituitary-adrenal axis, amygdala and hippocampus supporting stress reactivity. While there are limits to the explanatory and predictive power of the uncontrolled eating phenotype, we conclude that treating different eating-related constructs as a single concept, uncontrolled eating, enables drawing robust conclusions on the relationship between food intake and BMI, psychological variables and brain structure and function.

A narrative review of the construct of hedonic hunger and its measurement by the Power of Food Scale

INTRODUCTION

The term 'hedonic hunger' refers to one's preoccupation with and desire to consume foods for the purposes of pleasure and in the absence of physical hunger. The Power of Food Scale (PFS) was developed as a quantitative measure of this construct in 2009. Since then, over 50 published studies have used the PFS to predict appetite-related outcomes including neural, cognitive, behavioural, anthropometric and clinical measures.

OBJECTIVE

This narrative review evaluates how closely the PFS captures the construct it was originally presumed to assess and to more clearly define hedonic hunger itself.

METHODS

The measure's relationship to four domains is reviewed and summarized: motivation to consume palatable foods; level of actual consumption of such foods; body mass; and subjective loss-of-control over one's eating behaviour. Findings are synthesized to generate a more accurate understanding of what the PFS measures and how it may relate to the broader definition of hedonic hunger.

RESULTS

Results suggest that the PFS is closely related to motivation to consume palatable foods and, in extreme cases, occurrence of loss-of-control eating episodes. PFS scores are not consistently predictive of amount of food consumed or body mass.

CONCLUSIONS

Implications of these findings are discussed in the context of behavioural health, and avenues for further inquiry are identified.

Association between hedonic hunger and body-mass index versus obesity status

Obesity-associated differences in hedonic hunger, while consistently reported, have not been adequately quantified, with most studies failing to demonstrate strong correlations between Body Mass Index (BMI) and hedonic hunger indicators. Here, we quantified and assessed the nature of the relationship between hedonic hunger and BMI, in a cross-sectional study using the Portuguese version of the PFS (P-PFS) to measure hedonic hunger. Data were collected from 1266 participants belonging to non-clinical, clinical (candidates for weight-loss surgery) and population samples. Across samples, significant but weak positive associations were found between P-PFS scores and BMI, in adjusted linear regression models. However, in logistic regression models of data from the clinical and non-clinical samples, the P-PFS Food Available domain score was significantly and robustly associated with belonging to the clinical sample (OR = 1.8, 95%CI: 1.2–2.8; p = 0.008), while in the population sample it was associated to being obese (OR = 2.1, 95%CI: 1.6–2.7; p < 0.001). Thus, hedonic hunger levels are associated with obesity status with the odds of being obese approximately doubling for each unit increase in the P-PFS Food Available score.

Glucagon-like peptide 1 in the pathophysiology and pharmacotherapy of clinical obesity

Though the pathophysiology of clinical obesity is undoubtedly multifaceted, several lines of clinical evidence implicate an important functional role for glucagon-like peptide 1 (GLP-1) signalling. Clinical studies assessing GLP-1 responses in normal weight and obese subjects suggest that weight gain may induce functional deficits in GLP-1 signalling that facilitates maintenance of the obesity phenotype. In addition, genetic studies implicate a possible role for altered GLP-1 signalling as a risk factor towards the development of obesity. As reductions in functional GLP-1 signalling seem to play a role in clinical obesity, the pharmacological replenishment seems a promising target for the medical management of obesity in clinical practice. GLP-1 analogue liraglutide at a high dose (3 mg/d) has shown promising results in achieving and maintaining greater weight loss in obese individuals compared to placebo control, and currently licensed anti-obesity medications. Generally well tolerated, provided that longer-term data in clinical practice supports the currently available evidence of superior short- and long-term weight loss efficacy, GLP-1 analogues provide promise towards achieving the successful, sustainable medical management of obesity that remains as yet, an unmet clinical need.

Task-Based and Questionnaire Measures of Inhibitory Control Are Differentially Affected by Acute Food Restriction and by Motivationally Salient Food Stimuli in Healthy Adults

Adaptive eating behaviors are dependent on an interaction between motivational states (e.g., hunger) and the ability to control one's own behavior (inhibitory control). Indeed, behavioral paradigms are emerging that seek to train inhibitory control to improve eating behavior. However, inhibitory control is a multifaceted concept, and it is not yet clear how different types (e.g., reactive motor inhibition, proactive motor inhibition, reward-related inhibition) are affected by hunger. Such knowledge will provide insight into the contexts in which behavioral training paradigms would be most effective. The present study explored the impact of promoting a "need" state (hunger) together with motivationally salient distracting stimuli (food/non-food images) on inhibitory control in 46 healthy adults. Participants attended two study sessions, once after eating breakfast as usual and once after acute food restriction on the morning of the session. In each session, participants completed questionnaires on hunger, mood and inhibitory control, and undertook task-based measures of inhibitory control, and had physiological measurements (height, weight, and blood glucose) obtained by a researcher. Acute food restriction influenced task-based assessments but not questionnaire measures of inhibitory control, suggesting that hunger affects observable behavioral control but not self-reported inhibitory control. After acute food restriction, participants showed greater temporal discounting (devaluation of future rewards), and subjective hunger and these were inversely correlated with stop accuracy on the stop signal task. Finally, participants generally responded faster when food-related distractor images were presented, compared to non-food images, independent of state. This suggests that although food stimuli motivate approach behavior, stimulus relevance does not impact inhibitory control in healthy individuals, nor interact with motivational state. These findings may provide some explanation for poorer inhibitory control often reported in studies of individuals who practice restraint over eating.

Power of Food Scale in association with weight outcomes and dieting in a nationally representative cohort of U.S. young adults

Food reward sensitivity may influence susceptibility to overeating in a permissive food environment, contributing to unintended weight gain and intentional weight loss behavior. This study examined associations of food reward sensitivity, assessed by the Power of Food Scale (PFS), with weight outcomes and dieting in a nationally representative cohort of U.S. emerging adults. Wave 5 (W5, 5th year of follow-up) respondents from the NEXT Generation Health Study were included (N = 2202, W5 age = 20.3 ± 0.02 years). Baseline and W5 BMI, W5 weight status (normal weight = 18.5 ≤ BMI < 25, overweight = 25 ≤ BMI < 30, obese = BMI ≥ 30), BMI change (W5-baseline BMI) and onset of overweight or obesity (OWOB) were calculated from self-reported height and weight. PFS (aggregate and 3 domain scores: food available, present, and tasted) and dieting for weight-loss were assessed at W5. Adjusted linear regressions estimated associations of PFS with W5 BMI and BMI change. Log-binomial regressions estimated associations of high W5 BMI (≥25), OWOB onset and dieting with PFS. Post hoc analyses estimated associations of PFS with W5 perceived weight status (overweight vs. about right or underweight). W5 BMI = 25.73 ± 0.32 kg/m(2), and OWOB onset occurred in 27.7% of participants. The PFS-food available score was associated with BMI change, β ± SE = 0.41 ± 0.19. Other PFS scores were not associated with weight outcomes. Dieting prevalence was higher in participants with high versus low W5 BMI (61% versus 32%), and was positively associated with all PFS scores except the PFS-food tasted score, e.g., relative risk (RR) of dieting for PFS-aggregate = 1.13, 95%CI [1.01-1.26]. Post-hoc analyses indicated perceived overweight was positively associated with PFS-food available, 1.12, [1.01-1.24], and PFS-food present, 1.13, [1.03-1.24]. PFS was positively related to dieting and perceived overweight, but not concurrent or change in weight status in a representative cohort of U.S. emerging adults.

It's the power of food: individual differences in food cue responsiveness and snacking in everyday life

BACKGROUND

Discretionary eating behaviour ("snacking") is dependent on internal and external cues. Individual differences in the effects of these cues suggest that some people are more or less likely to snack in certain situations than others. Previous research is limited to laboratory-based experiments or survey-based food recall. This study for the first time examines everyday snacking using real-time assessment, and examines whether individual differences in cue effects on snacking can be explained by the Power of Food scale (PFS).

METHODS

Ecological Momentary Assessment (EMA) study with 53 non-clinical participants over an average of 10 days. Multiple daily assessments: Participants reported every snack and responded to randomly timed surveys during the day. Internal and external cues were measured during both types of assessment. Demographic data and PFS scores were assessed during a baseline lab visit. Data were analysed using multilevel linear and multilevel logistic regression with random intercepts and random slopes as well as cross-level interactions with PFS scores.

RESULTS

Higher individual PFS scores were associated with more daily snacking on average (B = 0.05, 95% CI = 0.02,0.08, p < .001). More average daily snacking was associated with higher BMI (B = 1.42, 95% CI = 0.19,2.65, p = .02). Cue effects (negative affect, arousal, activities, company) on snacking were significantly moderated by PFS: People with higher PFS were more likely to snack when experiencing negative affect, high arousal, engaging in activities, and being alone compared to people with lower PFS scores.

CONCLUSIONS

PFS scores moderate the effects of snacking cues on everyday discretionary food choices. This puts people with higher PFS at higher risk for potentially unhealthy and obesogenic eating behaviour.

Eating behavior and obesity in bipolar disorder

OBJECTIVES

Individuals with bipolar disorder are more frequently overweight or obese than the general population, but the reasons for this association are unknown. The aim of this study is to further understand the etiology of overweight and obesity in bipolar disorder.

METHODS

We invited patients in a specialty outpatient bipolar clinic to complete the Eating Inventory. Patients provided self-reported restraint, disinhibition, and perceived hunger as well as general perceptions of dietary intake.

RESULTS

Sixty-two individuals (37 female) between the ages of 18 and 67 (M = 41.5, SD = 13.38) and with an average body mass index (BMI) of 27.18 (SD = 5.71) completed the survey. Disinhibition and perceived hunger were positively correlated with BMI and self-reported difficulty eating healthy foods. Restraint was positively correlated with healthy eating (ps < .05). Stepwise linear regressions revealed that hunger was the most significant predictor of BMI (F(1) = 8.134, p = .006). Those participants with bipolar I or II disorder reported greater hunger scores (p < .01) and difficulty eating healthily (p < .05) than those without a full diagnosis.

CONCLUSIONS

These results suggest that disinhibition and perception of hunger may be linked to the disproportionately high rate of obesity in bipolar disorder.

Exploring the "weight" of food cravings and thought suppression among Cuban adults

PURPOSE

The current study aimed to analyze individual differences on food cravings, intrusive-related thoughts and its suppression between normal weight and overweight/obese Cuban adults.

METHODS

Participants were 1,184 individuals from general population, aged between 18 and 64 years (M = 32.89; SD = 12.87), with 69.1 % females. All participants answered a set of questionnaires and provided demographic, anthropometric and clinical data.

RESULTS

Overweight/obese individuals had higher mean scores than normal weight individuals on food cravings (including its nine dimensions) and food and body weight/shape thought suppression. Large effect sizes were found for body weight/shape thoughts suppression and lack of control over eating, where overweight and obese individuals showed the highest scores. This trend was also found for food thoughts suppression, food cravings trait, cue-dependent eating, preoccupation with food and guilty feelings, with effect sizes from medium to large. Finally, medium effect sizes were observed for intention to eat and negative affect.

CONCLUSION

Overweight/obese individuals experienced more food cravings and food and body weight/shape thought suppression than normal weight individuals among Cuban adults.

Bariatric endocrinology: principles of medical practice

Obesity, is a chronic, biological, preventable, and treatable disease. The accumulation of fat mass causes physical changes (adiposity), metabolic and hormonal changes due to adipose tissue dysfunction (adiposopathy), and psychological changes. Bariatric endocrinology was conceived from the need to address the neuro-endocrinological derangements that are associated with adiposopathy, and from the need to broaden the scope of the management of its complications. In addition to the well-established metabolic complications of overweight and obesity, adiposopathy leads to hyperinsulinemia, hyperleptinemia, hypoadiponectinemia, dysregulation of gut peptides including GLP-1 and ghrelin, the development of an inflammatory milieu, and the strong risk of vascular disease. Therapy for adiposopathy hinges on effectively lowering the ratio of orexigenic to anorexigenic signals reaching the the hypothalamus and other relevant brain regions, favoring a lower caloric intake. Adiposopathy, overweight and obesity should be treated indefinitely with the specific aims to reduce fat mass for the adiposity complications, and to normalize adipose tissue function for the adiposopathic complications. This paper defines the principles of medical practice in bariatric endocrinology-the treatment of overweight and obesity as means to treat adiposopathy and its accompanying metabolic and hormonal derangements.