Measurement and validation of measures for impulsive food choice across obese and healthy-weight individuals

Individual differences in degree of discounting, Do different procedures and measures assess the same construct?

The present study compared the two most prominent procedures for measuring delay discounting, the Adjusting-Amount procedure and the Monetary Choice Questionnaire (MCQ). Of interest was whether the two procedures measure the same construct. Results obtained from two online samples recruited using the Prolific (N = 150) and MTurk (N = 243) platforms revealed generally similar results for both procedures. Regardless of the procedure, the sample, the reward amount, and whether the discounting measure used was theoretically based (i.e., log k) or was atheoretical (i.e., area under the curve, proportion of choices of the delayed reward option), the degree of discounting on the Adjusting-Amount procedure was highly correlated with the degree of discounting on the MCQ, consistent with the hypothesis that both procedures assess the same construct.

Age-related effects in delay discounting for food

Developmental influences of growth, such as hormones and metabolic factors, increase food intake and weight across the lifespan. Delay discounting (DD), a choice procedure that characterizes preferences for immediate rewards, such as food, over larger, more delayed ones may be useful in understanding developmental and metabolic changes in decision making processes related to food intake. The present study examined the relation between age and food DD in a cross-sectional design. Other variables, such as pubertal stage, were examined also as these may influence discounting. Participants (N = 114; 28 children and 86 adult) from a community sample completed measures of food and money delay discounting to determine if age-related variation in discounting tendencies is food-specific or more general. Both measures yield an omnibus discounting value and three additional values for small, medium, and large magnitudes. Analyses first revealed magnitude effects-- smaller magnitudes of both food and money were discounted more steeply than larger magnitudes. Hierarchical regressions indicated subjective hunger predicted steeper food discounting. When subjective hunger was controlled, age, but not puberty, significantly predicted food discounting for omnibus, medium, and large magnitudes of food. In children, food discounting decreased from early childhood to late adolescence. In adults, food discounting increased from early to late adulthood. Neither age, puberty, nor obesity status predicted any measure of monetary discounting. Food discounting, then, appears to change across the lifespan, and therefore, may be appropriate to examine psychological processes that accompany developmental and metabolic changes across the lifespan.

Sexual discounting: A systematic review of discounting processes and sexual behavior

Behavioral processes underlying sexual behavior are important for understanding normal human functioning and risk behavior leading to sexually transmitted infections (STIs). This systematic review examines delay and probability discounting in human sexual behavior through synthesis of 50 peer-reviewed, original research articles. Sixteen studies focusing exclusively on monetary delay discounting found small effect size positive correlations with sexual risk behaviors. Eleven studies examined delay or probability discounting of sexual behavior itself using tasks that varied duration, frequency, or quality of sex to determine value. Results show delay and uncertainty of sex causes systematic decreases in value. These studies also show consistent medium effect size relationships between sexual discounting measures and sexual health and substance use, supporting utility above and beyond monetary discounting. Twenty-three studies have modeled clinically relevant decision-making, examining effects of delay until condom availability and STI contraction probability on condom use. Observational and experimental designs found condom-use discounting is elevated in high-risk substance use populations, is sensitive to context (e.g., partner desirability), and is more robustly related to sexual risk compared with monetary discounting or condom use decisions when no delay/uncertainty was involved. Administering cocaine, alcohol, and, for some participants, methamphetamine increased condom-use discounting with minimal effect on monetary discounting or condom use when no delay/uncertainty was involved. Reviewed studies robustly support that sexual behavior is highly dependent on delay and probability discounting, and that these processes strongly contribute to sexual risk. Future research should exploit these systematic relationships to design behavioral and pharmacological approaches to decrease sexual risk behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impulsivity and neural mechanisms that mediate preference for immediate food rewards in people with vs without excess weight

People with excess weight (overweight or obese; body mass index [BMI]>25) are generally characterized as impulsive with regards to food. However, the underlying brain mechanisms of this impulsivity are not fully understood. As such, this study aims at understanding the neural mechanisms underlying impulsivity toward food rewards, as well as differences in delay discounting patterns for hypothetical food between people with vs without excess weight. To this end, participants (79 college students, 33 with excess weight and 46 without) performed a food delay discounting task and completed questionnaires related to food addiction and impulsivity. In the task, we manipulated the magnitude of immediate and delayed rewards and employed event-related fMRI design to measure brain activity. The results showed that people with excess weight, compared to those without, were more impulsive and presented a lower probability of choosing delayed rewards. The higher the BMI was, the lower the probability of choosing delayed rewards was. People with excess weight also had higher impulsivity scores than people with no excess weight. Moreover, people with excess weight had less activation in executive function areas such as the anterior cingulate gyrus, the frontal pole, and the inferior frontal gyrus in both difficult and easy decision-making conditions. These results suggest that hypo-activation of executive function areas may contribute to the progression of decision impulsivity in relation to food, which in turn is associated with excess weight.

The relationship between dietary fat intake, impulsive choice, and metabolic health

Unhealthful foods are convenient, ubiquitous, and inexpensive. Overconsumption of unhealthful foods can result in disease states such as obesity and Type 2 diabetes. In addition to the physiological consequences of unhealthful foods, research in rats has shown that diets high in processed fat and sugar induce impulsive choice behavior. Research in humans has demonstrated a link between metabolic health and impulsive choice, but most investigations have not included diet. We investigated how dietary fat intake interacts with body fat percentage, fasting glucose, insulin response, and systemic inflammation levels to predict impulsive choices in humans. Participants were split into either Control (<35% calories from fat) or High-Fat (≥40% calories from fat) groups based on self-reported dietary intake, completed an impulsive choice task, and underwent testing to determine their body fat, glucose, insulin response, and inflammation levels. High-fat diets were not predictive of impulsive choices, but added sugar was predictive. Body fat percentage was associated with impulsive choices only in the group who reported consuming high-fat diets. In addition, fasting glucose was associated with impulsive choices in the control group. Therefore, metabolic health and dietary fat intake interacted to predict impulsive choices. These findings indicate that knowledge of dietary patterns coupled with metabolic health markers may help us better understand impulsive choices, thereby improving our ability to target individuals who could benefit from interventions to reduce impulsive choice behavior, with the goal of promoting more self-controlled food choices.

Temporal discounting as a candidate behavioral marker of obesity

Although obesity is a result of processes operating at multiple levels, most forms result from decision-making behavior. The aim of this review was to examine the candidacy of temporal discounting (TD) (i.e. the reduction in the value of a reinforcer as a function of the delay to its receipt) as a behavioral marker of obesity. For this purpose, we assessed whether TD has the ability to: identify risk for obesity development, diagnose obesity, track obesity progression, predict treatment prognosis/outcomes, and measure treatment effectiveness. Three databases (Pubmed, PsycINFO, and Web of Science) were searched using a combination of terms related to TD and obesity. A total of 153 papers were reviewed. Several areas show strong evidence of TD's predictive utility as a behavioral marker of obesity (e.g., distinguishing obese from non obese). However, other areas have limited and/or mixed evidence (e.g., predicting weight change). Given the positive relationship for TD in the majority of domains examined, further consideration for TD as a behavioral marker of obesity is warranted.

The influence of COVID-19-related stress on food motivation

The COVID-19 pandemic and public health measures to reduce its transmission have increased stress. Stress is associated with alterations in eating behavior which may be partly driven by effects on food-related motivation. To investigate effects of COVID-related stress on food motivation, we recruited adults (N = 429; 272 F, 157 M) to complete an online survey via Amazon MTurk in May 2020. Current COVID-related stress, retrospective pre-COVID stress, and motivation in relation to individualized preferred foods from five categories (sweet snacks, fruit, savory snacks, vegetables, and fast food) were assessed. Food motivation measures included willingness to wait, willingness to expend low effort [finger taps], willingness to expend high effort [jumping jacks], and willingness to pay for hypothetical delivery of the food item. Food motivation for each food type was assessed using a novel instrument designed for brief assessment of multiple aspects of food motivation across multiple food types. Participants were willing to pay the most for fast food followed by sweet snacks, and willing to wait longer for sweet snacks relative to other food types. While fast food and sweets also generated the most willingness to expend high and low effort, willingness to expend low effort for fruit was similar to that for fast food and sweets, and willingness to expend high effort for fruit was comparable to that for fast food. Participants were least willing to pay or expend low effort for vegetables. Higher COVID-related stress levels were associated with willingness to expend more effort and pay more for food items. These data collected during the pandemic demonstrate that highly processed and sweet foods have high motivating value across multiple measures of motivation, and COVID-related stress increases food motivation across food categories. Interventions to mitigate stress and target the link between stress and overeating may help to limit the effects of the COVID-19 pandemic on obesity.

Delay discounting and obesity in food insecure and food secure women

OBJECTIVES

The relation between food insecurity (FI) and delay discounting (DD) and probability discounting (PD) for food and money was tested in women. In addition, discounting was tested as a variable that mediates the relation between obesity and FI.

METHOD

Women recruited from a community sample (N = 92) completed questionnaires. They completed the food choice questionnaire, the monetary choice questionnaire, measures for food and money probability discounting (which quantify sensitivity to risk aversion), and demographic measures.

RESULTS

Women with FI had higher rates of obesity and higher food DD compared to food-secure women. However, DD for money or probability discounting for food or money did not significantly differ between FI and food secure groups when controlling for significant covariates. Neither DD or PD significantly mediated the relation between FI and obesity.

CONCLUSIONS

These results suggest that FI is associated with greater impulsive food choice, but its association with other monetary discounting and probability discounting for food and money appears contingent upon other demographic factors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Vicarious Trial-and-Error Is Enhanced During Deliberation in Human Virtual Navigation in a Translational Foraging Task

Foraging tasks provide valuable insights into decision-making as animals decide how to allocate limited resources (such as time). In rodents, vicarious trial-and-error (back and forth movements), or VTE, is an important behavioral measure of deliberation which is enhanced early in learning and when animals are presented with difficult decisions. Using new translational versions of a rodent foraging task (the "Movie Row" and "Candy Row"), humans navigated a virtual maze presented on standard computers to obtain rewards (either short videos or candy) offered after a variable delay. Decision latencies were longer when participants were presented with difficult offers, overrode their preferences, and when they accepted an offer after rejecting a previous offer. In these situations, humans showed VTE-like behavior, where they were more likely to pause and/or reorient one or more times before making a decision. Behavior on these tasks replicated previous results from the rodent foraging task ("Restaurant Row") and a human version lacking a navigation component ("Web-Surf") and revealed some species differences. Compared to survey measures of delay-discounting, willingness to wait for rewards in the foraging task was not related to willingness to wait for hypothetical rewards. And, smoking status (use of cigarettes or e-cigarettes) was associated with stronger discounting of hypothetical future rewards, but was not well-related to performance on the foraging tasks. In contrast, individuals with overweight or obese BMI (≥25) did not show stronger delay-discounting, but individuals with BMI ≥ 25, and especially females, showed reduced sensitivity to sunk-costs (where their decisions were less sensitive to irrecoverable investments of effort) and less deliberation when presented with difficult offers. These data indicate that VTE is a behavioral index of deliberation in humans, and further support the Movie and Candy Row as translational tools to study decision-making in humans with the potential to provide novel insights about decision-making that are relevant to public health.

Reconsidering delay discounting in bulimia nervosa

Delay discounting measures one's preference for smaller-sooner versus larger-later reward and is a facet of impulsivity. Studying delay discounting in bulimia nervosa (BN) may enhance clinical understanding of BN, as BN is characterized by engagement in behaviors that provide immediate reward (i.e., binge eating, purging) at the expense of future well-being. Prior research suggests that individuals with BN prefer smaller amounts of money available sooner compared to psychiatrically healthy (HC) persons. Here, we aimed to replicate and extend previous work by studying delay discounting of both monetary and food reward in women with BN relative to HC women. We also compared delay discounting of monetary and food reward, and examined associations among delay discounting, trait impulsivity, and eating disorder symptom expression in women with BN. Participants were 20 women with sub- or full-threshold DSM-5 BN and 20 HC women who completed a diagnostic interview, paper-and-pencil measures of delay discounting of monetary and food commodities, and a measure of trait impulsivity. Contrary to previous work, we found that women with BN showed decreased delay discounting of monetary and food reward relative to HC women. Within-group analyses demonstrated that women with BN showed elevated delay discounting of food reward relative to monetary reward. Within women with BN, elevated delay discounting of food, but not money, was associated with elevated negative and positive urgency, two facets of trait impulsivity that relate to acting rashly when experiencing strong emotion. Results suggest that delay discounting may be more variable in BN than previously assumed.

Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated with Greater Delay Discounting of Condom-Protected Sex and Money

Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk of detrimental life outcomes. Recent research also indicates that ADHD is associated with sexual risk behavior, such as unprotected sex. Some risky sexual behaviors may be driven, in part, by preference for immediate rewards, referred to as delay discounting, which is prominent in etiological models of ADHD. Therefore, the present study examined the effect of delay on preference for both monetary and sexual outcomes in adults with many ADHD symptoms (both on and off medication) and with fewer ADHD symptoms. Online participants (N = 275; n = 161 males, n = 114 females) completed a monetary delay discounting task, assessing preference for smaller sooner versus larger delayed hypothetical money, and the Sexual Delay Discounting Task, assessing preference for condom use in hypothetical casual sex scenarios based on delay until condom availability. Those with greater ADHD symptoms discounted delayed monetary outcomes as well as delayed condom-protected sex (i.e., preferred sooner money rewards and immediate unprotected sex) significantly more than those with fewer symptoms; however, no effect of current medication use was found across monetary or sexual delay discounting among those with greater ADHD symptoms. This study is the first to demonstrate the relation between ADHD symptoms and reduced condom-use likelihood. Increased discounting of delayed condom-protected sex might constitute one mechanism of risky sexual behavior among individuals with ADHD symptoms. Interventions geared toward increasing condom use in situations in which condoms may otherwise be unavailable, may mitigate risky sexual behaviors and their associated harms in this population.

The Time Is Ripe: Thinking about the Future Reduces Unhealthy Eating in Those with a Higher BMI

Research suggests that being oriented more towards the future (than the present) is correlated with healthier eating. However, this research tends to be correlational, and thus it is unclear whether inducing people to think about their future could increase healthy eating. Therefore, we investigated whether inducing people to think about their lives in the future versus the present would influence their intake of healthy (muesli) and unhealthy (Maltesers) food. Across two experiments, the effect of thinking about the future versus the present interacted with participants’ body mass index (BMI) to influence their consumption of unhealthy food, but no reliable effects were found for the consumption of healthy food. Among individuals with a higher BMI, thinking about their lives in the future resulted in lower consumption of the unhealthy food compared to thinking about their lives in the present. However, this effect was reversed for those with a lower BMI. In Experiment 2, we found no evidence that this effect was due to reduced impulsivity (as measured by a delay discounting task and a stop-signal task). This suggests that thinking about the future can reduce unhealthy eating among heavier people.

Preference-based serial decisions are counterintuitively influenced by emotion regulation and conscientiousness

Our decisions have a temporally distributed order, and different choice orders (e.g., choosing preferred items first or last) can lead to vastly different experiences. We previously found two dominant strategies (favorite-first and favorite-last) in a preference-based serial choice setting (the 'sushi problem'). However, it remains unclear why these two opposite behavioral patterns arise: i.e., the mechanisms underlying them. Here we developed a novel serial-choice task, using pictures based on attractiveness, to test for a possible shared mechanism with delay discounting, the 'peak-end' bias (i.e., preference for experienced sequences that end well), or working-memory capacity. We also collected psychological and clinical metric data on personality, depression, anxiety, and emotion regulation. We again found the two dominant selection strategies. However, the results of the delay, peak-end bias, and memory capacity tasks were not related to serial choice, while two key psychological metrics were: emotion regulation and conscientiousness (with agreeableness also marginally related). Favorite-first strategists actually regulated emotions better, suggesting better tolerance of negative outcomes. Whereas participants with more varied strategies across trials were more conscientious (and perhaps agreeable), suggesting that they were less willing to settle for a single, simpler strategy. Our findings clarify mechanisms underlying serial choice and show that it may reflect a unique ability to organize choices into sequences of events.

The effects of outcome unit framing on delay discounting

We examined the effects of outcome framing on delay discounting. In Experiment 1, participants completed four delay-discounting tasks. In one monetary task, money was framed in units of dollars (＄50), and in the other, money was framed in units of handfuls of quarters (equal to ＄50). In one food task, food was framed in clear units of food (e.g., 100 M&Ms), and in the other, food was framed in units of servings (e.g., 10 servings of M&Ms). When money was framed in units of dollars, participants discounted less by delay compared to discounting of handfuls of quarters. When food was framed as clear units, participants also discounted less compared to how they discounted servings. In Experiment 2, participants completed two delay-discounting tasks for dollars and quarters (e.g., ＄50 or 200 quarters) to determine if the results of Experiment 1 were due to the differences in handling costs. In one delay-discounting task, money was framed in units of dollars. In the other delay-discounting task, money was framed in units of quarters. There was no difference in how participants discounted delayed money framed as dollars or quarters. Clear unit framing may result in less discounting by delay than fuzzy unit framing.

Less is more: Negative income shock increases immediate preference in cross commodity discounting and food demand

Negative income shock, or the rapid reduction in financial stability, has previously been shown to increase impulsive choice for money and demand for fast food. The interplay of these conditions for obesity is called reinforcer pathology. The present work examines the impact of negative income shock on monetary and fast food discounting using a cross-commodity delay discounting task and on purchasing of fast food and an alternative commodity. An obese sample (n = 120) was recruited from Amazon Mechanical Turk and assigned to read one of two narratives: negative income shock (n = 60) or control (n = 60). Participants then completed both within- and cross-commodity discounting tasks of money and food, and purchase tasks for fast food and bottled water. The negative income shock group demonstrated greater impulsive choice across discounting tasks, as well as higher intensity of demand for fast food but not for a non-caloric control commodity (bottled water). These results suggest that negative income shock increases preference for immediate reinforcement regardless of commodity type (money or fast food), but has specific effects increasing demand for particular commodities (fast food but not an alternative). In a reinforcer pathology framework, negative income shock increasing discounting of the future while increasing demand for fast food specifically represents a high-risk state for negative health behavior in obesity.

Relative reinforcing value of food and delayed reward discounting in obesity and disordered eating: A systematic review

Understanding the food choice decision-making may help identify those at higher risk for excess weight gain and dysregulated eating patterns. This paper systematically reviews the literature related to eating behavior and behavioral economic constructs of relative reinforcing value of food (RRV_food) and delayed reward discounting (DRD). RRV_food characterizes how valuable energy-dense food is to the individual, and DRD characterizes preferences for smaller immediate rewards over larger future rewards, an index of impulsivity. Literature search on PubMed was conducted using combination of terms that involve behavioral economics and dysregulated eating in youth and adults. Forty-seven articles were reviewed. There is consistent evidence that obese youth and adults exhibit higher RRV_food. There is a need for more research on the role of RRV_food in eating disorders, as an insufficient number of studies exist to draw meaningful conclusions. There is accumulating evidence that obese individuals have higher DRD but the study of moderators of this relationship is crucial. Only a small number of studies have been conducted on DRD and binge eating, and no clear conclusions can be made currently. Approximately half of existing studies suggest lower DRD in individuals with anorexia nervosa. Research implications and treatment application are discussed.

Unhealthy diets, obesity and time discounting: a systematic literature review and network analysis

There is an increasing policy commitment to address the avoidable burdens of unhealthy diet, overweight and obesity. However, to design effective policies, it is important to understand why people make unhealthy dietary choices. Research from behavioural economics suggests a critical role for time discounting, which describes how people's value of a reward, such as better health, decreases with delay to its receipt. We systematically reviewed the literature on the relationship of time discounting with unhealthy diets, overweight and obesity in Web of Science and PubMed. We identified 41 studies that met our inclusion criteria as they examined the association between time discount rates and (i) unhealthy food consumption; (ii) overweight and (iii) response to dietary and weight loss interventions. Nineteen out of 25 cross-sectional studies found time discount rates positively associated with overweight, obesity and unhealthy diets. Experimental studies indicated that lower time discounting was associated with greater weight loss. Findings varied by how time discount rates were measured; stronger results were observed for food than monetary-based measurements. Network co-citation analysis revealed a concentration of research in nutrition journals. Overall, there is moderate evidence that high time discounting is a significant risk factor for unhealthy diets, overweight and obesity and may serve as an important target for intervention. © 2016 The Authors Obesity Reviews published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity (IASO).

Steep discounting of delayed monetary and food rewards in obesity: a meta-analysis

BACKGROUND

An increasing number of studies have investigated delay discounting (DD) in relation to obesity, but with mixed findings. This meta-analysis synthesized the literature on the relationship between monetary and food DD and obesity, with three objectives: (1) to characterize the relationship between DD and obesity in both case-control comparisons and continuous designs; (2) to examine potential moderators, including case-control v. continuous design, money v. food rewards, sample sex distribution, and sample age (18 years); and (3) to evaluate publication bias.

METHOD

From 134 candidate articles, 39 independent investigations yielded 29 case-control and 30 continuous comparisons (total n = 10 278). Random-effects meta-analysis was conducted using Cohen's d as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger tests, meta-regression of publication year and effect size, and imputation of missing studies.

RESULTS

The primary analysis revealed a medium effect size across studies that was highly statistically significant (d = 0.43, p < 10-14). None of the moderators examined yielded statistically significant differences, although notably larger effect sizes were found for studies with case-control designs, food rewards and child/adolescent samples. Limited evidence of publication bias was present, although the Begg-Mazumdar test and meta-regression suggested a slightly diminishing effect size over time.

CONCLUSIONS

Steep DD of food and money appears to be a robust feature of obesity that is relatively consistent across the DD assessment methodologies and study designs examined. These findings are discussed in the context of research on DD in drug addiction, the neural bases of DD in obesity, and potential clinical applications.

Exploring Relationships Among Experience of Regret, Delay Discounting, and Worries About Future Effects of Smoking Among Current Smokers

BACKGROUND

Smoking regret differs by smoker characteristics (dependence) and may be linked to delay discounting (DD), where smaller immediate rewards are preferred to larger delayed rewards. It is hypothesized that those who exhibit stronger tendencies to delay rewards also express fewer future health concerns and possibly less regret about smoking.

OBJECTIVES

The objective is to determine the interrelationships of regret, dependence, and delay discounting among current smokers.

METHODS

In July 2010, 1062 smokers completed a 45-minute at-home web based survey and answered questions including regret, dependence (Fagerstrom Test for Cigarette Dependence), and delay discounting (Monetary Choice Questionnaire). Relationships among these variables and perceived future health effects were analyzed using correlations, repeated measures analysis of variance, and generalized linear models.

RESULTS

Most smokers (85%) regretted smoking. FTCD and log-k (DD) scores were positively associated (rs = 0.15, p < .001). Though a strong decline in log-k was shown as reward increased (p's < .001), there were no differences in discounting by regret. Regret was positively associated with worries concerning health effects, quality of life, and finances (p's < .001). Little association was found between DD and future health concerns.

CONCLUSIONS/IMPORTANCE

Though this study confirms that regret for smoking is associated with perceived future risks as well as supports previous findings between FTCD and DD, it shows little association between DD and perceived future risks.

The utility of behavioral economics in expanding the free-feed model of obesity

Animal models of obesity are numerous and diverse in terms of identifying specific neural and peripheral mechanisms related to obesity; however, they are limited when it comes to behavior. The standard behavioral measure of food intake in most animal models occurs in a free-feeding environment. While easy and cost-effective for the researcher, the free-feeding environment omits some of the most important features of obesity-related food consumption-namely, properties of food availability, such as effort and delay to obtaining food. Behavior economics expands behavioral measures of obesity animal models by identifying such behavioral mechanisms. First, economic demand analysis allows researchers to understand the role of effort in food procurement, and how physiological and neural mechanisms are related. Second, studies on delay discounting contribute to a growing literature that shows that sensitivity to delayed food- and food-related outcomes is likely a fundamental process of obesity. Together, these data expand the animal model in a manner that better characterizes how environmental factors influence food consumption.

Reward-related decision making in eating and weight disorders: A systematic review and meta-analysis of the evidence from neuropsychological studies

Eating disorders (EDs) and overweight/obesity (OW/OB) are serious public health concerns that share common neuropsychological features and patterns of disturbed eating. Reward-related decision making as a basic neurocognitive function may trans-diagnostically underlie both pathological overeating and restricted eating. The present meta-analysis synthesizes the evidence from N=82 neuropsychological studies for altered reward-related decision making in all ED subtypes, OW and OB. The overall effect sizes for the differences between currently-ill ED patients and OW/OB people and controls were Hedge's g=-0.49 [CI: -0.63; -0.35], and Hedge's g=-0.39 [CI: -0.53; -0.25], respectively. Decision making was found to be altered to similar degrees in all ED subtypes and OB. Effect sizes, however, diverged for the different measures of decision making. Adolescents appear to be less affected than adults. When foods were used as rewarding stimuli, decision making was found to be intact in OB. The findings support that altered general reward-related decision making is a salient neuropsychological factor across eating and weight disorders in adulthood.

I can't wait: Methods for measuring and moderating individual differences in impulsive choice

Impulsive choice behavior occurs when individuals make choices without regard for future consequences. This behavior is often maladaptive and is a common symptom in many disorders, including drug abuse, compulsive gambling, and obesity. Several proposed mechanisms may influence impulsive choice behavior. These mechanisms provide a variety of pathways that may provide the basis for individual differences that are often evident when measuring choice behavior. This review provides an overview of these different pathways to impulsive choice, and the behavioral intervention strategies being developed to moderate impulsive choice. Because of the compelling link between impulsive choice behavior and the near-epidemic pervasiveness of obesity in the United States, we focus on the relationship between impulsive choice behavior and obesity as a test case for application of the multiple pathways approach. Choosing immediate gratification over healthier long term food choices is a contributing factor to the obesity crisis. Behavioral interventions can lead to more self controlled choices in a rat pre-clinical model, suggesting a possible gateway for translation to human populations. Designing and implementing effective impulsive choice interventions is crucial to improving the overall health and well-being of impulsive individuals.