Cognitive training as a potential treatment for overweight and obesity: A critical review of the evidence

Neural activity and connectivity are related to food preference changes induced by food go/no-go training

Simply withholding a response while viewing an appetizing food, over the course of many presentations (i.e., during food go/no-go training) can modify individuals' food preferences-which could, in turn, promote healthier eating behaviors. However, the neural mechanisms underlying this food go/no-go training-induced change in food preferences are still relatively unclear. We addressed this issue in the present functional magnetic resonance imaging (fMRI) study. To this end, we administered a novel passive viewing task before and after food go/no-go training to 91 participants in the scanner. Participants' food preferences were measured with a binary food choice task. At the behavioral level, we found the expected training effect on food preferences: Participants preferred go over no-go foods following training. At the neural level, we found that changes in food preferences were associated with training-related go vs. no-go differences in activity and functional connectivity, such as less activity in the anterior cingulate cortex and superior frontal gyrus but greater functional connectivity between the superior frontal gyrus and middle occipital gyrus. Critically, Dynamic causal modeling showed that this preference change effect was largely driven by top-down influence from the superior frontal gyrus to the middle occipital gyrus. Together, these findings suggest a neural mechanism of the food go/no-go training effect-namely, that the food-viewing-related interplay between prefrontal regions and visual regions might be related to the food preference change following food go/no-go training.

Virtual reality assessment of a high-calorie food bias: Replication and food-specificity in healthy participants

BACKGROUND

Theoretical models and behavioural studies indicate faster approach behaviour for high-calorie food (approach bias) among healthy participants. A previous study with Virtual Reality (VR) and online motion-capture quantified this approach bias towards food and non-food cues in a controlled VR environment with hand movements. The aim of this study was to test the specificity of a manual approach bias for high-calorie food in grasp movements compared to low-calorie food and neutral objects of different complexity, namely, simple balls and geometrically more complex office tools.

METHODS

In a VR setting, healthy participants (N = 27) repeatedly grasped or pushed high-calorie food, low-calorie food, balls and office tools in randomized order with 30 item repetitions. All objects were rated for valence and arousal.

RESULTS

High-calorie food was less attractive and more arousing in subjective ratings than low-calorie food and neutral objects. Movement onset was faster for high-calorie food in push-trials, but overall push responses were comparable. In contrast, responses to high-calorie food relative to low-calorie food and to control objects were faster in grasp trials for later stages of interaction (grasp and collect). Non-parametric tests confirmed an approach bias for high-calorie food.

CONCLUSION

A behavioural bias for food was specific to high-calorie food objects. The results confirm the presence of bottom-up advantages in motor-cognitive behaviour for high-calorie food in a non-clinical population. More systematic variations of object fidelity and in clinical populations are outstanding. The utility of VR in assessing approach behaviour is confirmed in this study by exploring manual interactions in a controlled environment.

A systematic review of the effectiveness of attentional bias modification to support weight management in individuals who are overweight or obese

Attentional bias modification (ABM) is a novel cognitive-based treatment that may help individuals reduce overeating by decreasing food processing bias and food cravings. However, most empirical studies have evaluated the short-term effects of ABM in populations that have body mass indexes that are within healthy ranges; therefore, the extent to which this training method can influence eating behavior in individuals who are overweight or obese remains unclear. This systematic review explored the efficacy of ABM as a tool to support weight management for individuals who are overweight or obese. Ten studies met the inclusion criteria for the review. The findings reveal that although training is effective at manipulating attentional bias to food cues, there is limited evidence that training significantly impacted appetite and eating behaviors or led to maintained weight loss.

Modifying biased attention towards food stimuli in binge eating disorder: A multi-session training study

Individuals with binge eating disorder (BED) exhibit a biased attention towards food stimuli. Against this backdrop, the present study with pre-registered design (ID: DRKS00012984) tested whether (a) a training designed to reduce attentional food processing indeed modifies this bias, (b) this reduction is evident in several measures of food-related attention and (c) this is associated with reductions in craving, binge frequency over the past 28 days and calories eaten in a laboratory based bogus taste test. Individuals with BED were randomly allocated to four sessions of either an attentional bias modification training (ABMT; n = 39) or a comparable no-modification control training (CT; n = 27). In all measures assessed via eye-tracking - dwell time bias, dwell time bias variability and first fixation bias - food-related bias decreased in the ABMT relative to the CT. Against our hypothesis, no differential between-group effects were found for reaction time (RT) bias and its variability as well as for calories consumed in a bogus taste test. By contrast, reductions in binge frequency and subjective craving were found for both groups. Taken together, the tendency to preferentially process food seems a modifiable phenomenon in individuals with BED. However, modifying this selective viewing pattern does not seem a prerequisite for a successful reduction of binge frequency.

Testing Go/No-Go training effects on implicit evaluations of unhealthy and healthy snack foods

OBJECTIVE

Despite intending to eat healthy foods, people often yield to temptation. In environments rife with unhealthy food options, a positive implicit evaluation of unhealthy foods may inadvertently influence unhealthy choices. This study investigates if and under which conditions implicit evaluations of unhealthy and healthy foods can be influenced by a computer-based Go/No-Go (GNG) training.

DESIGN

Undergraduate student participants (N = 161 participants; 117 females, 44 males; Mage = 19 years, SD = 2 years) completed a GNG training with two healthy (grape and nut) and two unhealthy (potato chip and cookie) stimuli. Participants were either instructed to inhibit their responses to the potato chip (No-Go Chips/Go Grape) or to a grape (No-Go Grape/Go Chips).

MAIN OUTCOME MEASURE

Implicit evaluations of chips and grapes were assessed using the Extrinsic Affective Simon Task.

RESULTS

This GNG training impacted implicit evaluations of chips, but not grapes. GNG training effects were stronger for participants with lower sensitivity for behavioural inhibition measured with the Behavioural Inhibition System scale.

CONCLUSION

GNG training might help people change implicit food evaluations. More research is needed to understand how individual and training characteristics affect outcomes with the goal of tailoring and optimising the GNG training to produce the strongest effect.

Response inhibition training as an intervention to modify liking and wanting for foods based on energy density: a proof of concept study

The ubiquity of energy-dense, processed foods has been implicated as a salient feature of the modern 'obesogenic' environment. Cognitive strategies, such as response inhibition training, have been demonstrated to reduce the hedonic value of such foods in previous studies. However, this effect has generally been inconsistent or heterogenous, depending on the outcome measure, characteristics of the sample, and the specificity of food stimuli. Characterising the extent of generalised effects may help define the application of this type of intervention in natural settings. A repeated-measures, proof-of-concept study, using mobile app-based response inhibition training (RIT) versus a control app-based activity (N = 25), was undertaken to establish the valid application of a food reward measure to assess intervention efficacy. Liking (i.e., affect) and wanting (i.e., motivation) for food stimuli categorised by energy density were taken concurrently pre- and post-training. A statistically significant reduction in explicit liking, but not implicit wanting, for foods irrespective of their energy density was observed during the RIT app-based training session relative to the control (p = .041, ηp2 = .16). However, effect sizes associated with devaluation of energy-dense relative to low calorie food stimuli, although non-significant, were higher when measured as implicitly wanting (p = .098, ηp2 = .11) than explicit liking (p = .756, ηp2 = .00). Trends in explicit stimulus evaluations were empirically discordant from implicit evaluations for low calorie foods in particular. Additional research is needed to investigate whether these trends are reproducible with larger samples, trained and novel food stimuli in outcome measures, and more comprehensive training protocols.

Food go/no-go training alters neural circuits for food evaluation for appetite reduction

Food go/no-go training has been traditionally categorized as a type of inhibitory training that decreases the desire for high-calorie food consumption. This training requires participants to either respond or withhold their responses to presented items with go cues or food items with no-go cues, respectively. Recent findings have suggested that this training may devalue food items associated with no-go cues instead of facilitating inhibitory control, leading to reduced food consumption. We thus hypothesized that food go/no-go training would alter the brain response to food items with no-go cues in food evaluation regions. To examine this hypothesis, we conducted a repeated measures functional magnetic resonance imaging using food images in healthy participants, who underwent 3 weeks of food go/no-go training (n = 26) using high- and low-calorie food items paired with no-go cues (no-go food) and go cues (go food), respectively, and control training (n = 24). The food go/no-go training reduced the ratings for the desire to eat no-go foods and increased the ratings for go foods. The reduction in no-go food rating was positively associated with a decrease in daily snack intake. The neural responses in the food evaluation regions increased for go foods. Moreover, the functional connectivity of those regions was altered. The food go/no-go training did not decrease impulsivity traits or increase restrained eating, which are associated with inhibitory control. Overall, food go/no-go training influenced the brain regions associated with food evaluation, thus devaluating no-go foods and reducing the daily snack intake. Accordingly, food go/no-go training could promote healthier food choices.

Executive functioning as a moderator of flossing behaviour among young adults: a temporal self-regulation theory perspective

Background

Flossing among young adults is often infrequent and barriers not completely understood. One explanation concerns the capacity for executive functioning (EF) during the self-regulation of behaviour.

Methods

Using Temporal Self-Regulation Theory (TST) as a framework to explore EF, young adults from Norwegian universities completed a survey that measured monthly flossing frequency, flossing-related intentions and behavioural prepotency (BP), and EF using the Behaviour Rating Inventory of Executive Function - Adult Version (BRIEF-A).

Results

Data from 362 participants were analysed. The TST-model explained a substantial proportion of variance in monthly flossing (R2 = 0.74), and flossing was associated directly with intention and BP, and interactions between intention and both BP and global-EF. Sub-domains of EF were explored using the same model, revealing that behavioural regulation processes, specifically those related to emotional control and shifting between tasks, offered better fit. Simple slopes revealed that moderation effects were only present at lower levels of BP.

Conclusion

EF plays a role in moderating the translation of intentions into flossing behaviour. Specifically, emotional control and task-shifting appear to be influential, and this influence increases when habitual and environmental support (i.e. BP) is reduced. Overcoming EF-barriers may represent a key step in establishing flossing behaviours.

Preventing type 2 diabetes: A research agenda for behavioural science

AIMS

The aim of this narrative review was to identify important knowledge gaps in behavioural science relating to type 2 diabetes prevention, to inform future research in the field.

METHODS

Seven researchers who have published behaviour science research applied to type 2 diabetes prevention independently identified several important gaps in knowledge. They met to discuss these and to generate recommendations to advance research in behavioural science of type 2 diabetes prevention.

RESULTS

A total of 21 overlapping recommendations for a research agenda were identified. These covered issues within the following broad categories: (a) evidencing the impact of whole population approaches to type 2 diabetes prevention, (b) understanding the utility of disease-specific approaches to type 2 diabetes prevention such as Diabetes Prevention Programmes (DPPs) compared to generic weight loss programmes, (c) identifying how best to increase reach and engagement of DPPs, whilst avoiding exacerbating inequalities, (d) the need to understand mechanism of DPPs, (e) the need to understand how to increase maintenance of changes as part of or following DPPs, (f) the need to assess the feasibility and effectiveness of alternative approaches to the typical self-regulation approaches that are most commonly used, and (g) the need to address emotional aspects of DPPs, to promote effectiveness and avoid harms.

CONCLUSIONS

There is a clear role for behavioural science in informing interventions to prevent people from developing type 2 diabetes, based on strong evidence of reach, effectiveness and cost-effectiveness. This review identifies key priorities for research needed to improve existing interventions.

Neural correlates of changing food choices while bypassing values

Current theories suggest that altering choices requires value modification. To investigate this, normal-weight female participants' food choices and values were tested before and after an approach-avoidance training (AAT), while neural activity was recorded during the choice task using functional magnetic resonance imaging (fMRI). During AAT, participants consistently approached low- while avoiding high-calorie food cues. AAT facilitated low-calorie food choices, leaving food values unchanged. Instead, we observed a shift in indifference points, indicating the decreased contribution of food values in food choices. Training-induced choice shifts were associated with increased activity in the posterior cingulate cortex (PCC). In contrast, the medial PFC activity was not changed. Additionally, PCC grey matter density predicted individual differences in training-induced functional changes, suggesting anatomic predispositions to training impact. Our findings demonstrate neural mechanisms underlying choice modulation independent of valuation-related processes, with substantial theoretical significance for decision-making frameworks and translational implications for health-related decisions resilient to value shifts.

The nature and persistence of the effects of posthypnotic suggestions on food preferences: The final report of an online study

The persistence of food preferences, which are crucial for diet-related decisions, is a significant obstacle to changing unhealthy eating behavior. To overcome this obstacle, the current study investigates whether posthypnotic suggestions (PHSs) can enhance food-related decisions by measuring food choices and subjective ratings. After assessing hypnotic susceptibility in Session 1, at the beginning of Session 2, a PHS was delivered aiming to increase the desirability of healthy food items (e.g., vegetables and fruit). After the termination of hypnosis, a set of two tasks was administrated twice, once when the PHS was activated and once deactivated in counterbalanced order. The task set consisted of rating 170 pictures of food items, followed by an online supermarket where participants were instructed to select enough food from the same item pool for a fictitious week of quarantine. After 1 week, Session 3 mimicked Session 2 without renewed hypnosis induction to assess the persistence of the PHS effects. The Bayesian hierarchical modeling results indicate that the PHS increased preferences and choices of healthy food items without altering the influence of preferences in choices. In contrast, for unhealthy food items, not only both preferences and choices were decreased due to the PHS, but also their relationship was modified. That is, although choices became negatively biased against unhealthy items, preferences played a more dominant role in unhealthy choices when the PHS was activated. Importantly, all effects persisted over 1 week, qualitatively and quantitatively. Our results indicate that although the PHS affected healthy choices through resolve, i.e., preferred more and chosen more, unhealthy items were probably chosen less impulsively through effortful suppression. Together, besides the translational importance of the current results for helping the obesity epidemic in modern societies, our results contribute theoretically to the understanding of hypnosis and food choices.

Comparing the effects of inhibitory control training and evaluative conditioning for unhealthy food behaviours

Cognitive Bias Modification (CBM) is hypothesised to reduce unhealthy food preference and consumption through the completion of computerised cognitive training tasks. While there is evidence to suggest that two popular CBM paradigms (Inhibitory Control Training (ICT) and Evaluative Conditioning (EC)) can have a positive influence on food-related outcomes, issues (and inconsistencies) related to task standardisation and control group design make it difficult to evaluate their standalone efficacy. In a pre-registered laboratory study using a mixed experimental design, our aim was to directly compare a single session of ICT and EC on implicit preference, explicit choice and ad-libitum food intake, while ensuring appropriate active control groups were utilised for each training type (in addition to a passive control group). The results revealed that there were no significant differences in terms of implicit preferences, ad-libitum food consumption or food choice. These results provide limited evidence to support the use of CBM as a psychological intervention for unhealthy food choice or consumption. Further work is needed to isolate mechanisms of effect for successful training and identify the most effective CBM protocols for implementation in future studies.

Long-term effects of imaginal retraining in overweight and obesity: A controlled study

BACKGROUND

Imaginal retraining (IR) is a self-help technique that targets automatic approach tendencies toward appetitive stimuli. In a randomized controlled trial (RCT; N = 384), IR reduced craving for high-calorie foods after a six-week intervention period (small effect). The aim of the present study was to evaluate long-term effects of IR in this sample.

METHODS

One year after baseline, participants from the initial RCT were recontacted. A visual analogue scale measuring craving, the Food Cravings Questionnaire-Trait-reduced (FCQ-T-r), the Three-Factor Eating Questionnaire, the Beck Depression Inventory, quality of life, and subjective appraisal of the intervention were assessed online. Participants were classified as users or nonusers based on self-reported usage of IR over the previous year.

RESULTS

Linear-mixed models showed no significant interaction effects of time and group for any outcome (trend level effects were found for two subscales of the FCQ-T-r). Yet, higher usage of IR was associated with greater symptom reduction. Although overall subjective appraisal of the intervention was comparably good to the initial study, usage of IR and completion rate were unsatisfactory.

LIMITATIONS

Main limitations of the present study include the nonrandomized group allocation and the low completion rate.

CONCLUSIONS

This study did not find evidence for the long-term efficacy of IR in individuals with craving for high-calorie foods. Only upon high usage of IR, improvement was found. However, low completion rate and usage of the intervention may have resulted in a Type-II error. Future studies may consider low-intensity professional guidance to increase adherence and assess the long-term effects of IR in RCTs.

The relationship between weight loss and cognitive function in bariatric surgery

BACKGROUND

Previously, we reported short-term improvements in auditory attention, oromotor processing speed, and executive function during the active weight loss phase following bariatric surgery that persisted out to 3 months. In this study, our aims were to investigate the relationship between weight loss and cognitive performance in these patients 1 year following vertical sleeve gastrectomy (VSG) and Roux-en Y gastric bypass (RYGB) surgery and to determine whether preoperative cognitive performance predicted weight loss.

METHODS

Adult women ages 18-55 approved for bariatric surgery completed a cognitive battery prior to and at 2, 12, 24, and 52 weeks following VSG (N = 17) or RYGB (N = 18). Scores from each task were assigned to one of the following cognitive domains: auditory attention, processing speed, memory, and executive functioning. Weight loss and cognitive scores for each domain were calculated and compared between cohorts.

RESULTS

RYGB surgery resulted in greater weight loss at 1-year follow-up relative to VSG. Both VSG and RYGB procedures resulted in improved performance on different measures of auditory attention and both surgery groups improved across all processing speed tasks. Within the executive function domain, both groups showed improvements, but only the RYGB procedure resulted in improved performance in the Trail Making Test. Baseline auditory attention and memory performance predicted weight loss at 1 year following RYGB but not VSG surgery. Controlling for baseline cognitive performance, percent total weight loss predicted auditory attention at 1 year following RYGB but not VSG surgery.

CONCLUSIONS

Bariatric surgery type may result in selective improvements in cognition during the first year following surgery. Presurgical cognitive performance as well as surgery type appears to influence weight loss outcomes.

Imaginal retraining reduces craving for high-calorie food

Imaginal retraining (IR) is a treatment derived from approach bias modification to reduce strong craving for high-calorie food. The push component (IR_push) seems to be the most effective element according to a recent dismantling trial. Conclusions derived from prior studies are limited, however, by small sample sizes and restriction of participants to women. The present study aimed to overcome these limitations and also tested a new variant of IR (3P; decoupling with the elements pull, pause, push), which has previously been found to be more effective than the standard protocol in individuals with problematic alcohol use. The study was conducted online. A total of 1,106 participants with strong craving for high-calorie food were randomized to different brief interventions of IR or a passive control group. Before and after the interventions, participants indicated their craving for high-calorie food and appraised food pictures. The main conditions of interest were IR_push and 3P. The other two experimental conditions did not contain a motor element and served as active control conditions. IR_push proved the most effective intervention and reduced craving by approximately 18%, which was significantly larger than in the passive control group. IR_push worked especially well for those with higher initial weight, higher cravings, and more dysfunctional eating behavior. The novel 3P technique significantly reduced craving across time and was especially effective for those with high BMI and craving. The study suggests that a simple self-help component of imaginal retraining, IR_push, can decrease craving for high-calorie food to a relevant extent. Future trials should elucidate whether different forms of substance-related and behavioral addictions require adapted IR or 3P protocols to increase effectiveness.

Pilot study of food-specific go/no-go training for overweight individuals: brain imaging data suggest inhibition shapes food evaluation

Food-specific go/no-go training might reduce overeating and facilitate weight loss. In this pilot study, we examined whether a food-specific go/no-go training over five weeks, as compared to a non-food-specific training, could produce changes in behavioral and neural responses to food images and body weight. Here, we used a sample of 51 overweight participants divided into training and control groups whose brain activity and food evaluation were measured before and after the training. Compared with the control group, in the training group we found significant reductions in high-calorie food evaluation. We also found lower activations in inhibitory control- and reward-related brain regions in response to high-calorie food images. Further, activation change of the mid-insula in response to the high-calorie food images was positively associated with change in the evaluation of those images. However, we found no evidence for a significant effect of food-specific go/no-go training on body weight change. Our findings highlight that food-specific go/no-go training in overweight individuals can reduce high-calorie food evaluation, but also neural activations in inhibitory control- and reward- related brain regions.

Explicit and Implicit Devaluation Effects of Food-Specific Response Inhibition Training

The overvaluation of reward-associated stimuli such as energy-dense foods can drive compulsive eating behaviours, including overeating. Previous research has shown that training individuals to inhibit their responses towards appetitive stimuli can lead to their devaluation, providing a potential avenue for behaviour change. Over two preregistered experiments, we investigated whether training participants to inhibit their responses to specific foods would be effective in reducing their evaluations when these were assessed using both explicit and implicit measures. Participants completed an online session of go/no-go training with energy-dense foods that were consistently associated with either responding (go) or inhibiting a response (no-go). An 'explicit' devaluation effect was expected as a reduction in self-reported liking from pre-to post-training for no-go items compared to both go items and foods that were not presented during training (untrained items). An 'implicit' devaluation effect was then measured using the affective priming paradigm, by comparing differences in reaction times for congruent and incongruent trials (i.e., priming effects) between food primes. Experiment 1 revealed conclusive evidence for small-to-medium devaluation effects both in terms of explicit ratings and priming effects. We also observed that the priming effect for no-go items was close to zero. Experiment 2 successfully replicated most of the preregistered and exploratory outcomes from Experiment 1 except for the priming effect for untrained items. Potential explanations for this discrepancy are discussed but overall, these findings provide further support for a devaluation effect of response inhibition training. To our knowledge, our study provides the first evidence that training-induced devaluation can potentially be captured by affective priming measures, but more research is needed to further assess their sensitivity before they can be used to elucidate the mechanisms of action underlying devaluation effects.

The effects of prefrontal vs. parietal cortex transcranial direct current stimulation on craving, inhibition, and measures of self-esteem

While prefrontal cortex dysfunction has been implicated in high food cravings, other cortical regions, like the parietal cortex, are potentially also involved in regulating craving. This study explored the effects of stimulating the inferior parietal lobule (IPL) and dorsolateral prefrontal cortex (DLPFC) on food craving state and trait. Transcranial direct current stimulation (tDCS) was administered at 1.5 mA for 5 consecutive days. Participants received 20 min of IPL, DLPFC, or sham stimulation (SHAM) each day which consisted of two rounds of 10-min stimulation, divided by a 10-min mindfulness task break. In addition, we studied inhibition and subjective psychological aspects like body image and self-esteem state and trait. To decompose immediate and cumulative effects, we measured the following on days 1 and 5: inhibition through the Go/No-go task; and food craving, self-esteem, and body appreciation through a battery of questionnaires. We found that false alarm errors decreased in the participants receiving active stimulation in the DLPFC (DLPFC-group). In contrast, false alarm errors increased in participants receiving active stimulation in the IPL (IPL-group). At the same time, no change was found in the participants receiving SHAM (SHAM-group). There was a trending reduction in craving trait in all groups. Momentary craving was decreased in the DLPFC-group and increased in IPL-group, yet a statistical difference was not reached. According to time and baseline, self-esteem and body perception improved in the IPL-group. Furthermore, self-esteem trait significantly improved over time in the DLPFC-group and IPL-group. These preliminary results indicate that tDCS modulates inhibition in frontoparietal areas with opposite effects, enhancing it in DLPFC and impairing it in IPL. Moreover, craving is moderately linked to inhibition, self-esteem, and body appreciation which seem not to be affected by neuromodulation but may rely instead on broader regions as more complex constructs. Finally, the fractionated protocol can effectively influence inhibition with milder effects on other constructs.

Exploring acute and non-specific effects of mobile app-based response inhibition training on food evaluation and intake

Previous studies have demonstrated that response inhibition training can modify the appeal of palatable and energy-dense foods, thus serving as a potential intervention for weight management, via changes in food selection and intake. However, empirical findings of efficacy have been inconsistent across studies due to heterogenous approaches to measuring salient appetitive outcomes, training implementation strategies, and sample recruitment. Systematic assessment of both affective and motivational components of food reward may help characterise to what extent devaluation can be generalised to nutritionally similar foods post-training. In this mixed factorial experiment, a non-clinical, adult sample completed time-matched single sessions with mobile app-based response inhibition training and control tasks of short (12 min; n = 27) or long (20 min; n = 25) duration. Participants were assessed on two discrete facets of food reward pre- and post-training: pleasure (i.e., explicit liking) and desire (i.e., implicit wanting) for non-specific (i.e., novel) food stimuli differing in energy-density. Consumption of snacks categorised by energy density was also assessed in a laboratory ad libitum taste test post-training. No significant differences were found between intervention and control sessions on explicit liking or implicit wanting for non-specific energy-dense foods. Moreover, participants ate a similar volume of snack foods during both sessions. Training duration did not significantly moderate differences between intervention and control sessions in primary outcomes. Variance between intervention and control sessions in chocolate intake and frequency of choice for energy-dense foods, but not explicit liking, was associated with a higher BMI. Methodological and theoretical implications for appropriate intervention implementation and underlying mechanisms, respectively, are discussed.

Situated Affectivity and Mind Shaping: Lessons from Social Psychology*

Proponents of situated affectivity hold that “tools for feeling” are just as characteristic of the human condition as are “tools for thinking” or tools for carpentry. An agent’s affective life, they argue, is dependent upon both physical characteristics of the agent and the agent’s reciprocal relationship to an appropriately structured natural, technological, or social environment. One important achievement has been the distinction between two fundamentally different ways in which affectivity might be intertwined with the environment: the “user-resource-model” and the “mind-invasion-model.” The twofold purpose of this paper is to complement the debate about situated affectivity in general and about “mind invasion” in particular by, firstly, connecting it to situationist research in social psychology and, secondly, broadening the perspective to not only accommodate decidedly detrimental “invasions” but also potentially beneficial forms of “mind shaping” that include the manipulation of an agent’s experiential life and behaviour through the moulding of both the agent’s environment and the agent’s body.

The Nature and Persistence of Posthypnotic Suggestions' Effects on Food Preferences: An Online Study

Food preferences are crucial for diet-related decisions, which substantially impact individual health and global climate. However, the persistence of unfavorable food preferences is a significant obstacle to changing eating behavior. Here we explored the effects of posthypnotic suggestions (PHS) on food-related decisions by measuring food choices, subjective ratings, and indifference points. In Session 1, demographic data and hypnotic susceptibility of participants were assessed. In Session 2, following hypnosis induction, PHS aiming to increase the desirability of healthy food was delivered. Afterward, a task set was administrated twice, once when PHS was activated and once deactivated. The order of PHS activation was counterbalanced across participants. The task set included a liking-rating task for 170 pictures of different food items, followed by an online supermarket where participants were instructed to select enough food for a fictitious week of quarantining from the same item pool. After 1 week, Session 3 repeated Session 2 without hypnosis induction in order to assess the persistence of PHS. The crucial dependent measures were food choices, subjective ratings, and the indifference points as a function of time and PHS condition.

Food-Specific Inhibition Training for Food Devaluation: A Meta-Analysis

Theories have suggested that food-specific inhibition training could lead to food devaluation which, in turn, may help people to regulate their eating behavior. In this review, we have synthesized the current literature on this topic by conducting a meta-analysis of studies investigating the effects of food-specific inhibition training on food evaluation. We identified 24 studies-with 36 independent samples, 77 effect sizes, and 3032 participants-that met our inclusion criteria. Effect sizes were analyzed using the robust variance estimation in random effects meta-regression technique. The results indicate that food-specific inhibition training can lead to statistically significant reductions in food evaluation. More specifically, it was observed that the effects of training on participants' food evaluation differed according to the type of evaluation; food-specific inhibition training significantly decreased participants' explicit food evaluation, but not their implicit food evaluation. However, because most of the included studies focused on trained food items and short-term outcomes in normal-weight samples, more research is needed on the continuance of the training effects, as well as on the extent to which effects can be generalized to untrained food items or different populations (e.g., overweight or obese individuals).

The evidential value of research on cognitive training to change food-related biases and unhealthy eating behavior: A systematic review and p-curve analysis

Cognitive bias modification (CBM), which retrains implicit biases towards unhealthy foods, has been proposed as a promising adjunct to improve the efficacy of weight loss interventions. We conducted a systematic review of research on three CBM approaches (i.e., cue-specific inhibitory control, approach bias modification, and attentional bias modification) for reducing unhealthy eating biases and behavior. We performed a p-curve analysis to determine the evidential value of this research; this method is optimally suited to clarify whether published results reflect true effects or false positives due to publication and reporting biases. When considering all CBM approaches, our results suggested that the findings of CBM trials targeting unhealthy eating are unlikely to be false positives. However, only research on attentional bias modification reached acceptable levels of power. These results suggest that CBM interventions may be an effective strategy to enhance the efficacy of weight loss interventions. However, there is room for improvement in the methodological standards of this area of research, especially increasing the statistical power can help to fully clarify the clinical potential of CBM, and determine the role of potential moderators.

Incidental exposure to hedonic and healthy food features affects food preferences one day later

Memories acquired incidentally from exposure to food information in the environment may often become active to later affect food preferences. Because conscious use of these memories is not requested or required, these incidental learning effects constitute a form of indirect memory. In an experiment using a novel food preference paradigm (n = 617), we found that brief incidental exposure to hedonic versus healthy food features indirectly affected food preferences a day later, explaining approximately 10% of the variance in preferences for tasty versus healthy foods. It follows that brief incidental exposure to food information can affect food preferences indirectly for at least a day. When hedonic and health exposure were each compared to a no-exposure baseline, a general effect of hedonic exposure emerged across individuals, whereas health exposure only affected food preferences for high-BMI individuals. This pattern suggests that focusing attention on hedonic food features engages common affective processes across the general population, whereas focusing attention on healthy food features engages eating restraint goals associated with high BMI. Additionally, incidental exposure to food features primarily changed preferences for infrequently consumed foods, having less impact on habitually consumed foods. These findings offer insight into how hedonic information in the obesogenic food environment contributes to unhealthy eating behavior that leads to overweight and obesity. These findings further motivate the development of interventions that counteract the effects of exposure to hedonic food information and that broaden the effects of exposure to healthy food information.

A cross-sectional examination of executive function and its associations with grazing in persons with obesity with and without eating disorder features compared to a healthy control group

PURPOSE

The current study aimed to investigate associations between grazing and different facets of executive functioning in persons with obesity with and without significant eating disorder psychopathology, compared to a healthy-weight control group.

METHODS

Eighty-nine participants (of which 20 had obesity and marked eating disorder symptomatology, 25 had obesity but without marked eating disorder symptoms, and 44 were healthy-weight age- and sex-matched participants; N = 89; 66.3% female, age = 28.59 (8.62); 18.18-58.34 years) completed a battery of neuropsychological tests and demographic and eating disorder-related questionnaires. Poisson, Negative Binomial, and Ordinary Least Squares regressions were performed to examine group differences and the associations of grazing with executive functioning within the three groups.

RESULTS

Significantly lower inhibitory control and phonemic fluency were observed for the obesity group without ED features compared to healthy-weight controls. Increasing grazing severity was associated with improved performance in inhibitory control in both groups with obesity, and with phonemic fluency in the obesity group with marked eating disorder features.

CONCLUSION

Although there is mounting evidence that specific cognitive domains, especially inhibition, are affected in obesity, evidence of further detrimental effects of eating disorder psychopathology remains mixed; additionally, for persons with obesity, there may be a weak but positive link between executive functioning and grazing behaviour.

LEVEL OF EVIDENCE

III, comparative cross-sectional observational study with a concurrent control group.

Attentional bias modification for chocolate: Sham-n training as a new control group

Although attentional bias modification has been shown effective in several appetitive domains, results have been mixed. A major contributor seems to be the choice of control condition. The aim of the present study was to compare attentional bias modification for chocolate against a new control condition, sham-n (neutral or no-contingency) training. Using a modified dot probe protocol, participants (N = 192; 17–30 years) were randomly trained to attend to chocolate pictures, avoid chocolate pictures, or received sham-n training. In the attend and avoid conditions, stimulus pairs consisted of one chocolate and one non-chocolate picture, and probes replaced most often (90/10) chocolate or non-chocolate pictures, respectively. In the sham-n training condition, stimulus pairs consisted of two chocolate or two non-chocolate pictures, and probes replaced pictures within pairs with equal frequency (50/50). Attentional bias for chocolate increased following attend training, decreased following avoidance training, and did not change following sham-n training. The findings clearly demonstrate that both attend and avoidance training alter (in opposite direction) attentional bias for chocolate, whereas sham-n training is inert. This makes sham-n training particularly promising for use in clinical samples who tend to show strong initial biases.

Effects of go/no-go training on food-related action tendencies, liking and choice

Inhibitory control training effects on behaviour (e.g. 'healthier' food choices) can be driven by changes in affective evaluations of trained stimuli, and theoretical models indicate that changes in action tendencies may be a complementary mechanism. In this preregistered study, we investigated the effects of food-specific go/no-go training on action tendencies, liking and impulsive choices in healthy participants. In the training task, energy-dense foods were assigned to one of three conditions: 100% inhibition (no-go), 0% inhibition (go) or 50% inhibition (control). Automatic action tendencies and liking were measured pre- and post-training for each condition. We found that training did not lead to changes in approach bias towards trained foods (go and no-go relative to control), but we warrant caution in interpreting this finding as there are important limitations to consider for the employed approach-avoidance task. There was only anecdotal evidence for an effect on food liking, but there was evidence for contingency learning during training, and participants were on average less likely to choose a no-go food compared to a control food after training. We discuss these findings from both a methodological and theoretical standpoint and propose that the mechanisms of action behind training effects be investigated further.

Targeting executive function for weight loss in adults with overweight or obesity

Obesity is associated with a multitude of negative health sequalae. Behavioral weight loss (BWL) is currently the recommended behavioral treatment for obesity; however, it is not effective for approximately half of the individuals who participate. BWL requires individuals to carry out many tasks requiring executive function (EF; i.e., higher order cognitive functions such as planning and problem solving) in order to be successful. Growing research supports that lower EF may be associated with attenuated weight loss following BWL, and targeting EF in treatment could improve outcomes. This paper aims to describe the rationale for the development of Novel Executive Function Training for Obesity (NEXT), which adapts Compensatory Cognitive Training to be delivered in conjunction with BWL. We summarize evidence relating EF to obesity and reduced weight loss following BWL, as well as the past success of cognitive training on EF. Then we describe the treatment model for NEXT followed by initial data suggesting that NEXT is feasible and acceptable and may impact EF and weight. Obesity treatments incorporating cognitive training, especially those that train compensatory strategies, may improve weight-loss outcomes and provide a more durable treatment than traditional interventions, but larger randomized control trials are necessary.

Food-related inhibitory control training reduces food liking but not snacking frequency or weight in a large healthy adult sample

Inhibitory control training has recently been used as an intervention to aid healthy eating and encourage weight loss. The aim of this pre-registered study was to explore the effects of training on food liking, food consumption and weight loss in a large (n = 366), predominantly healthy-weight sample. Participants received four training sessions within a week, in which they had to inhibit their responses to either energy-dense foods (active group) or non-food images (control group). Subjective food ratings, food consumption frequency and weight were measured pre- and post-training. At two-weeks post-training, the active group reported a greater reduction in liking for energy-dense foods, compared to the control group. Active participants also reported a significantly greater increase in healthy food liking, immediately post-training, relative to the control group. There was no statistically significant difference between groups for the change in consumption of trained foods or for weight loss. These findings are partially consistent with previous research conducted in smaller, more overweight samples. Exploratory analyses suggest that some effects of training may be driven by awareness effects. Methodological differences across findings and avenues for future investigation are discussed.

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.

Improving Serious Games to Tackle Childhood Obesity

Childhood obesity has become a global public health issue. Today, there are opportunities to promote health through technological devices such as serious games. Despite the major advancement of this field of research, the use of serious games as a validated intervention in clinical practice requires further clarifications on some methodological aspects. In this perspective article, we report the pros and cons of existing serious games. Besides, we attempt to propose a new methodology of design of a serious game that could help to cope with childhood obesity. The proposed idea consists of a serious game in virtual reality based on enjoyment, movement, education, and executive functioning (EF) training. Longitudinal studies and solid research protocol would certainly ensure consistency and aid interpretation.

Bridging executive function and disinhibited eating among youth: A network analysis

OBJECTIVE

Poorer executive function (EF) has been linked to disinhibited eating in youth, suggesting poor EF predisposes toward obesity, yet the specific nature and extent of interconnections between facets of these domains is unclear. Network analysis provides a promising framework for elucidating the relationship between poor EF and disinhibited eating, and offers insights into potential maintenance processes.

METHOD

Among youth ages 8-17 years, a regularized partial correlation network of EF and disinhibited eating facets was estimated to examine expected influence centrality and bridge expected influence. Computerized neurocognitive tasks assessed EF variables, including decision-making, general and food-related inhibitory control, delayed gratification, cognitive flexibility, and working memory. Disinhibited eating variables included total carbohydrate-fat intake at a laboratory test meal and self-reported eating in the absence of hunger, emotional eating, and loss-of-control eating severity.

RESULTS

In the current sample (N = 248; Mage = 12.5; 54.8% female; 43.5% non-Hispanic White; 25.8% non-Hispanic Black; BMI %ile = 65.8 ± 27.8), emotional eating in response to depressive symptoms emerged as a central symptom in the network. Carbohydrate-fat intake had the highest bridge expected influence and was most strongly connected to general inhibitory control (part r = .14).

DISCUSSION

The link between general inhibitory control and objective palatable food intake may be particularly salient in maintaining maladaptive eating behavior. Interventions targeting behavioral disinhibition may disrupt associations among a network of disinhibited eating facets in youth and should be targets for longitudinal research.

A Dual-Pathway Perspective on Food Choices in Adolescents: The Role of Loss of Control Over Eating

Introduction

One in three adolescents frequently consume unhealthy snacks, which is associated with negative developmental outcomes. To date, it remains unclear how intrapersonal factors account for food choices in adolescents. Guided by the dual-pathway model, the current study aimed to: (1) examine the joint contribution of inhibitory control and attentional bias in predicting unhealthy food choices in adolescents, and (2) determine whether this mechanism is more pronounced in adolescents who experience loss of control over eating (LOC).

Materials and Methods

A community sample of 80 adolescents (65% female; 10–17 years old, M_age = 13.28, SD = 1.94) was recruited. Based on a self-report questionnaire, 28.7% of this sample reported at least one episode of LOC over the past month. Food choice was assessed using a computerized food choice task. Both inhibitory control and attentional bias were measured with behavioral tasks (go/no-go and dot probe task, respectively). Binary logistic regressions were conducted to address the research questions.

Results

Inhibitory control and attentional bias did not significantly interact to predict unhealthy food choices. However, there was a significant three-way interaction between inhibitory control, attentional bias and LOC. For adolescents without LOC, the combination of poor inhibitory control and low attentional bias was significantly associated with unhealthy food choice. Surprisingly, for adolescents with LOC, there was no significant association between unhealthy food choice and inhibitory control or attentional bias.

Discussion

Dual-pathway processes do not seem to add to the explanation of food choice behavior for adolescents with LOC. For adolescents who do not experience LOC, those with poor inhibitory control combined with low attentional bias might be at particular risk for making unhealthy food choices.

Executive Functions in Predicting Weight Loss and Obesity Indicators: A Meta-Analysis

While previous studies have suggested that there exists a relationship between obesity and executive function (EF), the mechanisms and causal relationship between them remain unclear. There are important clinical implications of determining whether EF can predict and treat obesity. We conducted a multilevel meta-analysis of randomized controlled trials (RCTs) and longitudinal studies. Specifically, we investigate (a) whether EF interventions have an effect on weight loss, (b) whether baseline EF can be a predictor of future weight loss through obesity intervention, and (c) whether early-life EF can predict future weight loss. Eight RCTs and 17 longitudinal studies with a total of 11,393 participants were identified. We found that (a) EF interventions may not have an effect on weight loss, (b) baseline inhibition (β = 0.259, p = 0.03) and delay discounting (β = −0.17, p = 0.04) significantly predict future weight loss through obesity intervention, (c) age (F = 13.666, p = 0.005) moderates the relationship between working memory and weight loss through intervention, but not weight status, type of intervention, and percentage of female, and (d) early life inhibition (β = 0.185, p = 0.07) is a marginally significant predictor of future weight loss. Our results seem to support the assumption that the relationship between EF and obesity is not direct, and a higher-order factor, such as genes, may link obesity and EF. Building on the preliminary findings, further studies focusing on EF and obesity are needed in the future.

Cognitive remediation-enabled cognitive behaviour therapy for obesity: a case series

PURPOSE

Despite varied treatment effects, weight recidivism is common and typically associated with the abandonment of prescribed weight management strategies. Literature suggests that difficulty with weight management is associated with deficits in executive functioning, in particular cognitive flexibility and response inhibition, the neurocognitive processes that are involved in goal-directed behaviours, such as dietary adherence. These processes are overlooked by mainstream weight loss programmes. The aim of the study was to assess the effectiveness of a cognitive remediation-enabled cognitive behaviour therapy (CR-CBT) in addressing the neurocognitive, psychological and behavioural correlates of weight loss. It was hypothesised that CR-CBT would improve cognitive flexibility and response inhibition, reduce binge eating, aid weight loss and improve metabolic health.

METHODS

Four adults with obesity (body mass index > 30 kg/m²) received 7 weeks of manualised CR-CBT and were assessed via a case series analysis at baseline, end of treatment and 3-month follow-up. Treatment included 3 weekly 90-min group-based behaviour weight loss sessions for 3 weeks, followed by twice-weekly 50-min individualised CR-CBT sessions for 4 weeks.

RESULTS

Cognitive remediation-enabled cognitive behaviour therapy produced improvements in response inhibition and cognitive flexibility, and reductions in binge eating frequency, weight, and metabolic health readings between baseline and 3-month follow-up.

CONCLUSIONS

This is the first study to assess the effectiveness of CR-CBT in the treatment of obesity. Preliminary indications of treatment success are discussed with respect to study limitations. In light of these results, we recommend further investigation via a randomised control trial (RCT).

LEVEL OF EVIDENCE

Level IV, case series.

Cognitive Training: Associations and Implications for Weight Management and Translational Research

Behavioral weight loss programs combining energy restriction and increased physical activity (PA) are generally successful in producing clinically significant weight loss (≥5%) over 3-6 mos. However, weight maintenance (≥ 2 yrs.) continues to be problematic, due in part to an inability of individuals to continue adherence to diet and PA recommendations. It is hypothesized that neurocognitive processes, specifically executive functions (EFs, i.e., inhibition, working memory, mental flexibility), underlie self-regulation, self-efficacy, and are essential for the adoption and maintenance of health behaviors. Behavioral weight loss programs generally attempt to improve self-regulation; however, these skills are difficult to implement long-term. Strengthening EFs through cognitive training may improve weight maintenance by improving self-efficacy and self-regulation, resulting in improved program attendance and improved adherence to dietary and PA recommendations. Although randomized trials have not been conducted to specifically evaluate this hypothesis, results from the available literature suggest the potential for cognitive training to improve weight maintenance.

Conceptual Models of Food Choice: Influential Factors Related to Foods, Individual Differences, and Society

Understanding individual food choices is critical for transforming the current food system to ensure healthiness of people and sustainability of the planet. Throughout the years, researchers from different fields have proposed conceptual models addressing factors influencing the food choice, recognized as a key leverage to improve planetary and human health. However, a multidisciplinary approach is needed to better understand how different factors are involved and interact with each other in the decision-making process. The present paper reviews and analyzes existing models, providing an intact point-of-view by integrating key elements into a bigger framework. Key determinants of general food choice are identified and categorized, including food-internal factor (sensory and perceptual features), food-external factors (information, social environment, physical environment), personal-state factors (biological features and physiological needs, psychological components, habits and experiences), cognitive factors (knowledge and skills, attitude, liking and preference, anticipated consequences, and personal identity), as well as sociocultural factors (culture, economic variables, political elements). Moreover, possible directions of influence among the factors towards final food choice were discussed. The need of multidisciplinary impulses across research field with the support of empirical data are crucial for understanding factors influencing food choice as well as for enriching existing conceptual models. The framework proposed here would serve as a roadmap for facilitating communications and collaborations between research fields in a structural and systematic way.

Examining cognitive bias modification interventions for reducing food value and choice: Two pre-registered, online studies

There is considerable interest in Cognitive Bias Modification (CBM) as a potential treatment for overweight/obesity. Inhibitory Control Training (ICT: also known as motor response training) and Evaluative Conditioning (EC) are two popular paradigms which rely on associatively learned responses (unhealthy food - > inhibition, or unhealthy food- > negative stimulus, respectively) through repeated cue-response contingencies. Both ICT and EC have demonstrated some effectiveness for reducing food intake, value and/or choice, when administered in the laboratory and online. However, studies have been criticised for inconsistencies in design (e.g. use of inadequate control groups) which makes it difficult to draw robust conclusions. In two pre-registered, online studies our aim was to examine active ICT (study 1: N = 170) and EC (study 2: N = 300) in multiple groups where the cue- > response contingencies were systematically varied (100%, 75%, 50%, 25%), before examining food-cue valuations and hypothetical food choice. In both studies varying the cue- > response contingencies did not lead to significant changes in food-cue devaluation following training. ICT did not substantially influence hypothetical food choice, whereas there was weak evidence that EC reduced choice for unhealthy foods, compared to a control group with 50% cue-response contingencies. Taken together both studies provide limited evidence for online CBM as a viable psychological treatment - at least through the mechanism of food-cue devaluation or changes in healthy and unhealthy food choice. Future research is needed to investigate the factors that contribute towards successful CBM training to critically evaluate the potential for these strategies within interventions.

The Influence of Response Inhibition Training on Food Consumption and Implicit Attitudes toward Food among Female Restrained Eaters

Restrained eaters display difficulties engaging in self-control in the presence of food. Undergoing cognitive training to form associations between palatable food and response inhibition was found to improve self-control and influence eating behaviors. The present study assessed the impact of two such response inhibition trainings on food consumption, food-related anxiety, and implicit attitudes toward food among female restrained eaters (Dutch Eating Behavior Questionnaire-restrained eating subscale ≥ 2.5). In Experiment 1, 64 restrained eaters completed either one of two training procedures in which they were asked to classify food vs. non-food images: a food-response training, in which stop cues were always associated with non-food images, or a balanced food-response/inhibition training, in which participants inhibited motor actions to food and non-food stimuli equally. The results revealed reduced snack consumption following the food-response/inhibition training compared to the food-response training. The food-response training was associated with increased levels of food-related anxiety. In Experiment 2, the same training procedures were administered to 47 restrained eaters, and implicit attitudes toward palatable foods were assessed. The results revealed an increase in positive implicit attitudes toward palatable foods in the food-response/inhibition group but not in the food-response training group. The results suggest that balancing response inhibition and execution across food and non-food stimuli may reduce overeating while retaining positive attitudes toward food among female restrained eaters.

Does alcohol cue inhibitory control training survive a context shift?

Inhibitory control training (ICT) is a novel psychological intervention that aims to improve inhibitory control in response to alcohol-related cues through associative learning. Laboratory studies have demonstrated reductions in alcohol consumption following ICT compared with control/sham training, but it is unclear if these effects are robust to a change of context. In a preregistered study, we examined whether the effects of ICT would survive a context shift from a neutral context to a seminaturalistic bar setting. In a mixed design, 60 heavy drinkers (40 female) were randomly allocated to receive either ICT or control/sham training in a neutral laboratory over 2 sessions. We developed a novel variation of ICT that used multiple stop signals to establish direct stimulus-stop associations. The effects of ICT/control were measured once in the same context and once following a shift to a novel (alcohol-related) context. Our dependent variables were ad libitum alcohol consumption following training, change in inhibitory control processes, and change in alcohol value. ICT did not reduce alcohol consumption in either context compared with the control group. Furthermore, we demonstrated no effects of ICT on inhibitory control processes or alcohol value. Bayesian analyses demonstrated overall support for the null hypotheses. This study failed to find any effects of ICT on alcohol consumption or candidate psychological mechanisms. These findings illustrate the difficulty in training alcohol-inhibition associations and add to a growing body of literature suggesting that ICT holds little evidential value as a psychological intervention for alcohol use disorders. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The psychology of obesity: An umbrella review and evidence-based map of the psychological correlates of heavier body weight

Psychological factors may explain why some people develop obesity and others remain a normal weight during their life course. We use an umbrella review approach to build an evidence-based map of the psychological correlates of heavier body weight. Synthesising findings from 42 meta-analyses that have examined associations between psychological factors and heavier body weight, we assessed level of evidence for a range of cognitive, psychosocial and mental health individual difference factors. There is convincing evidence that impaired mental health is associated with heavier body weight and highly suggestive evidence that numerous cognitive factors are associated with heavier body weight. However, the relatively low methodological quality of meta-analyses resulted in lower evidential certainty for most psychosocial factors. Psychological correlates of heavier body weight tended to be small in statistical size and on average, people with obesity were likely to be more psychologically similar than different to people with normal weight. We consider implications for understanding the development of heavier body weight and identifying effective public health interventions to reduce obesity.

Linking Grazing to Inhibition and Goal-Directed Behaviour in Obesity With and Without Eating Disorder Features

Recent models of obesity and eating behaviour have implicated both automatic responding to food-related cues and executive functioning in driving dietary choice. This study aimed to relate grazing severity to high weight with and without significant eating disorder features via the effects of inhibition and degree of goal-directed behaviour, in persons with obesity with and without significant eating disorder features compared to healthy controls. Forty-four participants with obesity (43.1% endorsing marked eating disorder features), and 43 healthy-weight age- and sex-matched participants (N = 87; 67.8% female, age = 28.57 (8.70; 18.18–58.34) years, BMI = 29.18 (7.80; 18.65–51.95) kg/m2) completed demographic and eating disorder-related questionnaires, a neuropsychological task of inhibition and an instrumental decision-making task. Bootstrapped serial mediation analyses were performed to examine the effect of group on grazing via goal-directed behaviour and inhibition. While significant differences existed between the groups in terms of inhibition, goal-directed behaviour and grazing severity, the effect of group on grazing severity was not found to be mediated by the degree of behavioural goal-directedness and inhibition. Therefore, :in persons with obesity with or without eating disorder symptoms, putative relationships between a reduced inhibitory profile and/or behaviour that is less flexible and goal-directed and eating behaviours such as grazing, remain unclear.

Is cognitive training an effective tool for improving cognitive function and real-life behaviour in healthy children and adolescents? A systematic review

Computerised cognitive training (CCT) has been applied to improve cognitive function in pathological conditions and in healthy populations. Studies suggest that CCT produces near-transfer effects to cognitive functions, with less evidence for far-transfer. Newer applications of CTT in adults seem to produce certain far-transfer effects by influencing eating behaviour and weight loss. However, this is more unexplored in children and adolescents. We conducted a systematic review of 16 studies with randomised controlled design to assess the impact of CCT on cognitive functioning and real-life outcomes, including eating behaviour, in children and adolescents with typical development (PROSPERO registration number: CRD42019123889). Results show near-transfer effects to working memory, with inconsistent results regarding far-transfer effects to other cognitive functions and real-life measures. Long-term effects show the same trend. Far-transfer effects occurred after cue-related inhibitory control and attentional training, although effects seem not to last. CCT may be a potential weight-loss treatment option but more research is needed to determine the specific characteristics to enhance treatment outcomes.

Executive functioning and disinhibited eating in children and adolescents

BACKGROUND

Executive functioning (EF) difficulties may be associated with problems regulating eating behaviours. Few studies have evaluated this question in youth using diverse measures of EF or objective measures of energy intake.

METHODS

The current study used neuropsychological tasks and a laboratory test meal to evaluate the links between EF and youth's disinhibited eating patterns. Two-hundred-five nontreatment seeking youth (M age = 13.1 ± 2.8 years; M BMIz = 0.6 ± 1.0; 33.2% overweight; 54.1% female) completed tasks measuring decision making, general and food-specific behavioural disinhibition, willingness to delay gratification for food and money, cognitive flexibility, and working memory. Age (children vs adolescents) was examined as a moderator. All analyses adjusted for demographic factors, pubertal status, lean mass (kg), fat mass (%), height, general intellectual functioning, and depressive symptoms.

RESULTS

After adjusting for multiple comparisons, more general behavioural disinhibition was associated with greater total energy intake (P = .02), and poorer cognitive flexibility was associated with more fat intake (P = .03) across all ages. Poorer decision making in children (P = .04), but not adolescents (P = .24), was associated with greater fat intake. Food-specific behavioural disinhibition, the ability to delay gratification for both food and monetary rewards, and working memory were not significantly associated with youth's disinhibited eating patterns during a single meal.

CONCLUSIONS

Most domains of EF were not associated with youth's disinhibited eating. Significant associations may highlight the need to target specific cognitive processes, particularly behavioural disinhibition, decision making, and cognitive flexibility, in potential intervention strategies for children's disinhibited eating.