Control and loss of control over eating: An experimental investigation

Nondietary psychological app program leads to sustained weight loss due to trained physiological satiety perception

Obese people are mostly unable to maintain successful weight loss after the end of a dietary change. One reason is that conventional weight reduction concepts neglect physiological hunger and satiety perception, leading to a relapse to previous eating habits on the long run. We examined the long-term efficacy of a psychological smartphone weight loss program, which avoids any dietary instructions and aims at relearning of satiety perception. Parameters of body weight alterations and psychological features, for example, satiety perception, food cravings, and emotional eating, were explored in a nonrandomized experimental study comprising 75 obese participants. Measurements occurred at baseline, two times during program application, as well as at 6- and 12-month follow-up. Participants displayed significant weight loss during the entire study period (p = .029) and showed an improved body composition at the 6-month follow-up (p = .018). These effects were associated with increased satiety perception, as well as reduced food cravings, and emotional eating habits. Notably, all improvements in measured parameters significantly sustained between the end of the program and the 12-month follow-up (p < .005 for all). Psychological relearning of satiety perception may outclass dietary approaches in terms of long-term efficiency.

Treatment Outcomes and Trajectories of Change in Patients Attributing Their Eating Disorder Onset to Anti-obesity Messaging

OBJECTIVE

Given the increased prevalence of eating disorders (EDs) among individuals higher on the weight spectrum, we aimed to 1) report the prevalence of ED patients in higher levels of care (residential, partial hospitalization, and intensive outpatient) attributing the onset of their ED to anti-obesity messaging, 2) report the most commonly recollected sources of those messages, and 3) determine if those attributing the onset of their ED to anti-obesity messaging a) enter, b) exit, and c) respond to treatment differently from peers who did not.

METHODS

This retrospective cohort study used data from 2901 patients receiving ED treatment in higher levels of care at a US-based center between 2015 and 2018. Multilevel models examined differences in ED symptoms and trajectories of change over time. NVivo was used to analyze the patients' comments about sources of messages.

RESULTS

Eighteen percent attributed their ED onset to anti-obesity messaging, 45% did not, and 37% were unsure. Of those providing comments, the most common sources included the following: educational curriculum/school context (45.9%), media/Internet (24.7%), health care (10.4%), family (9%), and peer bullying (3.7%). At admission, patients attributing their ED onset to anti-obesity messaging had more severe ED symptoms than those who did not (γ = 0.463, standard error [SE] = 0.086, p < .001) and those who were unsure (γ = 0.288, SE = 0.089, p < .001); no differences were evident at discharge (p > .483). During phase 2 of treatment, patients attributing their ED onset to anti-obesity messaging improved faster than those who did not (γ = 0.003, SE = 0.001, p = .008) and those who were unsure (γ = 0.003, SE = 0.001, p = .014).

CONCLUSIONS

Anti-obesity messaging may put vulnerable individuals at risk for EDs. We recommend increasing weight bias training for school personnel and health care professionals. To reduce health disparities, we also suggest the promotion of weight-neutral health-enhancing self-care practices in media and public health campaigns, legislative policies, and health care overall.

Eating Your Words: Discursive Psychology and the Reconstruction of Eating Practices

Psychological research into eating practices has focused mainly on attitudes and behaviour towards food, and disorders of eating. Using experimental and questionnaire-based designs, these studies place an emphasis on individual consumption and cognitive appraisal, overlooking the interactive context in which food is eaten. The current article examines eating practices in a more naturalistic environment, using mealtime conversations tape-recorded by families at home. The empirical data highlight three issues concerning the discursive construction of eating practices, which raise problems for the existing methodologies. These are: (1) how the nature and evaluation of food are negotiable qualities; (2) the use of participants' physiological states as rhetorical devices; and (3) the variable construction of norms of eating practices. The article thus challenges some key assumptions in the dominant literature and indicates the virtues of an approach to eating practices using interactionally based methodologies.

Misestimating betting behavior: the role of negative asymmetries in emotional self prediction

This paper addresses the role of negative asymmetries in emotional self-prediction by looking at the extent to which individuals misestimate their own betting behavior in sequential gambles. In a series of three experimental studies, we demonstrate that losses lead to higher than planned bets whereas bets are on average carried over after gains. Such asymmetric deviations from the plan emerge (1) when monetary and non-monetary incentives are used, and (2) when participants face fair and unfair gambles. The asymmetry is based on people's inability to predict how much the negative emotions generated by a bad experience (e.g. the loss) will influence them to put more effort (e.g. bet more) than planned in an attempt to re-establish a homeostatic state in the prospect of a good experience (e.g. winning).

Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women

OBJECTIVE

To examine the association between eating in response to hunger and satiety signals (intuitive eating) and BMI. A second objective was to determine whether the hypothesized higher BMI in less intuitive eaters could be explained by the intake of specific foods, speed of eating or binge eating.

DESIGN

Cross-sectional survey. Participants were randomly selected from a nationally representative sampling frame. Eating in response to hunger and satiety signals (termed 'intuitive eating'), self-reported height and weight, frequency of binge eating, speed of eating and usual intakes of fruits, vegetables and selected high-fat and/or high-sugar foods were measured.

SETTING

Nationwide study, New Zealand.

SUBJECTS

Women (n 2500) aged 40-50 years randomly selected from New Zealand electoral rolls, including Māori rolls (66 % response rate; n 1601).

RESULTS

Intuitive Eating Scale (IES) scores were significantly associated with BMI in an inverse direction, after adjusting for potential confounding variables. When controlling for confounding variables, as well as potential mediators, the inverse association between intuitive eating (potential range of IES score: 21-105) and BMI was only slightly attenuated and remained statistically significant (5.1 % decrease in BMI for every 10-unit increase in intuitive eating; 95 % CI 4.2, 6.1 %; P < 0.001). The relationship between intuitive eating and BMI was partially mediated by frequency of binge eating.

CONCLUSIONS

Eating in response to hunger and satiety signals is strongly associated with lower BMI in mid-age women. The direction of causality needs to be investigated in longitudinal studies and randomized controlled trials.

Alcohol, appetite and energy balance: is alcohol intake a risk factor for obesity?

The increased recognition that the worldwide increase in incidence of obesity is due to a positive energy balance has lead to a focus on lifestyle choices that may contribute to excess energy intake, including the widespread belief that alcohol intake is a significant risk factor for development of obesity. This brief review examines this issue by contrasting short-term laboratory-based studies of the effects of alcohol on appetite and energy balance and longer-term epidemiological data exploring the relationship between alcohol intake and body weight. Current research clearly shows that energy consumed as alcohol is additive to that from other dietary sources, leading to short-term passive over-consumption of energy when alcohol is consumed. Indeed, alcohol consumed before or with meals tends to increase food intake, probably through enhancing the short-term rewarding effects of food. However, while these data might suggest that alcohol is a risk factor for obesity, epidemiological data suggests that moderate alcohol intake may protect against obesity, particularly in women. In contrast, higher intakes of alcohol in the absence of alcohol dependence may increase the risk of obesity, as may binge-drinking, however these effects may be secondary to personality and habitual beverage preferences.

Neither restrained eating nor tendency toward overeating predict food consumption after tension induction

The present study investigates whether the so-called disinhibition effect is better accounted for by tendency toward overeating than by restraint. The rationale was that in mood-induction studies, so far, the disinhibition effect has only been found in studies that applied the Restraint Scale and hardly ever in studies that used other restraint scales. Tension was induced by the public-speaking method in half of 86 female college students before they participated in an alleged taste test. The Restraint Scale (RS), the Three-Factor Eating Questionnaire (TFEQ) and the Dutch Eating Behaviour Questionnaire (DEBQ) were used to measure restraint and tendency toward overeating. No differences were found between the tension and the control condition as to the amounts of food the participants ate. Also no proof of the disinhibition effect was obtained and, remarkably, tendency toward overeating did not predict the amount of food eaten. Possible explanations for these results are offered in the discussion.

Construct validation of the Restraint Scale in normal-weight and overweight females

The Restraint Scale (RS) is a widely used measure to assess restrained eating. The purpose of this study was to examine the construct validity of the RS in a sample of normal-weight (n=349) and overweight (n=409) females using confirmatory factor analyses of the RS in relation to other measures for dieting, overeating and body dissatisfaction. Following Laessle et al. [(1989a). A comparison of the validity of three scales for the assessment of dietary restraint. Journal of Abnormal Psychology, 98, 504-507], we assumed a three-factor structure: (1) overeating and disinhibitory eating, (2) dieting and restriction of food intake, and (3) body dissatisfaction and drive for thinness. Analyses revealed that the RS loaded significantly on all three factors for both samples, confirming its multifactorial structure. However, the RS appears to capture these constructs differently in overweight and normal-weight females such that the RS may overestimate restraint in overweight individuals. This may explain the greater effectiveness of the RS in predicting counter-regulation in normal-weight than in overweight samples of dieters.

Effects of academic examination stress on eating behavior and blood lipid levels

The influence of academic examination stress on eating behavior and lipid profiles and the moderating effect of dietary restraint, trait anxiety, and social support availability was assessed in university students. One hundred and seventy-nine students were divided into exam-stress groups (51 women, 64 men) and control groups (48 women, 16 men) and were assessed at baseline and then within 2 weeks of exams or an equivalent point for the control group. Perceived stress, emotional well-being, and fasting lipid profiles were measured, and dietary information was collected by interview. The exam-stress group reported significant increases in perceived stress and deterioration in emotional well-being at the exam sessions compared with baseline sessions. No general effects of exam stress on food intake were observed, and there was no interaction between stress and dietary restraint. However, students in the exam-stress group with high trait anxiety and low social support showed significant increases in total energy intake between baseline and exam sessions, whereas individuals with low trait anxiety and high social support showed a reduction in energy intake. Students with high trait anxiety and low social support showed increases between baseline and exam sessions in the amount of fat and saturated fat consumed. Women in the exam-stress group taking oral contraceptives showed a significant increase in total cholesterol between baseline and exam sessions. The results are discussed in relation to the effects of naturally occurring episodic stress on health behavior and on lipid profiles.

A naturalistic evaluation of the relation between dietary restraint, the urge to binge, and actual binge eating: a clarification

OBJECTIVE

The current study attempted to characterize the natural course of events linking dietary restraint to urges to binge and actual binge episodes.

METHOD

Using preprogrammed, hand-held computers, 39 women with bulimia-spectrum eating disorders monitored ongoing eating episodes, dietary restraint, and binge cravings over a 7-29-day interval.

RESULTS

Multilevel modeling analyses indicated that restraint was not systematically elevated before binging. However, elevated restraint preceded strong binge cravings.

CONCLUSION

Results suggest that dietary restraint may contribute to binge cravings, but may not be a direct antecedent to binge episodes. Such findings are consistent with restraint theory, which suggests that dietary restraint potentiates binging, but does not necessarily trigger its occurrence.

Validation of the Dutch Eating Behaviour Questionnaire parent version (DEBQ-P) in the Italian population: a screening tool to detect differences in eating behaviour among obese, overweight and normal-weight preadolescents

OBJECTIVE

To validate the Dutch Eating Behaviour Questionnaire Parent version (DEBQ-P) in the Italian population and investigate the differences in eating behaviour among Italian normal-weight, overweight and obese preadolescents.

DESIGN

A cross-sectional validation study. Participants were measured and the approved translation of the questionnaire was administered to their parents.

SETTING

: Three school communities in the province of Bergamo, Northern Italy.

SUBJECTS

A total of 312 preadolescents (mean age 12.9 y; s.d. 0.8, both sexes) from three secondary schools of the province of Bergamo, Northern Italy, and their parents were invited to participate to the study. Informed written consent was obtained from each subject and their parents. Students were measured and their parents filled in the approved translation of the DEBQ-P. Recruitment was opportunistic and school based.

RESULTS

Factor and internal consistency analysis confirmed the factor structure of the DEBQ-P and the high internal consistency of its three scales. Variance analysis showed that eating behaviour of Italian normal-weight, overweight and obese preadolescents differs significantly only in regards to the 'restrained eating' scale (F 19.29, P < 0.001), with overweight and obese scoring higher.

CONCLUSIONS

The DEBQ-P can be used for screening projects regarding eating behaviour in the Italian population. The association between restrained eating and weight status was confirmed for both sexes, but the relationship between external eating and emotional overeating and overweight requires further exploration.

The role of interpersonal stress in overeating among high and low disinhibitors

This study was concerned with the role of interpersonal stress in precipitating eating for high and low disinhibitors. Two forms of stress, ostracism and argument, were compared. A second comparison focused on targets and sources of both forms of interpersonal stress. Fifty-seven females who differed in their level of disinhibition participated in a two-stage experiment. In the first stage, they were engaged in a social interaction with two other people. The second stage involved a taste test; the dependent variable was the amount of food eaten. There were no differences between the ostracism and argument conditions for the amount of food eaten; nor did high and low disinhibitors differ. There was, however, a significant interaction between level of disinhibition and role (target vs. source) for the amount of food eaten. High disinhibitors ate markedly more than low disinhibitors when they were targets; the two groups ate similar amounts when they were sources. Strategies that dieters can employ in order to overcome the tendency to overeat are outlined.

Absence of a disinhibition effect of alcohol on food consumption

Alcohol is frequently mentioned as a disinhibitor of restrained eating behavior although only a small number of studies have investigated this disinhibition effect. The present study was conducted to fill this gap. A total of 116 female college students participated in a questionnaire-based assessment and a taste-test experiment. Before the taste test, half of the participants consumed a preset amount of alcohol-laced orange juice, the other half were given plain orange juice. The dependent variable was the amount of savory crackers eaten during the taste test. The Dutch Eating Behavior Questionnaire (DEBQ), the Three-Factor Eating Questionnaire (TFEQ), and the Restraint Scale (RS) were used to measure eating behavior dimensions, which formed the independent variables in various regression analyses. No disinhibition effect was found. On the contrary, participants scoring high on restraint (DEBQ, TFEQ) proved to consume even less food than those having lower scores. Participants that rated high on the scales measuring tendency toward overeating consumed more food than participants with low scores. These results support earlier contentions that the validity of the Restraint Theory's statement that dieting leads to overeating is questionable.

Eating, mood, and gender in a noneating disorder population

Recently, eating in relation to emotions has been the focus of much research. The present study evaluates the role of mood, gender, and tendency for emotions to impact on eating (as measured by a revised form of the Emotional Eating Scale-II, EES II) within an analogue mood-related eating paradigm, e.g., Baucom & Aiken [J. Pers. Soc. Psychol. 41 (1981) 577], with a nonclinical population. The results indicate that there is a complex relationship that exists between gender and mood. Males appeared to experience a reduction in the negative component of their overall mood after eating, while females appeared to be more emotionally responsive to eating overall. This effect is not dependent on tendency for emotions to impact on eating as measured by the EES II. This suggests that there is a need to examine the impact of mood on eating in both clinical and nonclinical populations as there appears to be important differences between the populations.

Risk and maintenance factors for eating pathology: a meta-analytic review

This meta-analytic review of prospective and experimental studies reveals that several accepted risk factors for eating pathology have not received empirical support (e.g., sexual abuse) or have received contradictory support (e.g.. dieting). There was consistent support for less-accepted risk factors(e.g., thin-ideal internalization) as well as emerging evidence for variables that potentiate and mitigate the effects of risk factors(e.g., social support) and factors that predict eating pathology maintenance(e.g., negative affect). In addition, certain multivariate etiologic and maintenance models received preliminary support. However, the predictive power of individual risk and maintenance factors was limited, suggesting it will be important to search for additional risk and maintenance factors, develop more comprehensive multivariate models, and address methodological limitations that attenuate effects.

Subtyping binge eating-disordered women along dieting and negative affect dimensions

OBJECTIVE

Because etiologic and maintenance models of binge eating center around dieting and affect regulation, this study tested whether binge eating-disordered (BED) individuals could be subtyped along dieting and negative affect dimensions and whether subtypes differed in eating pathology, social functioning, psychiatric comorbidity, and response to treatment.

METHOD

Three independent samples of interviewer-diagnosed BED women (N = 218) were subtyped along dieting and negative affect dimensions using cluster analysis and compared on the outcomes of interest.

RESULTS

Cluster analyses replicated across the three independent samples and revealed a dietary subtype (63%) and a dietary-depressive subtype (37%). The latter subtype reported greater eating and weight obsessions, social maladjustment, higher lifetime rates of mood, anxiety, and personality disorders, and poorer response to treatment than did the dietary subtype.

DISCUSSION

Results suggest that moderate dieting is a central feature of BED and that affective disturbances occur in only a subset of cases. However, the confluence of dieting and negative affect signals a more severe variant of the disorder marked by elevated psychopathology, impaired social functioning, and a poorer treatment response.

Restrictive dieting vs. "undieting" effects on eating regulation in obese clinic attenders

This study tested predictions from restraint theory [Herman & Polivy (1984). A boundary model for the regulation of eating. In: A. J. Stunkard, & E. Stellar (Eds.), Eating and its disorders (pp. 141-156) New York: Raven Press.] and the three-factor model of dieting [Psychol. Bull. 114 (1993) 100.] using an eating regulation paradigm. Participants were 42 obese, nonbinge eaters assigned to either a weight loss group (restrictive dieters or RDs) or a group designed to eliminate dieting ("undieters" or UDs). Participants took part in an ostensible ice cream taste test with or without a preload, both before and after the weight control intervention. At pretest, restraint theory's prediction that participants would engage in counter-regulatory eating was not supported. At posttest, after 8 weeks of the dieting interventions, RDs increased and UDs decreased their intake following a preload, a pattern most consistent with the predictions of restraint theory. This counter-regulatory trend was observed in spite of a significant decrease in RDs' Disinhibition scale scores following treatment. Implications of these findings for restraint theory, the three-factor model of dieting, and relapse in obesity treatment were discussed.

A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect

Because there have been few longitudinal investigations of integrative etiological theories of bulimia nervosa, this study prospectively tested the dual-pathway model using random regression growth curve models and data from a 3-wave community sample of adolescent girls (N = 231). Initial pressure to be thin and thin-ideal internalization predicted subsequent growth in body dissatisfaction, initial body dissatisfaction predicted growth in dieting and negative affect, and initial dieting and negative affect predicted growth in bulimic symptoms. There was prospective evidence for most of the hypothesized mediational effects. Results are consistent with the assertion that pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and negative affect are risk factors for bulimic pathology and provide support for the dual-pathway model.

Ice-cream consumption, tendency toward overeating, and personality

OBJECTIVE

The exploration of the mechanisms underlying the tendency toward overeating by investigating the Dutch Eating Behavior Questionnaire (DEBQ)/Revised Eating Disorders Inventory (EDI-R) disinhibition, in sequence to the milkshake-ice cream study (van Strien, Cleven, and Schippers, in press).

METHOD

In hierarchical multiple regression analyses, the relative predictive power for ice-cream consumption was assessed, that is, emotional versus external versus bulimic eating using scales of the DEBQ and the EDI-R. In nonplanned stepwise multiple regression analyses, the association was assessed between these three types of eating behaviors and non-eating-related EDI-R scales.

RESULTS

Emotional eating was the most important variable for ice-cream consumption. External eating was borderline significant and bulimic eating nonsignificant when emotional and external eating had been partialled out. Emotional eating was best predicted by the EDI-R scales Asceticism, Interoceptive Awareness, and Social Insecurity.

DISCUSSION

Results are consistent with psychosomatic theory, which focuses on emotional eating as the result of confusion and apprehension in recognizing and accurately responding to emotional and visceral states related to hunger and satiety.

Negative affect moderates the relation between dieting and binge eating

OBJECTIVE

Although laboratory experiments suggest that negative affect inductions potentiate the relation between dieting and disinhibited eating, little research has tested whether this finding generalizes to binge eating in the natural environment. Thus, we assessed whether negative affect moderated the relation between dieting and binge eating in a passive-observational study.

METHOD

This aim was addressed with longitudinal data from a community sample of adolescents (N = 631).

RESULTS

For females, dieting and negative affect predicted binge eating in cross-sectional and prospective analyses, but negative affect potentiated the relation between dieting and binge eating only in the cross-sectional analyses. Similar, but attenuated results were found for males.

DISCUSSION

Findings converge with those from laboratory studies in suggesting that negative affect moderates the relation between dieting and binge eating, but also imply that dieting and negative affect constitute independent risk factors for binge eating. The lack of prospective effects may suggest that the interactive relations have a short time lag or are difficult to detect prospectively.

Distress and eating: why do dieters overeat?

OBJECTIVE

It has been shown that distress suppresses eating in nondieters (unrestrained eaters), but increases it in chronic dieters (restrained eaters). This study attempted to investigate several possible explanations for this phenomenon, in particular, the "masking hypothesis." This hypothesis states that dieters use overeating to mask their distress in other areas of their lives by eating when distressed so that they can attribute their distress to their overeating rather than to more uncontrollable aspects of themselves or their lives. In addition, comfort, learned helplessness, and distraction explanations were investigated.

METHOD

Female college student subjects were led to believe that they had or had not failed at a cognitive task, then were either given ad libitum or just three small spoonfuls of ice cream to taste and rate.

RESULTS

It was predicted that restrained subjects who ate ad libitum following failure would attribute more of their distress to their eating than would those who were allowed only a taste of ice cream. The results were more complicated than predicted. They indicated that the masking, distraction, and helplessness hypotheses all received some support in the present study and that they may work in tandem with each other.

DISCUSSION

The results suggest that distress-induced overeating in restrained eaters may serve psychological functions for the individual, allowing for distraction from the distress or masking of the source of dysphoria. The possible relevance of these results to bulimic patients who may use their binges to mask the true source of their distress is discussed.

The role of dieting in binge eating disorder: etiology and treatment implications

Dieting has been implicated as a potential contributor in the development of binge eating problems in binge eating disorder (BED). If dieting plays a causal role in the etiology of BED, this could have major implications for understanding and treating individuals with the disorder. This article reviews the existing literature on the role of dieting in BED. Retrospective studies of dieting history, research on levels of dietary restraint, and prospective studies investigating the effects of dieting on subsequent eating behavior are explored. Although the literature is inconclusive as to the exact role that dieting plays in the etiology of BED, recommendations for future research and suggestions for treatment are given.

A problematic counter-regulation experiment: implications for the link between dietary restraint and overeating

The current study failed to find any evidence of laboratory counter-regulation amongst restrained eaters given a preload, regardless of the measures of dietary restraint used to classify subjects, including dieting status on the day of the study. Furthermore, there was no evidence to suggest that high restrainers characteristically overeat or experience a sense of loss of control over eating in naturalistic settings. These findings indicate that the link between dietary restraint and overeating or bulimic episodes is, at most, a weak one. Future investigations must incorporate more detailed and sensitive measures of both restraint and overeating if analogue studies are to be useful for understanding the process involved in clinically significant episodes of overeating or binge eating.

The measurement of restraint: confounding success and failure?

The present study examined the concept of restrained eating as measured by the Restraint Scale and the restrained eating section of the Dutch Eating Behaviour Questionnaire. The results showed that when answering questionnaires, subjects do not differentiate between items relating to attempts at dieting and actual restrictive behavior and that restrained eating can be conceptualized in terms of both successful and failed restraint. In addition, the results suggest that subjects who report high scores on both these measures of restraint represent a population of dieters prone to overeating behavior. The results are discussed in terms of the population selected by measures of restrained eating and in relation to the definition of restraint.

An investigation of the influence of dieting and self-esteem on dietary disinhibition

Recent research on the eating behavior of restrained eaters following a dietary preload indicates that both dieting and self-esteem may influence consumption. While Polivy, Heatherton, and Herman (Journal of Abnormal Psychology, 97, 354-356, 1988) found a forced preload to lead to increased consumption by low self-esteem restrained eaters, Lowe, Whitlow, and Bellwoar (International Journal of Eating Disorders, 10, 461-471, 1991) found restrained dieters to decrease their consumption following a dietary preload. The current study was designed to investigate the influences of self-esteem and dieting on the eating behavior of restrained eaters while in a negative mood state. Subjects were 80 normal weight undergraduate women in a 2 x 2 x 2 design (Restrained/Unrestrained by Success/Failure by Low Self-Esteem/High Self-Esteem). Current dieting, though not self-esteem, was found to influence consumption. Restrained dieters consumed significantly less in a negative mood state than when in a positive mood state, while nondieters, irrespective of restraint status, consumed comparable amounts in both mood states.

Hypnosis and weight reduction: which is the cart and which is the horse?

Hypnosis has often been described as a useful adjunctive treatment for excess weight. However, the literature shows that very few controlled studies have been conducted in this realm, and none have incorporated the key variables of either the hypnosis components or the weight-reduction components. In this paper I offer a brief review of the literature on hypnosis for weight reduction, present weight-reduction outcome data, outline variables common to people with chronic weight problems, and I offer suggestions for future uses of hypnosis within a comprehensive approach to weight reduction rather than as the primary treatment. Suggestions are also made concerning the multiple opportunities for future research using hypnosis in the substance-abuse field.

Eating style and eating behaviour in adolescents

The relationship between eating style, attitudes towards food and food intake was investigated in 846 British adolescent schoolchildren. Eating style was assessed with the Dutch Eating Behaviour Questionnaire, attitudes towards food with a series of specially prepared questions, and food intake with a diet history taken by a dietitian. The results showed that restraint, external and emotional eating were associated with very different profiles of attitudes and behaviour. Restrained subjects had a higher body weight, more negative attitudes towards food, a lower likelihood of overeating and a lower overall energy intake. External eaters had a lower body weight, positive attitudes to food, and reported a higher energy intake. Emotional eaters fell in between in some ways, with some signs of situational loss of control combined with a negative attitude towards overeating. While external eating appeared to be attenuated by restraint, emotional eating was enhanced by it. The implications of these eating styles for later patterns of eating and weight are discussed.

No counterregulation after breaking the external restraint of children

At the present, it is unknown how restraint and binge eating/counterregulation are exactly related. Earlier studies on this relationship suffer from two main shortcomings: the studies are all correlational in nature or could not rule out the contribution of confounding variables such as weight loss. The present study investigated whether a break of restraint is a sufficient condition for the occurrence of counterregulation by studying a restrained sample which is not liable to dieting practices and weight loss. The externally imposed restraint on children with regard to eating sweets was broken. However, after breaking their external restraint the children did not counterregulate. It is discussed whether restraint of food intake is really as important for binge eating as it is claimed to be or whether it is merely a consequence or an epiphenomenon of binge eating.

Physiological effects of dieting and bingeing in rats

Female rats were assigned to dietary conditions as follows for 3.5 months: 1) Low-fat control (LFC); 2) Moderately high-fat control (HFC); 3) Alternation between restricted access to a low-fat diet and ad lib access to a very high fat diet (RA); 4) Unrestricted access to the same diets as RA (URA). Results indicate that: 1) HFC consumed the same energy as LFC, but showed a tendency to become heavier and fatter through greater food efficiency. 2) URA and LFC did not differ in body weight, food intake, body composition or energy efficiency. 3) Intake of the very high fat diet declined over time in the RA. 4) RA ate less total calories, weighed less than all other groups, and showed a tendency for decreased percentage body fat and increased percentage of weight gained due to FFM gained. Results provide no evidence that dieting and bingeing promote obesity or increased preference for dietary fat, and suggest that dietary restriction has greater impact on energy balance and body composition than does alternation of diet composition.

Weight loss and sweetness preferences: the effects of recent versus past weight loss

The present study examined the effects of weight loss, recent and past, on perceptions of pleasantness and sweetness intensity of sucrose solutions. Subjects high or low in current weight loss, and high or low in past weight loss (weight suppression) rated sucrose solutions before and after the ingestion of a glucose solution. Current weight loss was total weight loss over the 3 months prior to the study; past weight loss was defined in terms of the difference between maximal and current weight. Subjects were 40 women, all of whom reported that they were dieting. After a 12-hour overnight fast, each subject tasted and rated five concentrations of sucrose solutions (2.5, 5.0, 10.0, 20.0, and 40.0) for pleasantness and sweetness. High weight suppressors rated the sucrose solutions, before and after the glucose load, as significantly less pleasant than did low weight suppressors. High recent weight losers rated the sucrose solutions as significantly more pleasant than did low current weight losers following, but not prior to, the glucose load. These results were inconsistent with setpoint theory. High weight suppressors did not show an increase in sweetness preference as predicted by this theory. It was suggested that while weight loss affects taste hedonics, the nature of this relationship depends on the recency of the weight loss.

Conditioning processes and cue exposure in the modification of excessive eating

Excessive eating is one of the principal characteristics of bulimia. Eating more than intended is also a prominent feature both of obese people who are trying to lose weight and normal weight women who are attempting to restrict their food intake. Overeating tends to be triggered by a specific set of cues, which commonly involve either mood disturbances or exposure to "forbidden" food, but may include other environmental cues. It is argued that conditioning processes are relevant both to the establishment of meal patterns in normal subjects and in the maintenance of excessive eating. Treatment procedures have typically followed the general approach of "Self Management" which emphasises reducing exposure to the cues associated with eating. An alternative approach derives from the idea that the association between eating responses (or urges to eat) and external cues may be learned, and therefore should in principle be ameanable to extinction through systematic unreinforced exposure. In this article the possible mechanisms of cue-induced overeating are discussed and the potential utility of cue exposure techniques for the management of excessive eating evaluated.

Psychological features of obesity

The study of obesity from a variety of psychological perspectives has been exciting and inventive, although we still do not understand fully the role of psychological variables in the etiology of obesity. Many of the factors thought to be of etiologic significance--field dependence, lack of impulse control, inability to delay gratification, or a maladaptive eating style--have not been supported by experimental evidence. Other factors once thought to be of importance as causes of obesity, depression and dysphoria, for example, appear, instead, to be consequences of being obese and may serve to maintain and intensify weight-related problems. Dieting behavior in response to weight concerns appears, perversely, to be implicated in increasing overweight and adiposity. Finally, arousability in response to food cues in the environment may play a causal role in some obesities.

Cognitive control of eating

Eating behaviour, unlike many other biological functions, is often subject to sophisticated cognitive regulation. One of the most widely practised forms of cognitive control over food intake is dieting, i.e. attempting to restrict intake as a means of weight regulation. In this paper the development of dieting will be discussed, followed by an evaluation of the impact of cognitive control on food intake regulation. Cross-sectional studies, comparing dieters with non-dieters, suggest that dieting is linked with a variety of disturbances of food intake control, and that it may even provoke paradoxical overeating. An experimental investigation of the link between cognitive control and paradoxical overeating will also be discussed, along with the implications of this work for the understanding and treatment of eating disorders.