Role of response habits and cognitive factors in determination of behavior of obese humans

Longitudinal associations between self-regulation and health across childhood and adolescence

OBJECTIVE

There is some evidence to suggest that one's ability to delay gratification is associated with a lower body mass index (BMI) and slower overall weight gain. Less is known about the role that a broader set of self-regulatory skills, including attention focusing, inhibitory control, and impulsivity, might play in fostering not only a healthy weight but also better overall health and health-related behaviors such as sleep.

METHOD

Participants in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were followed from birth through age 15 beginning in 1991. Self-regulation was assessed when children were 4.5 years old, whereas health-related outcomes were assessed regularly between toddlerhood and adolescence. Structural equation modeling was used to test direct associations between self-regulation and either physical health or sleep in childhood and adolescence.

RESULTS

Findings suggest that there are long-term benefits of self-regulation, indexed by multiple dimensions, for children's health-related outcomes. Children with better self-regulatory skills demonstrated smaller increases in standardized BMI scores and maintained greater mother-reported health across childhood and adolescence. Furthermore, better self-regulation predicted fewer sleep problems and longer sleep duration when children were 8 and 11 but not when they were 15.

CONCLUSIONS

Early self-regulation, marked by numerous skills, appears to have long-term benefits for children's health-related outcomes. These findings provide some evidence that targeting childhood self-regulatory skills for improvement may help reduce poor health-related outcomes later in life and offer important insight into potential avenues for intervention. (PsycINFO Database Record

Research on Eating Behavior and Obesity: Where Does it Fit in Personality and Social Psychology?

The study of human eating behavior provides a model for understanding the operation of a system of motivated behaviors involving the integration of physiological, sensory, cognitive, social and cultural inputs in a control system to which they are all essential. A review of current research in the area demonstrates the reciprocal relationship of these factors and indicates that eating must be examined at many different levels of analysis and with mul tiple methodologies. Work on eating and obesity suggests conceptual issues relevant to the use of the internal-external dichotomy in social psychology and has importance for research on stigmatiza tion and deviance, self perception, control and predictability, group processes, and individual differences. Research on eating behavior further demonstrates how conceptual analyses evolve in settings and for problems which were not specifically created to test theory.

Executive functioning, emotion regulation, eating self-regulation, and weight status in low-income preschool children: how do they relate?

The purpose of the present study was to examine relationships between child eating self-regulation, child non-eating self-regulation, and child BMIz in a low-income sample of Hispanic families with preschoolers. The eating in the absence of hunger task as well as parent-report of child satiety responsiveness and food responsiveness were used to assess child eating self-regulation. Two laboratory tasks assessing executive functioning, a parent questionnaire assessing child effortful control (a temperament dimension related to executive functioning), and the delay of gratification and gift delay tasks assessing child emotion regulation were used to assess child non-eating self-regulation. Bivariate correlations were run among all variables in the study. Hierarchical linear regression analyses assessed: (1) child eating self-regulation associations with the demographic, executive functioning, effortful control, and emotion regulation measures; and (2) child BMI z-score associations with executive functioning, effortful control, emotion regulation measures, and eating self-regulation measures. Within child eating self-regulation, only the two parent-report measures were related. Low to moderate positive correlations were found between measures of executive functioning, effortful control, and emotion regulation. Only three relationships were found between child eating self-regulation and other forms of child self-regulation: eating in the absence of hunger was positively associated with delay of gratification, and poor regulation on the gift delay task was associated positively with maternal reports of food responsiveness and negatively with parent-reports of satiety responsiveness. Regression analyses showed that child eating self-regulation was associated with child BMIz but other forms of child self-regulation were not. Implications for understanding the role of self-regulation in the development of child obesity are discussed.

Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study

Objective

To examine associations between attention-deficit/hyperactivity disorder (ADHD) symptoms, obesity and hypertension in young adults in a large population-based cohort.

Design, Setting, and Participants

The study population consisted of 15,197 respondents from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents followed from 1995 – 2009 in the United States. Multinomial logistic and logistic models examined the odds of overweight, obesity, and hypertension in adulthood in relation to retrospectively reported ADHD symptoms. Latent curve modeling was used to assess the association between symptoms and naturally occurring changes in body mass index (BMI) from adolescence to adulthood.

Results

Linear association was identified between the number of inattentive (IN) and hyperactive/impulsive (HI) symptoms and waist-circumference, BMI, diastolic blood pressure, and systolic blood pressure (all ps for trend < .05). Controlling for demographic variables, physical activity, alcohol use, smoking, and depressive symptoms, those with 3 or more HI or IN symptoms had the highest odds of obesity (HI 3+ OR, 1.50; 95% CI, 1.22-2.83; IN 3+ OR, 1.21; 95% CI, 1.02-1.44) compared to those with no HI or IN symptoms. HI symptoms at the 3+ level were significantly associated with a higher OR of hypertension (HI 3+ OR, 1.24; 95% CI 1.01-1.51; HI continuous OR, 1.04; 95% CI 1.00-1.09), but associations were non-significant when models were adjusted for BMI. Latent growth modeling results indicated that compared to those reporting no HI or IN symptoms, those reporting more 3 or symptoms had higher initial levels of BMI during adolescence. Only HI symptoms were associated with change in BMI.

Conclusion

Self-reported ADHD symptoms were associated with adult BMI and change in BMI from adolescence to adulthood, providing further evidence of a link between ADHD symptoms and obesity.

Ability to delay gratification at age 4 years and risk of overweight at age 11 years

OBJECTIVES

To determine if limited ability to delay gratification (ATDG) at age 4 years is independently associated with an increased risk of being overweight at age 11 years and to assess confounding or moderation by child body mass index z score at 4 years, self-reported maternal expectation of child ATDG for food, and maternal weight status.

DESIGN

Longitudinal prospective study.

SETTING

Ten US sites.

PARTICIPANTS

Participants in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Main Exposure Ability to delay gratification at 4 years, measured as pass or fail on a validated task.

OUTCOME MEASURES

Overweight at 11 years, defined as a body mass index greater than or equal to the 85th percentile based on measured weight and height.

RESULTS

Of 805 children, 47% failed the ATDG task. Using multiple logistic regression, children who failed the ATDG task were more likely to be overweight at 11 years (relative risk, 1.29; 95% confidence interval, 1.06-1.58), independent of income to needs ratio. Body mass index z score at 4 years and maternal expectation of child ATDG for food did not alter the association, but maternal weight status reduced the association significantly.

CONCLUSIONS

Children with limited ATDG at age 4 years were more likely to be overweight at age 11 years, but the association was at least partially explained by maternal weight status. Further understanding of the association between the child's ATDG and maternal and child weight status may lead to more effective obesity intervention and prevention programs.

The effects of yoghurt containing a novel fat emulsion on energy and macronutrient intakes in non-overweight, overweight and obese subjects

OBJECTIVE

To investigate the effects of a yoghurt containing a novel fat emulsion on energy and macronutrient intakes up to 8 h post-consumption in non-overweight, overweight and obese subjects, and to assess energy compensation over the following 24 h.

DESIGN

A double-blind, placebo-controlled, within-subject crossover design was used. Twenty (10 female, 10 male) non-overweight (body mass index (BMI) 20-24.9 kg/m(2)), 20 (10 female, 10 male) overweight (BMI 25-29.9 kg/m(2)) and 20 (13 female, 7 male) obese (BMI>30 kg/m(2)) subjects participated in the study. Subjects were given in random order, 7 days apart, either a 200 g portion of a test (5 g of a novel fat emulsion+1 g milk fat) or control (6 g milk fat) yoghurt at 09:00 h. At 4 and 8 h post-consumption subjects were given ad libitum access to a range of foods. Amounts of food consumed were determined by pre and post-covert weighing of individual serving dishes. Over the following 24 h subjects weighed and recorded all food intakes.

RESULTS

Mean energy intakes were significantly lower after the test yoghurt compared with the control yoghurt in non-overweight (3.79 vs 5.43 MJ; P<0.01) and overweight (4.43 vs 6.12 MJ; P<0.001) subjects 4 h post-consumption and in non-overweight (3.82 vs 5.38 MJ; P<0.001), overweight (3.94 vs 5.80 MJ; P<0.001) and obese (4.91 vs 6.26 MJ; P<0.01) subjects 8 h post-consumption. The corresponding macronutrient intakes were also significantly reduced in non-overweight and overweight subjects (P<0.01) at 4 h post-consumption and in all subjects 8 h post-consumption (P<0.01). In the total group, energy intakes over the following 24 h were also significantly reduced (6.35 vs 7.70 MJ; P<0.01) after the test yoghurt relative to the control yoghurt.

CONCLUSIONS

These results suggest that the effects of this novel fat emulsion are maintained at least up to 8 h and are evident in non-overweight, overweight and obese subjects.

Effects of variety on food intake of underweight, normal-weight and overweight women

The food intake of 27 underweight, normal-weight and overweight women was monitored during laboratory luncheon meals of solid food units (SFUs), bite-sized spirals of bread with different sandwich fillings. Simultaneous, but not sequential, presentation of three SFU flavors increased intake compared to presentation of a single flavor in normal-weight and overweight women. Neither variety manipulation enhanced intake in the underweight women, who are more than the other subjects in all conditions. The fact that the foods were so similar probably reduced the effectiveness of the variety manipulations. Overweight and normal-weight subjects had different patterns of intake, but only when eating a single flavor of SFU. Only overweight subjects ate less when three flavors of SFUs were hidden from view in the apparatus used to monitor intake. This procedure prevented subjects from selecting particular flavors of SFUs. Differences in cognitive restraint probably do not explain the differences in the eating behavior of normal-weight and overweight subjects in the present study. Lack of dietary restraint or a high level of hunger may account for the different eating behavior of the underweight subjects compared to the other subjects.

Responses of lean and obese subjects to preloads, deprivation, and palatability

The effects of preloads, deprivation, and palatability on the eating behavior of non-dieting lean and obese subjects were studied during laboratory meals, using small solid food units (SFUs) to measure the rate of ingestion over the time-course of the meals. In both weight groups, rate of intake decreased from the beginning to the end of meals. The smaller the preloads and the longer the deprivation interval, the faster subjects ate at the beginning of meals and the higher their hunger ratings were. The longest deprivation interval also increased palatability ratings, meal length, and the total amount that subjects ate. Increasing the palatability of the food increased the rate of intake at the beginning of meals, meal length, and the amount of food that subjects ate. Obese subjects were more sensitive to palatability and less responsive to deprivation than lean subjects. For example, while lean subjects became less discriminating about the palatability of the food at the beginning of meals as deprivation increased, obese subjects did not. The satiation mechanism of obese subjects was also different from lean subjects. For example, obese subjects overate after preloads while lean subjects underate compared to their baselines.

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.

A Moral Vision of Addiction: How People's Values Determine Whether They Become and Remain Addicts

Contemporary theories of addiction of all stripes rule out faulty values as a cause of addiction. Yet evidence from cross-cultural, ethnic, and social-class research, laboratory study of addictive behavior, and natural history and field investigations of addiction indicate the importance of value orientations in the development and expression of addictive behaviors, including drug and alcohol addiction, smoking, and compulsive eating. Furthermore, the rejection of moral considerations in addiction deprives us of our most powerful weapons against addiction and contributes to our current addiction binge. The disease myth of addiction in particular attacks the assumption of essential moral responsibility for people's drug use and related behavior, an assumption that we instead ought to be encouraging.

Delay of gratification in obese children

Obese (n = 20) and normal weight (n = 20) children (8-11 years) were compared using the delay of gratification paradigm. All children were asked to choose between an immediate reward or a larger delayed (one day) reward. Half the children were offered an edible incentive and half a non-edible incentive. Results showed that the obese choose immediate rewards more often than normals only when the incentive was edible. This suggests that deficits in delay of gratification shown by obese children are not generalized dispositions but are specific to food. A second aspect of the study examined preference for food vs non-food items and activities. Normals showed a much stronger preference for non-food items, nutritious foods and non-food related activities than the obese. This suggests that the deficits in delay of gratification shown by the obese children for food related items may be due to the stronger incentive value of these items for them.

Obesity, compatibility, and a taste preference

Ratings and proportions of two cookies eaten by obese and normal-weight individuals were affected by the requirement that subjects eat with their nonpreferred hands. Subjects were run in blocks either before or after dinner; it was only before dinner that strong preferences between the two cookies emerged. Normal weight subjects ate approximately equal proportions of the two cookies when using preferred hands but strongly favored the cashew cookie when using their nonpreferred hands. Obese subjects ate more of the cashew cookie when using the preferred hands but more of the oatmeal cookie when using nonpreferred hands. Also, subjects were given fictitious information about previous subjects' preferences between the cookies. Only the normal ones were affected by this information; the obese subjects ate more of the cashew cookie regardless of the "external" cue about other subjects' preferences.

Obesity and perceptual reactance

Similarities in anomalous perception of internal gastric states and sensitivity to distraction among the obese to variations in perceptual reactance suggest that the obese tend to augment the intensity of visceral cues associated with hunger. It was hypothesized that the obese would be overrepresented at the augmenter end of the perceptual reactance continuum. Thirteen obese (six male, seven female) and 14 nonobese (eight male, six female) college students participated in a study in which perceptual reactance was assessed by degree of Kinesthetic Figural Aftereffect (KFA). A highly significant relationship in the predicted direction was observed for perceptual reactance category and mean percent weight deviation. Additionally, there was a highly significant interaction of sex by category, with the hypothesized relationship intensified for the female Ss. Results supported interpretation of obesity as a consequence of animalous perception of cues associated with consuming behavior.

Field dependent eating and perception as a function of weight and sex

It was hypothesized that the greater influence of external cues on obese than on normal individuals' eating behavior is a manifestation of a generalized sensitivity to external cues. Responsivity of nut consumption to the external cue of shells on the nuts and responsivity of judgment of verticality to the external cue of a tilted visual field were assessed for male and female, obese and normal-weight subjects. As predicted, both obese subjects' nut consumption and their judgments of verticality were more influenced by external cues than were those of normals. Females' judgments of verticality were more influenced by external cues than males' were, but the sex differences in eating behavior were not statistically significant. A significant correlation between the field dependence of subjects' eating behavior and their judgments of verticality suggests that a single cause may generate sensitivity to external cues in these two diverse situations.