Neurobehavioral inhibition of reward-driven feeding: implications for dieting and obesity

The Self-Control of Eating

Many individuals struggle to regulate their own consumption of food. Beginning with general theories of self-control, we review psychological factors that have been shown to influence the regulation of eating, including those related to particular personality variables, such as external eating, restrained eating, and reward sensitivity, as well as situational constraints, including normative influences, emotions, and calorie deprivation. Strategies for the self-control of eating, including reappraisal, effortful inhibition, and various automatic strategies are also reviewed, along with a discussion of the strengths and limitations of historical and contemporary psychological studies investigating food consumption. Whereas extensive examinations of food preferences and body weight have appeared in the psychological literature, we call for more robust research that prioritizes actual eating as the primary dependent measure.

The healthy eating movement on social media and its psychological effects on body image

Introduction

The present study aims to investigate the relationship between social-media pressure, the tendency to internalize standards of beauty and attractiveness associated with thin bodies, which subsequently leads to distortion of body shape perceptions, and restrictive and emotional eating behavior disorders.

Methods

A survey-based research design was employed, utilizing an online questionnaire to collect data. The study sample consisted of 614 students, selected from the most prestigious universities in Bucharest. The questionnaire incorporated validated scales measuring Socio-Media Pressure for a Thin Body Image (SMPTB), Body Appreciation (BA), Body Shape Perception (BSP), Restrained Eating Behavior (REB), and Emotional Eating Behavior (EEB).

Results

The results confirmed the hypotheses of the research, meaning food restrictions are a way to diminish the level of dissatisfaction with body shape, to reduce the difference between the ideal body shape and the real one. Food restrictions are perceived as natural behaviors, appropriate to support the standards of beauty and attractiveness specific to this historical stage. Emotional eating disorders emerge as a way to compensate for the discomfort generated by low body esteem.

Discussion

The results underscore the pervasive influence of social media in shaping eating behaviors and body image perceptions. Food restrictions, framed as natural responses to societal pressures, highlight the need for interventions addressing the normalization of harmful beauty standards. Emotional eating behaviors reveal the psychological toll of body dissatisfaction, emphasizing the importance of strategies to foster positive body image and mental well-being. These findings provide a foundation for developing educational campaigns and therapeutic approaches targeting the psychological impact of social media on eating behaviors.

Efficacy of a cognitive training based on inhibitory spillover and attribute conditioning: No weight and food intake reductions in adults with overweight and obesity

BACKGROUND

Overeating and obesity have been linked to deficient self-control and recent evidence suggests that the inhibitory spillover effect (ISE) may be an effective means to improve self-control. Specifically, it was shown that the ISE increases self-control by transfer of self-control capacity from one domain to another unrelated domain. Against this backdrop, our aim was to reduce hedonic food intake and body weight in non-dieting participants with overweight and obesity by transferring inhibitory control abilities from a food-unrelated domain to the food domain by means of an attribute conditioning procedure in a novel cognitive training (vs. a placebo training) comprising 8-sessions delivered over four weeks.

METHOD

In total, 93 adults with overweight and obesity were included in a two-arm randomized controlled trial and assigned to the computerized cognitive training or a placebo training (active control condition). Food intake in a bogus taste test and body weight were assessed prior to and after the training. Weight was additionally assessed at 3-months follow-up.

RESULTS

There was no improvement in food intake and weight reduction.

DISCUSSION

The cognitive training based on the ISE and attribute conditioning (ISAC) is not yet ready for application. Future studies need to identify the factors critical for a successful implementation of conditioning procedures aiming to associate food stimuli with self-control in overweight and obesity.

Metabolic dysfunction-associated steatotic liver disease is associated with effects on cerebral perfusion and white matter integrity

It is unclear whether early metabolic and inflammatory aberrations in the liver are associated with detrimental changes in brain structure and cognitive function. This cross-sectional study examines putative associations between metabolic dysfunction-associated steatotic liver disease (MASLD) and brain health in 36-55 year-old participants with obesity (n = 70) from the BARICO study (BAriatric surgery Rijnstate and Radboudumc neuroImaging and Cognition in Obesity). The participants underwent brain magnetic resonance imaging to study brain volumes and cortical thickness (3T MRI including T1-weighted magnetization-prepared rapid gradient-echo sequence), cerebral blood perfusion (arterial spin labeling) and white matter integrity (diffusion weighted imaging to assess mean-skeletonized mean diffusivity and fluid-attenuated inversion recovery to detect the presence of white matter hyperintensities (WMH)). The participants additionally performed neuropsychological tests to assess global cognition, working and episodic memory, verbal fluency and the ability to shift attention. Liver biopsies were collected and liver dysfunction was examined with histopathological, biochemical, and gene expression analyses. Linear regression analyses were performed between liver and brain parameters and the influence of body-mass index, diabetes and hypertension was explored. Early stages of liver disease were not associated with cognitive status but with cerebrovascular changes independently of age, sex, BMI, diabetes and hypertension: hepatic fibrosis development was associated with higher spatial coefficient of variation (sCoV) in the nucleus accumbens (NAcc), reflecting greater variations in cerebral perfusion and reduced vascular efficiency. Elevated hepatic levels of free cholesterol and cholesteryl esters were associated with increased WMH, indicating cerebral small vessel disease. RNA-seq and pathway analyses identified associations between sCoV in NAcc and WMH and the expression of hepatic genes involved in inflammation and cellular stress. Additionally, sCoV in NAcc correlated with plasma IL-6 levels suggesting that systemic-low grade inflammation may, at least partly, mediate this relationship. In conclusion, this study demonstrates that specific features of liver dysfunction (e.g. free cholesterol, onset of fibrosis) are associated with subtle cerebrovascular impairments, when changes in cognitive performance are not yet noticeable. These findings highlight the need for future research on therapeutic strategies that normalize metabolic-inflammatory aberrations in the liver to reduce the risk of cognitive decline.

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.

Changes in functional connectivity and structural covariance between the fronto-parietal network and medial orbitofrontal cortex are associated with disinhibition in restrained eaters

Disinhibition, characterized by a loss of dietary control, is a significant risk factor for diet failure and the onset of eating disorders in restrained eaters. This study employs resting-state functional connectivity and structural covariance network analyses to explore the neural associations underlying this behavior. By analyzing functional MRI data from 63 female college students, we found that increased disinhibition correlates with enhanced functional connectivity between the medial orbitofrontal cortex and key components of the inhibition system, particularly within the fronto-parietal network. Moreover, we observed a relationship between the structural covariance of the medial orbitofrontal cortex and the inferior parietal lobule and the severity of disinhibition. Importantly, the functional connectivity between the medial orbitofrontal cortex and the inferior parietal lobule predicts the severity of binge eating symptoms in these individuals. These findings indicate that imbalances in the interaction between the brain's reward and inhibition systems can lead to dietary failures and eating disorders, emphasizing the need for targeted interventions.

Towards optimized methodological parameters for maximizing the behavioral effects of transcranial direct current stimulation

Introduction

Transcranial direct current stimulation (tDCS) administers low-intensity direct current electrical stimulation to brain regions via electrodes arranged on the surface of the scalp. The core promise of tDCS is its ability to modulate brain activity and affect performance on diverse cognitive functions (affording causal inferences regarding regional brain activity and behavior), but the optimal methodological parameters for maximizing behavioral effects remain to be elucidated. Here we sought to examine the effects of 10 stimulation and experimental design factors across a series of five cognitive domains: motor performance, visual search, working memory, vigilance, and response inhibition. The objective was to identify a set of optimal parameter settings that consistently and reliably maximized the behavioral effects of tDCS within each cognitive domain.

Methods

We surveyed tDCS effects on these various cognitive functions in healthy young adults, ultimately resulting in 721 effects across 106 published reports. Hierarchical Bayesian meta-regression models were fit to characterize how (and to what extent) these design parameters differentially predict the likelihood of positive/negative behavioral outcomes.

Results

Consistent with many previous meta-analyses of tDCS effects, extensive variability was observed across tasks and measured outcomes. Consequently, most design parameters did not confer consistent advantages or disadvantages to behavioral effects-a domain-general model suggested an advantage to using within-subjects designs (versus between-subjects) and the tendency for cathodal stimulation (relative to anodal stimulation) to produce reduced behavioral effects, but these associations were scarcely-evident in domain-specific models.

Discussion

These findings highlight the urgent need for tDCS studies to more systematically probe the effects of these parameters on behavior to fulfill the promise of identifying causal links between brain function and cognition.

Inhibition and shifting across the weight status spectrum

Executive functioning (EF) is of major interest in the study of cognitive factors involved in obesity. Among EF, shifting is related to behavioral flexibility, and inhibition to the ability to refrain from impulsive behavior. A deficit in those two EF could predict individual difficulties to maintain a healthy lifestyle. Weak evidence of deficits in shifting and inhibition in individuals of higher Body Mass Index (BMI) have been observed. The objective was to clarify the relationship between inhibition and shifting regarding weight status group differences in healthy adults. Two neuropsychological tests from the Test of Attentional Performance (TAP) battery were used to measure EF performance of three groups of men and women: normal-weight (NW, n = 38), overweight (OW, n = 40) and obesity (OB, n = 37). The results show that individuals with higher BMI have lower inhibition capacities and that classically used weight status categories might not capture cognitive variability. No differences in shifting were observed concerning weight status nor BMI. This paper provides new insights on cognitive factors in obesity by presenting data from healthy individuals with overweight and obesity. The results support that assessing inhibition capacities might be of interest in a clinical setting for patients with difficulties to lose weight.

Regional specificity of cathodal transcranial direct current stimulation effects on spatial-numerical associations: Comparison of four stimulation sites

Neuromodulation with transcranial direct current stimulation (tDCS) is an increasingly popular research tool to experimentally manipulate cortical areas and probe their causal involvements in behavior, but its replicability and regional specificity are not clear. This registered report investigated cathodal tDCS effects on spatial-numerical associations (i.e., the SNARC effect), the numerical distance effect (NDE), and inhibitory control (i.e., stop-signal reaction time; SSRT). Healthy adults (N = 160) were randomly assigned to one of five groups to receive sham tDCS or 1 mA cathodal tDCS to one of four stimulation sites (left/right prefrontal cortex [PFC], left/right posterior parietal cortex) with extracephalic return. We replicated that cathodal tDCS over the left PFC reduced the SNARC effect compared to sham tDCS and to tDCS over the left parietal cortex. However, neither NDE nor SSRT were modulated in the main analyses. Post hoc contrasts and exploratory analyses showed that cathodal tDCS over the right PFC had a time-dependent effect by delayed practice-related improvements in SSRT. Math anxiety moderated changes in the NDE in the groups receiving tDCS to the right parietal cortex. With few exceptions, the replicability and regional specificity of tDCS effects on behavior were weak and partially moderated by individual differences. Future research needs to characterize the parameter settings for effective neuromodulation.

Characterizing motor impulsivity of individuals classified as overweight to obese

Deficits in the impulse control system are an important predictor of energy intake and body weight. Adults classified as overweight to obese may possess these deficits as a general behavioral trait or they may be food-specific. The present study assessed motor impulsivity (ability to suppress a pre-potent response) when presented with food and neutral (non-food) cues, testing if deficits in motor impulsivity is specific to food cues or a general trait among participants classified as overweight to obese. The proportion of inhibitory failures to no-go targets following food cues (10.8%) was significantly greater than the proportion of inhibitory failures to no-go targets following neutral cues (1.9%, p ​< ​0.001). These differences remained when covering for sex and hunger. This indicates deficits in food-specific impulse control (as opposed to general impulse control) are present in those classified as overweight to obese. Understanding the specific aspect of impulse control that is present in this population is needed for the development of future impulse control training interventions that seek to change eating behaviors as a means for weight control.

Chronotype is associated with addiction-like eating behavior, mindful eating and ultra-processed food intake among undergraduate students

This study aimed to investigate the relationships between chronotype and addiction-like eating behavior, mindful eating and ultra-processed food consumption among undergraduate students. Specific and validated scales were used in order to evaluate chronotype, addiction-like eating behavior and mindful eating (N = 605). Dietary intake was determined by food frequency questionnaire and percentage energy from ultra-processed food was calculated. Self-reported weights and heights were obtained from the participants. Mean scores of scales, social jetlag, energy intake, ultra-processed food intake and BMI were compared by chronotypes. Associations between chronotype, addiction-like eating behavior, mindful eating, ultra-processed food consumption and BMI were determined by Pearson's test. The relationships between chronotype and addiction-like eating behavior, mindful eating and ultra-processed food intake were assessed by linear regression models and adjusted for sex, BMI, energy intake, season, smoking and alcohol consumption. Evening-type participants had higher scores of social jetlag (2.01 ± 0.09), appetitive drive (26.02 ± 0.63), low dietary control (20.50 ± 0.41), addiction-like eating behavior (46.52 ± 0.85), lower scores of recognition (21.91 ± 0.43) and higher percentage energy from ultra-processed food (32.24 ± 1.26%). Chronotype score showed negative associations with addiction like eating behavior (β=-0.247, p < 0.001) and ultra-processed food consumption (β=-0.247, p < 0.001), and a positive association with recognition (β = 0.124, p < 0.001). Results suggest that chronotype is inversely associated with addiction-like eating behavior and ultra-processed food consumption, and positively associated with mindful eating among undergraduate students.

Applying psycho-behavioural phenotyping in obesity characterization

Individual differences in obesity, beyond being explained by metabolic and medical complications, are understood by alterations in eating behaviour which underlie psychological processes. From this psychological perspective, studies have identified several potential characteristic features at the psycho-behavioural level that could additionally explain the maintenance of chronic excess weight or the unsuccessful results of current treatments. To date, despite the growing evidence, the heterogeneity of the psychological evidence associated with obesity has made it challenging to generate consensus on whether these psycho-behavioural phenotypes can be a complement to improve outcomes of existing interventions. For this reason, this narrative review is an overview focused on summarizing studies describing the psycho-behavioural phenotypes associated with obesity. Based on the literature, three psychological constructs have emerged: reward dependence, cognitive control, and mood and emotion. We discuss the clinical implications of stratifying and identifying these psycho-behavioural profiles as potential target for interventions which may ensure a better response to treatment in individuals with obesity. Our conclusions pointed out a considerable overlap between these psycho-behavioural phenotypes suggesting bidirectional interactions between them. These findings endorse the complexity of the psycho-behavioural features associated with obesity and reinforce the need to consider them in order to improve treatment outcomes.

Individual differences in late positive potential amplitude and theta power predict cue-induced eating

Cue-induced reward-seeking behaviors are regulated by both the affective and cognitive control systems of the brain. This study aimed at investigating how individual differences in affective and cognitive responses to cues predicting food rewards contribute to the regulation of cue-induced eating. We recorded electroencephalogram (EEG) from 59 adults while they viewed emotional and food-related images that preceded the delivery of food rewards (candies) or non-food objects (beads). We measured the amplitude of the late positive potential (LPP) in response to a variety of motivationally relevant images and power in the theta (4-8 Hz) frequency band after candies or beads were dispensed to the participants. We found that individuals with larger LPP responses to food images than to pleasant images (C>P group) ate significantly more during the experiment than those with the opposite response pattern (P>C group, p < 0.001). Furthermore, we found that individuals with higher theta power after dispensation of the candy than of the bead (θCA>θBE) ate significantly more than those with the opposite response pattern (θBE>θCA, p < 0.001). Finally, we found that the crossed P>C and θBE>θCA group ate less (p < 0.001) than did the other three groups formed by crossing the LPP and theta group assignments, who exhibited similar eating behavior on average (p = 0.662). These findings demonstrate that individual differences in both affective and cognitive responses to reward-related cues underlie vulnerability to cue-induced behaviors, underscoring the need for individualized treatments to mitigate maladaptive behaviors.

Self-control training supplementing inpatient multidisciplinary obesity treatment in children and adolescents

Research points to self-control as a possible mechanism for facilitating health behaviour and weight loss. The dual pathway model underpins the role of strong bottom-up reactivity towards food and weak top-down executive functions in obesity. Despite flourishing lab studies on attention bias modification or inhibition trainings, relatively few focused on training both processes to improve self-control in children and adolescents in inpatient multidisciplinary obesity treatment (MOT). Being part of the WELCOME project, this study investigated the effectiveness of Brain Fitness training (using the Dot Probe and Go/No-Go) as an adjunct to inpatient MOT in 131 Belgian children and adolescents. Changes in self-control (performance-based inhibitory control and attention bias as well as self-reported eating behaviour) in the experimental group were compared to sham training. Multiple Imputation was used to handle missing data. Inhibitory control and external eating improved over time (pre/post/follow-up), but we found no evidence for a significant interaction between time and condition. Future research should pay more attention to the role of individual variability in baseline self-control, sham training, and ecological validity of self-control training to improve real-life health behaviour and treatment perspectives for children and adolescents with weight problems.

Are trait self-control and self-control resources mediators of relations between executive functions and health behaviors?

This study investigated associations between executive functions (i.e., inhibition, working memory, cognitive flexibility) and individual differences in self-control and health behaviors. We examined whether executive functions predict physical activity, sedentary activity, and healthy and unhealthy diets, and whether trait self-control and self-control resources mediate these associations. Three hundred and eighty-five participants completed a questionnaire assessing trait self-control and self-control resources, physical activity, sedentary activity, and healthy and unhealthy diets. They also performed three randomly ordered cognitive tasks, a stop-signal task (i.e., inhibition), a letter memory task (i.e., updating), and a number-letter task (i.e., switching). Structural equation modeling revealed that self-control resources predicted positively physical activity (R2 = 0.08), negatively sedentary activity (R2 = 0.03) and positively healthy diet (R2 = 10). Moreover, trait self-control predicted positively healthy diet (R2 = 0.10) and negatively unhealthy diet (R2 = 0.19). Moreover, analyses revealed that switching significantly predicted self-control resources, and highlighted three totally mediated relations between this executive function and physical activity, sedentary activity and healthy diet. However, no evidence was found supporting associations between inhibition and updating, and health behaviors, or relations mediated by self-control for these executive functions. The findings suggest the importance of trait self-control and self-control resources for health behavior adoption and pave the way for studies exploring the role of the executive functions in an affective context. Open materials [https://osf.io/hpsjw/].

Obtaining long-term recovery: advances in optimizing treatment outcomes in patients with binge-eating disorder

INTRODUCTION

Binge-eating disorder (BED) is a complex and disabling eating disorder (ED) associated with considerable burden and impairments in quality of life and physical/mental health. It has been recognized as a formal ED category since 2013, however BED is still underdetected and undertreated.

AREAS COVERED

This review summarizes the advances in the understanding of the pathophysiology of BED as well as the evidence on the efficacy of the existing treatments. The authors searched Scopus, PubMed, ClinicalTrials.Gov, and ANZCTR with terms including 'assessment' OR 'treatment' OR 'diagnosis' OR 'mechanisms' AND 'binge eating' OR 'binge-eating disorder' for manuscripts published between January 2013 and April 2023.

EXPERT OPINION

Most of the trials on treatments of BED have been in people of high weight with weight loss as an outcome. Nevertheless, less is known about the treatment of this condition in people with body mass index (BMI) within the normal range where weight stabilization may be a more appropriate goal. Moreover, there is a need for an enhanced appreciation of the role of combination treatment to improve overall outcomes. Also, there are important opportunities for future research in understanding the mechanisms of action and effectiveness of BED treatments.

Relation of Overweight/Obesity to Reward Region Response to Food Reward and the Moderating Effects of Parental History of Eating Pathology in Adolescent Females

OBJECTIVE

To test whether overweight/obesity is associated with an elevated reward region response to milkshake cues and a low reward region response to milkshake receipt. To test whether the risk for eating pathology moderates the effects of weight status on the neural response to milkshake cues and milkshake receipt.

METHOD

The current study used functional magnetic resonance imaging (fMRI) to examine the neuronal responses of female adolescents (n = 80; M age = 14.6 ± 0.9; M BMI = 21.9 ± 3.6; 41% with a biological parental history of eating pathology) during a food receipt paradigm.

RESULTS

Females with overweight/obesity showed a greater ventromedial prefrontal cortex (vmPFC), and ventral anterior cingulate (ACC) response to milkshake cues and a greater ventral striatum, subgenual ACC, and dorsomedial prefrontal cortex response to milkshake receipt than those with a healthy weight. Females with overweight/obesity plus a parental history of eating pathology showed a greater vmPFC/medial orbitofrontal cortex response to milkshake cues than those without a parental history of eating pathology and those with a healthy weight. Females with overweight/obesity and without a parental history of eating pathology showed a greater thalamus and striatum response to milkshake receipt.

CONCLUSIONS

Overweight/obesity is associated with an elevated reward region response to palatable food cues and food receipt. A risk for eating pathology enhances the reward region response to food cues in those with excess weight.

Challenging inhibitory control with high- and low-calorie food: A behavioural and TMS study

Most people are often tempted by their impulses to "indulge" in high-calorie food, even if this behaviour is not consistent with their goal to control weight in the long term and might not be healthy. The outcome of this conflict is strongly dependent on inhibitory control. It has already been reported that individuals with weaker inhibitory control consume more high-calorie food, are more often unsuccessful dieters, overweight or obese compared to people with more effective inhibitory control. In the present study, we aimed at investigating inhibitory control in the context of human eating behaviour. A sample of 20 healthy normal-weight adults performed a 50% probability visual affective Go/NoGo task involving food (high- and low-calorie) and non-food images as stimuli. Single-pulse transcranial magnetic stimulation (TMS) was administered over the right primary motor cortex (M1) either 300 ms after image presentation to measure corticospinal excitability during the different stimulus categories or 300 ms after the appearance of a fixation point, as a control stimulation condition. The experimental session consisted of a food target and a non-food target block. Behavioural outcomes showed a natural implicit inclination towards high-calorie food in that participants were faster and more accurate compared to the other categories. This advantage was selectively deleted by TMS, which slowed down reaction times. MEPs did not differ according to the stimulus category, but, as expected, were bigger for Go compared to NoGo trials. Participants judged high-calorie food also as more appetising than low-calorie food images. Overall, our results point to a differential modulation when targeting inhibitory control, in favour of the more palatable food category (high-calorie). Present data suggest that the activity of the motor system is modulated by food nutritional value, being more engaged by appetising food. Future work should explore to what extent these processes are affected in patients with eating disorders and should aim to better characterise the related dynamics of cortical connectivity within the motor network.

The Association of Obesity and Overweight with Executive Functions in Community-Dwelling Older Women

Among the risk factors reported for cognitive decline, the literature highlights changes in body composition. Thus, the aim of the present study was to examine the relationship between obesity/overweight and executive functions in cognitively normal older adult women. This cross-sectional study included 224 individuals (60-80 years), stratified into normal weight (n = 45), overweight (n = 98), and obesity (n = 81). As outcomes, body mass index (BMI), waist circumference (WC), and Trail Making Test Parts A and B were assessed. We found positive correlations of BMI and WC with completion times of TMT-A and TMT-B, and a negative correlation of BMI and WC with education. ANCOVA showed an association between higher BMI and slower completion time of TMT-A, TMT-B, and ΔTMT (B-A). Impairment of executive functions of cognitively normal older women may be positively associated with obesity and negatively associated with years of education. The findings may contribute to designing strategies that make it possible to prevent cognitive decline in women during aging.

Disinhibited Eating and Executive Functioning in Children and Adolescents: A Systematic Review and Meta-Analysis

A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and behavioral findings support the notion that EF skills impact eating regulation. However, a major gap in the current literature is a synthesis of the association between various EF skills and disinhibited eating patterns across child development. To address this gap, a systematic review and meta-analysis was conducted to examine the effect of EF skills on disinhibited eating behaviors among youth ages 3-18 years old. PubMed and PsychINFO databases were utilized and data from 15 studies with a total sample of 4909 youth were included. A random effects meta-analysis revealed a small negative effect of overall EF skills on disinhibited eating behavior, r = -0.14, p < 0.01. Analysis of individual EF skills found working memory had an overall medium negative effect on disinhibited eating behavior, r = -0.25, p < 0.05. Taken together, findings from this meta-analysis support an inverse relationship between EF abilities and disinhibited eating patterns in children and adolescents, such that poorer EF abilities are associated with higher levels of disinhibited eating. Given the effect on eating behavior, future research is needed to assess whether EF difficulties may be a barrier to effective weight management in youth. Specifically, research is needed to examine whether EF skills may be a key target to consider for effective obesity prevention and treatment in children and adolescents.

An EEG study on the effect of being overweight on anticipatory and consummatory reward in response to pleasant taste stimuli

Two-thirds of adults in the United Kingdom currently suffer from overweight or obesity, making it one of the biggest contributors to health problems. Within the framework of the incentive sensitisation theory, it has been hypothesised that overweight people experience heightened reward anticipation when encountering cues that signal food, such as pictures and smells of food, but that they experience less reward from consuming food compared to normal-weight people. There is, however, little evidence for this prediction. Few studies test both anticipation and consumption in the same study, and even fewer with electroencephalography (EEG). This study sought to address this gap in the literature by measuring scalp activity when overweight and normal-weight people encountered cues signalling the imminent arrival of pleasant and neutral taste stimuli, and when they received these stimuli. The behavioural data showed that there was a smaller difference in valence ratings between the pleasant and neutral taste in the overweight than normal-weight group, in accordance with our hypothesis. However, contrary to our hypothesis, the groups did not differ in their electrophysiological response to taste stimuli. Instead, there was a reduction in N1 amplitude to both taste and picture cues in overweight relative to normal-weight participants. This suggests that reduced attention to cues may be a crucial factor in risk of overweight.

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.

Neural Response to Low Energy and High Energy Foods in Bulimia Nervosa and Binge Eating Disorder: A Functional MRI Study

Objective

Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating (BE) episodes. Overlap exists between ED diagnostic groups, with BE episodes presenting one clinical feature that occurs transdiagnostically. Neuroimaging of the responses of those with BN and BED to disorder-specific stimuli, such as food, is not extensively investigated. Furthermore, to our knowledge, there have been no previous published studies examining the neural response of individuals currently experiencing binge eating, to low energy foods. Our objective was to examine the neural responses to both low energy and high energy food images in three emotive categories (disgust; fear; and happy) in BN and BED participants.

Methods

Nineteen females with BN (n = 14) or BED (n = 5), comprising the binge eating group (BEG; N = 19), and 19 age-matched healthy control (HC)’s completed thorough clinical assessment prior to functional MRI (fMRI). Neural response to low energy and high energy foods and non-food images was compared between groups using whole-brain exploratory analyses, from which six regions of interest (ROI) were then selected: frontal, occipital, temporal, and parietal lobes; insula and cingulate.

Results

In response to low energy food images, the BEG demonstrated differential neural responses to all three low energy foods categories (disgust; fear; and happy) compared to HCs. Correlational analyses found a significant association between frequency of binge episodes and diminished temporal lobe and greater occipital lobe response. In response to high energy food images, compared to HC’s, the BEG demonstrated significantly decreased neural activity in response to all high energy food images. The HC’s had significantly greater neural activity in the limbic system, occipital lobe, temporal lobe, frontal lobe, and limbic system in response to high energy food images.

Conclusion

Results in the low energy food condition indicate that binge frequency may be related to increased aberrant neural responding. Furthermore, differences were found between groups in all ROI’s except the insula. The neural response seen in the BEG to disgust food images may indicate disengagement with this particular stimuli. In the high energy food condition, results demonstrate that neural activity in BN and BED patients may decrease in response to high energy foods, suggesting disengagement with foods that may be more consistent with those consumed during a binge eating episode.

The Mediation Role of Health Behaviors in the Association between Self-Regulation and Weight Status among Preschool Children: A Sex-Specific Analysis

Previous studies have supported the link between children’s self-regulation (CSR) and weight status, but the potential pathways have not been elucidated yet. We aimed to investigate whether and to what extent health behaviors mediate this association, as well as to explore the sex effect. For this study, we recruited 3740 preschoolers in Wuhan, China. The height and weight of children were measured, and a body mass index of the ≥85th percentile was defined as overweight/obesity (OWO). We used the Children’s Behavior Questionnaire, with measured domains including inhibitory control, impulsivity, anger, and attentional focusing, to assess CSR. The primary caregivers’ SR (PSR) was assessed with the Self-Control Scale. Information on lifestyles collected from questionnaires was utilized to construct the health behavior index (HBI). We found that Children’s HBI was associated with both CSR and PSR, inhibitory control (OR = 0.81, p < 0.001), anger (OR = 1.23, p < 0.001), attentional focusing (OR = 0.70, p < 0.001), impulsivity (OR = 1.23, p < 0.001), and PSR (OR = 0.73, p < 0.001). Children’s impulsivity was associated with their OWO (OR = 1.11, p = 0.013) which was partly mediated by the HBI (direct effect: β = 0.092, p = 0.026; indirect effect: β = 0.011, p = 0.007). The sex-specific analysis indicated that this mediation effect was only significant in boys. These results indicated that impulsivity is associated with childhood weight status, which is partially mediated by health behaviors, especially in boys.

Volume and Connectivity Differences in Brain Networks Associated with Cognitive Constructs of Binge Eating

Bulimia nervosa (BN) and binge eating disorder (BED) are characterized by episodes of eating large amounts of food while experiencing a loss of control. Recent studies suggest that the underlying causes of BN/BED consist of a complex system of environmental cues, atypical processing of food stimuli, altered behavioral responding, and structural/functional brain differences compared with healthy controls (HC). In this narrative review, we provide an integrative account of the brain networks associated with the three cognitive constructs most integral to BN and BED, namely increased reward sensitivity, decreased cognitive control, and altered negative affect and stress responding. We show altered activity in BED/BN within several brain networks, specifically in the striatum, insula, prefrontal cortex (PFC) and orbitofrontal cortex (OFC), and cingulate gyrus. Numerous key nodes in these networks also differ in volume and connectivity compared with HC. We provide suggestions for how this integration may guide future research into these brain networks and cognitive constructs.

Dynamic changes in the food-cue processing of obese adolescents: A controlled eye-tracking study from a dual-system perspective

Adolescent obesity is a growing global health problem. Studies have demonstrated that exposure to food cues plays a role in both the development and the persistence of obesity. Understanding how visual attention changes dynamically in response to food cues may explain how they contribute to obesity. The primary aims were to evaluate attentional bias for food cues and conduct a time-course analysis of obese adolescents' food-cue processing. We also investigated the roles of inhibition, cognitive flexibility, and eating styles in their visual attention to food stimuli. A total of 60 age- and gender-matched 12-16-year-olds (n = 30, obese group; n = 30, control group; M = 13.9 years, SD = 1.26) were included in this study's sample. The participants viewed a series of high-calorie and low-calorie food images along with nonfood images in the free exploration paradigm during eye-tracking. Time-course analysis of the proportion of fixations on images of food and high-calorie foods determined that the attentional processing of the two groups differed, especially in later stages. The obese group had higher Stroop Interference and Trail Making Test-B scores than the control group, but these executive functions' scores did not affect their proportions of fixations on food and high-calorie food images over time. Higher Perceptual Reasoning Index scores led to a decrease in the proportions of fixations on high-calorie food images over time in the obese group, and this was particularly noticeable after about 4000 ms. This study found that time-course analysis of visual attention to food cues allows us to understand how it changes dynamically over larger time intervals. Future studies should provide knowledge about maintained attention for food cues and their relationship with top-down factors in obese adolescents.

Exercise Increases Attentional Bias Towards Food Cues in Individuals Classified as Overweight to Obese

BACKGROUND

The obesity epidemic continues to be a major public health concern. Although exercise is the most common weight loss recommendation, weight loss outcomes from an exercise program are often suboptimal. The human body compensates for a large percentage of the energy expended through exercise to maintain energy homeostasis and body weight. Increases in energy intake appear to be the most impactful compensatory behavior. Research on the mechanisms driving this behavior has not been fully elucidated.

PURPOSE

To determine if exercise influences the attentional processing towards food cues (attentional bias) and inhibitory control for food cues among individuals classified as overweight to obese who do not exercise.

METHODS

Thirty adults classified as overweight to obese participated in a counterbalanced, crossover trial featuring two assessment visits on separate days separated by at least one week. Attentional bias and inhibitory control towards food cues was assessed prior to and after a bout of exercise where participants expended 500 kcal (one assessment visit) and before and after a 60 min bout of watching television (second assessment visit). Attentional bias was conceptualized as the percentage of time fixated on food cues when both food and neutral (non-food) cues were presented during a food-specific dot-probe task. Inhibitory control, specifically motor impulsivity, was assessed as percentage of inhibitory failures during a food-specific Go/NoGo task.

RESULTS

A significant condition by time effect was observed for attentional bias towards food cues, independent of hunger, whereas attentional bias towards food cues was increased pre-post exercise but not after watching TV. Inhibitory control was not affected by exercise or related to attentional bias for food cues.

CONCLUSIONS

An acute bout of exercise increased attentional bias for food cues, pointing to a mechanism that may contribute to the weight loss resistance observed with exercise. Future trials are needed to evaluate attentional bias towards food cues over a longitudinal exercise intervention.

Subtyping youngsters with obesity: A theory-based cluster analysis

Psychological mechanisms play a crucial role in explaining weight gain. Aim of the present study was to identify subtypes in youngsters with obesity in line with these mechanisms. Defining homogeneous clusters within this heterogeneous group provides relevant information for personalized treatments. Data were collected in N = 572 participants (51% boys, aged 7-19) with extreme obesity (%BMI M = 187.8; SD = 30.9) recruited in an inpatient treatment centre. Based on psychological models of overweight/obesity, the Affect Regulation Model, the Reward Deficiency Model and The Dual Pathway Model, cluster variables were selected assessing emotional eating, reward reactivity and regulative capacities. Youngsters reported on emotional eating (DEBQ Emotional Eating) and reward sensitivity (BAS), while parents reported on children's regulative Executive Functions (BRIEF). Characteristics of the different clusters were examined concerning weight variables (pre and post treatment) and variables indexing problematic eating (DEBQ External Eating, Ch-EDE), affect regulation (FEEL-KJ) and depressive symptoms (CDI). Hierarchical cluster analyses supported the presence of three clusters, further evaluated by K-means cluster analyses. The cluster solutions differed according to age and sex (boys 7-13, boys 14-19, girls 7-13, girls 14-19). In all four age and gender subsamples, an "Emotional Eating" cluster displaying a vulnerable profile (high depression, maladaptive emotion regulation, problematic eating) and a "Reward Deficiency" cluster displaying a more resilient profile were detected. In girls 7-13, a "Weak Executive Functioning" indicative of insufficient self-regulative capacities, showed moderate to high emotional problems and problematic eating. In the other subgroups, the "Mean Level Functioning" cluster also showed elevated emotional problems and problematic eating. Given that different clusters can be identified, and given that these clusters have different profiles on emotional problems and problematic eating, subtyping youngsters with severe obesity is indicated, setting the stage for personalized treatments.

Sensitization of the reinforcing value of high energy density foods is associated with increased zBMI gain in adolescents

Background/Objectives

Characterizing behavioral phenotypes that predict increased zBMI gain during adolescence could identify novel intervention targets and prevent the development of obesity. The purpose of this study was to determine if sensitization of the relative reinforcing value (RRV) of high (HED) or low energy density (LED) foods predicts adolescent weight gain trajectories. A secondary aim was to test the hypothesis that relationships between sensitization of the RRV of food and weight change are moderated by delay discounting (DD).

Subjects/Methods

We conducted a prospective, longitudinal cohort study in 201 boys and girls with an average zBMI of 0.4, who began the study between the ages of 12 and 14 years and completed the study 2 years later. Participants completed five laboratory visits where the RRV of HED and LED, and DD were assessed at a baseline (visits 1, 2, and 4) and then RRV was measured again after participants consumed a portion of the same HED and LED food for 2 weeks (visits 3 and 5; order counterbalanced). Increases (>1) in the RRV from baseline to post-daily intake were categorized as “sensitization” and decreases (≤1) were categorized as “satiation.” Participants returned to the laboratory for follow-up visits at 6, 15, and 24 months to have height and weight taken and to complete additional assessments.

Results

Sensitization to HED food was associated with a greater zBMI change over time (β = 0.0070; p = 0.035). There was no impact of sensitization to LED food or interaction between sensitization to HED and LED food on zBMI change and no moderation of DD on the relationship between HED sensitization and zBMI change (all p > 0.05).

Conclusion

Our prior work showed that sensitization to HED food is cross-sectionally associated with greater zBMI. This study extends this work by demonstrating that sensitization to HED food prospectively predicts increased zBMI gain over time in adolescents without obesity. Future studies should determine if sensitization can be modified or reduced through behavioral intervention.

Trial registration

Clinicaltrials.gov: NCT04027608.

Inflammation in obese children and adolescents: Association with psychosocial stress variables and effects of a lifestyle intervention

Obesity in childhood and adolescence is a complex health issue that has detrimental effects on the physical and psychological health of the youngster, both in the short and long term. A characteristic of obesity is the associated chronic low-grade inflammation which can result in insulin resistance. Previous research suggested that biomarkers referring to such increased inflammation may help in understanding resistance to weight loss. Whether and how psychosocial factors are related with inflammation remains to be proven. The current study consisted of 594 children and adolescents (7-19 years), of whom 480 had follow-up data, who enrolled for a ten-month inpatient multidisciplinary obesity treatment consisting of healthy food routines, physical activities and psychological treatment. The purpose of the study was to explore (1) the relationship between inflammation and psychosocial stress variables (i.e., depressive symptoms, eating behavior, concerns about eating/shape/weight, insecure parent-child attachment) (correlational and multiple regression analysis), (2) whether a lifestyle intervention for obese youngsters results in decreased C-reactive protein (CRP) values (paired t-test) and (3) which psychosocial variables influence this CRP change as indication of treatment success (multiple regression analysis with change in BMI as control variable). Results showed that the psychosocial stress variables emotional eating, external eating and attachment anxiety are related to higher CRP values. Our data further suggested that a lifestyle intervention decreases the CRP values. This significant reduction in blood inflammatory marker was besides being influenced by weight loss also dependent on psychosocial variables, more specific on self-reported attachment avoidance, as this latter was related to less CRP decrease.

Post-traumatic stress disorder and the association with overweight, obesity, and weight change among individuals exposed to the World Trade Center disaster, 2003-2016

BACKGROUND

Among Veterans, post-traumatic stress disorder (PTSD) has been shown to be associated with obesity and accelerated weight gain. Less is known among the general population. We sought to determine the impact of PTSD on body mass index (BMI) and weight change among individuals with exposure to the World Trade Center (WTC) disaster.

METHODS

We examined individuals from the WTC Health Registry. PTSD symptoms were assessed on multiple surveys (Waves 1-4) using the PTSD Checklist-Specific. Three categories of post-9/11 PTSD were derived: no, intermittent, and persistent. We examined two outcomes: (1) Wave 3 BMI (normal, overweight, and obese) and (2) weight change between Waves 3 and 4. We used multivariable logistic regression to assess the association between PTSD and BMI (N = 34 958) and generalized estimating equations to assess the impact of PTSD on weight change (N = 26 532). Sex- and age-stratified analyses were adjusted for a priori confounders.

RESULTS

At Wave 3, the observed prevalence of obesity was highest among the persistent (39.5%) and intermittent PTSD (36.6%) groups, compared to the no PTSD group (29.3%). In adjusted models, persistent and intermittent PTSD were consistently associated with a higher odds of obesity. Weight gain was similar across all groups, but those with persistent and intermittent PTSD had higher estimated group-specific mean weights across time.

CONCLUSIONS

Our findings that those with a history of PTSD post-9/11 were more likely to have obesity is consistent with existing literature. These findings reaffirm the need for an interdisciplinary focus on physical and mental health to improve health outcomes.

Food Attention Bias: appetite comes with eating

OBJECTIVE

Cognitive interventions may be effective in weight loss. The purpose of this study was to assess if cognitive reappraisal (CR; reframing the meaning of a stimulus in order to change the resulting emotional response), can reduce food attentional bias (FAB) using the Visual Dot Probe (VDP) paradigm.

METHOD

126 participants (age 27 ± 5.8) were randomly assigned either to a CR or to a control (CN) group. After assessing baseline VDP levels for FAB, participants either wrote sentences that discourage eating fattening food or neutral sentences. Next, all participants performed the VDP post intervention. Participants also self-reported on disordered eating behaviors and their height and weight were charted. We hypothesized that CR would reduce FAB and that disordered eating would moderate the association between group and FAB.

RESULTS

FAB decreased post intervention, specifically in the CR group. The bulimia sub-scale showed an interaction between bulimic eating, time and group. Among those who were high on the bulimia scale, the CR group showed lower FAB post-intervention compared to the CN group.

DISCUSSION

This study suggests that CR may decrease the attentional bias toward high-calorie food compared to other strategies in the general population and among people with high bulimia measures, in particular. Obesity has a negative impact on many aspects of life and much research is dedicated to trying to better understand behaviors concerning obesity. People are prone to focus their attention on things that are of importance to them, such as food. When people focus their attention on food, we call this Food Attention Bias (FAB). Cognitive reappraisal (CR) interventions involve the person's conscious cognitive change of the meaning of the situation aiming to consequently change the emotional response to it, such as saying to yourself "I shouldn't eat this because I don't want to get fat". CR has been found to be helpful in lowering FAB using brain imagining techniques but has not yet been studied in cognitive processes. Our study used a Visual dot probe paradigm (VDP) to assess the efficacy of CR on lowering FAB. Two groups, one using CR and a control group were assessed twice on FAB, using the VDP paradigm. Compared to the normal condition, the CR intervention helped reduce FAB. This reduction was especially significant for people with a higher tendency for bulimic behavior. The VDP paradigm, utilizing CR. can be expanded to help build an intervention aimed at reducing FAB over time. This, in turn might bring to weight reduction. People with bulimic tendencies might especially benefit from CR interventions when dealing with weight loss.

THE RELATIVE REINFORCING VALUE OF SNACK FOOD IS A SIGNIFICANT PREDICTOR OF FAT LOSS IN WOMEN WITH OVERWEIGHT OR OBESITY

Reinforcing Relative Value (RRV) of food and impulsivity are associated with energy intake and obesity. The study investigated the degree to which changes in RRV and impulsivity independently or interactively predict change in body weight and composition in women with overweight or obesity engaged in either a fast or in a slow weight loss programs. Body weight, body composition, Impulsivity (Barratt Impulsiveness Scale), RRV snack (computerized Behavioural Choice Task) were measured at baseline and post-intervention in 30 women with obesity undergoing either slow (n= 14 -500 kcal/day, 20 weeks) or fast n=16 (-1000kcal/day, 10 weeks) weight reduction. No group*time effects were noted on body composition, impulsivity or RRV, so participants from both groups were pooled for analysis. Multiple regression analyses indicated that none of the impulsivity variables predicted weight- or fat mass (FM) loss. However, Δ RRV snack predicted ΔFM (r=0.40, P=0.046), whereby greater increases in RRV snack were associated with less FM loss. Results indicate that different rates of weight loss do not differentially affect RRV snack or impulsivity traits. However, changes in RRV snack predicted FM loss, suggesting that dietary interventions that either mitigate increases or foster reductions in the RRV snack may yield greater reductions in adiposity. Trial Registration clinicaltrials.gov identifier: NCT04866875 NOVELTY POINTS • No differences in RRV of food were noted between fast and slow weight loss • Weight loss from combined fast and slow groups led to a moderate-sized reduction in the total impulsivity • Greater diet-induced increases in RRV snack was associated with less body fat-loss.

Do Hot Executive Functions Relate to BMI and Body Composition in School Age Children?

Deficits of 'hot' executive functions (EFs) involving emotional and motivational processes are considered as a risk factor for excessive weight, but few studies have tested the relationship between hot EFs and body composition in children. The aim of the study was to assess the association of the ability to delay gratification and affective decision-making with the body mass index (BMI) and body composition in children with typical neurocognitive development. The sample consisted of 553 Polish children aged between 6-12 y. The delay of gratification task (DGT) was applied to assess the ability to delay gratification. The Hungry Donkey test (HDT) was applied to assess affective decision-making. The indicators of decision-making in the HDT were net score and learning rate. The relationships between hot EFs and BMI, fat mass index (FMI), lean body mass index (LBMI) were tested. The association of the z scores of BMI and FMI, overweight/obesity, and the ability to delay gratification was found insignificant after controlling cofounding factors. Most of the results on affective decision-making and z scores for BMI, FMI and LBMI were insignificant as well. The relationship between the ability to delay gratification, affective decision-making, and adiposity is not pronounced in typically developed children.

A Pictorial Dot Probe Task to Assess Food-Related Attentional Bias in Youth With and Without Obesity: Overview of Indices and Evaluation of Their Reliability

Several versions of the dot probe detection task are frequently used to assess maladaptive attentional processes associated with a broad range of psychopathology and health behavior, including eating behavior and weight. However, there are serious concerns about the reliability of the indices derived from the paradigm as measurement of attentional bias toward or away from salient stimuli. The present paper gives an overview of different attentional bias indices used in psychopathology research and scrutinizes three types of indices (the traditional attentional bias score, the dynamic trial-level base scores, and the probability index) calculated from a pictorial version of the dot probe task to assess food-related attentional biases in children and youngsters with and without obesity. Correlational analyses reveal that dynamic scores (but not the traditional and probability indices) are dependent on general response speed. Reliability estimates are low for the traditional and probability indices. The higher reliability for the dynamic indices is at least partially explained by general response speed. No significant group differences between youth with and without obesity are found, and correlations with weight are also non-significant. Taken together, results cast doubt on the applicability of this specific task for both experimental and individual differences research on food-related attentional biases in youth. However, researchers are encouraged to make and test adaptations to the procedure or computational algorithm in an effort to increase psychometric quality of the task and to report psychometric characteristics of their version of the task for their specific sample.

The effect of alcohol on food-related attentional bias, food reward and intake: Two experimental studies

Acute alcohol consumption has been shown to increase food intake, and long-term alcohol consumption may be a risk for weight gain. A potential, but under-studied, mechanism for this effect is alcohol's ability to enhance food reward. In two studies, participants consumed an alcoholic drink (Study 1: 0.3 grams of alcohol per kilogram of bodyweight (g/kg); Study 2: 0.6 g/kg) and a placebo-alcohol drink in a within-subjects design. In both studies, food-related appetitive and motivational states, and attentional bias (AB) towards food-related cues were measured. In Study 1 (N = 44), participants completed a visual probe task with concurrent recording of eye-movements which measured AB towards images of palatable foods, unpalatable foods, and non-food control items. Participants also completed measures of appetite and snack urge ratings, salivary response towards palatable foods and an ad libitum food taste test. In Study 2 (N = 84), participants completed a similar procedure, but completed a modified Stroop task which measured differences in food-related and alcohol-related AB across the two drink conditions. In Study 1, there was no difference in food-related AB between drink conditions, and no differences in snack urge, appetite ratings, salivary response, or food intake. In contrast, Study 2 showed an alcohol-induced increase in AB towards food, but not alcohol. Snack urge, alcohol urge ratings and ad libitum food intake were also higher after alcohol consumption, relative to the placebo. Collectively, these findings suggest that alcohol can increase food reward and food intake, but these effects may only occur at a higher dose.

Oxytocin Administration Increases Proactive Control in Men with Overweight or Obesity: A Randomized, Double-Blind, Placebo-Controlled Crossover Study

OBJECTIVE

Preclinical and clinical evidence suggests that oxytocin administration decreases food intake and weight. The mechanisms underlying the anorexigenic effects of oxytocin in humans are unknown but critical to study to consider oxytocin as a neurohormonal weight loss treatment. Complementing ongoing research into metabolic and food motivation mechanisms of oxytocin, this study hypothesized that in humans, oxytocin improves cognitive control over behavior.

METHODS

In a randomized, double-blind, placebo-controlled crossover study of 24-IU single-dose intranasal oxytocin, 10 men with overweight or obesity completed a stop-signal task assessing ability and strategy to suppress behavioral impulses, in which they performed a choice-reaction task (go task) but had to withhold their response when prompted (stop task). It was hypothesized that oxytocin would improve suppression of behavioral impulses.

RESULTS

After receiving oxytocin, compared with placebo, participants showed increased reaction times in the go task (mean [M] = 936 milliseconds vs. 833 millseconds; P = 0.012; 95% CI: 29 to 178) and displayed fewer stop errors (M = 36.41% vs. 41.15%; P = 0.049; 95% CI: -9.43% to -0.03%).

CONCLUSIONS

Oxytocin triggers increased proactive control over behavior. Future studies need to further characterize the impact of oxytocin on cognitive control and investigate its potential role in the anorexigenic effects of oxytocin in human obesity.

Food reward sensitivity, impulsivity, and weight change during and after a 3-month weight loss program

Background

Greater sensitivity to food rewards and higher levels of impulsivity (and an interaction between these variables, termed “reinforcement pathology”) have been associated with obesity in cross-sectional studies. Less is known regarding how these constructs may impact attempts at weight loss or longer-term weight loss maintenance.

Methods

We provided 75 adults (69%Female, 84%White, age = 50.8y, BMI = 31.2kg/m²) with a 3-month Internet-based weight loss program and assessed weight, food reward sensitivity (via the Power of Food Scale [PFS]), and impulsivity (via Go No-Go [GNG] and Delay Discounting [DD] computer tasks) at baseline and at Months 3, 6, 9, and 12. No additional intervention was provided Months 3–12. Multi-level mixed-effect models were used to examine changes in PFS, GNG, and DD over time and associations between these measures and weight loss/regain.

Results

Participants lost 6.0±1.1kg Months 0–3 and regained 2.4±1.1kg Months 3–12. Across time points, higher PFS scores were associated with higher weight, p = .007; however, there were no significant associations between GNG or DD and weight nor between the interactions of PFS and GNG or DD and weight, ps>.05. There were significant decreases from Months 0–3 in PFS, GNG, and DD, ps < .05; however, neither baseline values nor changes were significantly associated with weight change and there were no significant associations between the interactions of PFS and GNG or DD and weight change, ps>.05.

Conclusion

Results demonstrated an association between food reward sensitivity and weight. Further, decreases in both food reward sensitivity and impulsivity were observed during an initial weight loss program, but neither baseline levels nor improvements were associated with weight change. Taken together, results suggest that the constructs of food reward sensitivity, impulsivity, and reinforcement pathology may have limited clinical utility within behavioral weight management interventions. Future intervention studies should examine whether food-related impulsivity tasks lead to a similar pattern of results.

Development and preliminary testing of a technology-enhanced intervention to improve energy intake regulation in children

Interventions designed to improve children's self-regulation of energy intake have yielded mixed results. We tested the efficacy of a technology-enhanced intervention designed to teach children to eat in response to internal hunger and fullness cues. Thirty-two children (mean age 4.9 ± 0.8 y) completed this within-subjects, pre-post design study that took place across 10 laboratory sessions, each scheduled approximately 1 week apart. The intervention was conducted across weeks 4-7 in small groups focused on teaching children how food travels through the body and how to respond to hunger and fullness signals. Children's short-term energy compensation, a measure of intake regulation, was collected at baseline and follow-up using a preloading protocol. Twenty-five minutes prior to receiving a standardized test meal, children consumed a low-energy (3 kcal) or high-energy (150 kcal) preload beverage, presented in random order at baseline and follow-up. Knowledge of intervention concepts was also assessed at baseline and follow-up. Linear mixed models were used to examine changes in short-term energy compensation and knowledge from baseline to follow-up. Knowledge related to the intervention improved from baseline to follow-up (3.5 ± 0.3 to 7.0 ± 0.3 correct responses out of a possible 10; P < 0.001). Children's energy compensation also improved from baseline to follow-up, as evidenced by a time-by-preload condition interaction (P = 0.02). However, this improvement was driven by boys who increased the adjustment for beverage energy content from baseline to follow-up (P = 0.04). Girls showed no change in energy compensation with the intervention (P = 0.58). The overall increase in knowledge, paired with the improvement in energy compensation in boys, suggests that this technology-enhanced intervention may be efficacious for some children. Further research is needed to determine whether boys and girls will benefit from different, personalized intervention strategies for obesity prevention.

The accelerator, the brake, and the terrain: associations of reward-related eating, self-regulation, and the home food environment with diet quality during pregnancy and postpartum in the pregnancy eating attributes study (PEAS) cohort

Background

Neurobehavioral factors, including reward-related eating and self-regulation, in conjunction with the food environment, may influence dietary behaviors. However, these constructs have not been examined in pregnancy and postpartum, a time of changing appetite and eating behaviors, and when dietary intake has implications for maternal and child health. This study examined associations of reward-related eating, self-regulation, and the home food environment with pregnancy and postpartum diet quality.

Methods

Participants in the Pregnancy Eating Attributes Study observational cohort were enrolled at ≤12 weeks gestation and followed through one-year postpartum. Pregnancy and postpartum Healthy Eating Index-2015 (HEI-total), and adequacy and moderation scores, respectively, were calculated by pooling 24-h diet recalls administered each trimester and during 2, 6, and 12 months postpartum. Participants completed four measures of reward-related eating – Modified Yale Food Addiction Scale (mYFAS), Power of Food Scale (PFS), Multiple Choice Procedure (MCP), and Reinforcing Value of Food Questionnaire (RVFQ); two measures of self-regulation – Barratt Impulsiveness Scale (BIS) and Delay of Gratification Inventory (DGI); and a Home Food Inventory (HFI), yielding obesogenic (OBES) and fruit/vegetables (FV) scores. Linear regression analyses estimated associations of reward-related eating, self-regulation, and home food environment with diet quality during pregnancy and postpartum, adjusting for sociodemographic characteristics.

Results

Pregnancy HEI-total was inversely associated with PFS (β = − 0.14 ± 0.05, p = 0.009), mYFAS(β = − 0.14 ± 0.06, p = 0.02), 2 of the 5 RVFQ indices, MCP (β = − 0.14 ± 0.05, p = 0.01), and DGI food subscale (β = 0.23 ± 0.05, p < 0.001), but associations of postpartum HEI-total with reward-related eating measures and self-regulation were small and not statistically significant. Pregnancy and postpartum HEI-total were associated inversely with HFI-OBES (β = − 0.17 ± 0.06, p = 0.004 and β = − 0.19 ± 0.07, p = 0.006, respectively), and positively with HFI-FV (β = 0.21 ± 0.05, p < 0.001 and β = 0.17 ± 0.06, p = 0.009, respectively).

Conclusions

Associations of poorer diet quality with greater reward-related eating during pregnancy but not postpartum suggests the need to better understand differences in the determinants of eating behaviors and approaches to circumvent or moderate reward-related eating to facilitate more optimal diet quality across this critical period.

Trial registration

Clinicaltrials.gov. URL – Registration ID – NCT02217462. Date of registration – August 13, 2014.

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.

Adipose Tissue Development and Expansion from the Womb to Adolescence: An Overview

Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity expansion are also discussed. The greatest fetal increases in AT were observed in the third pregnancy trimester, with growing evidence suggesting that maternal health and nutrition, toxin exposure, and genetic defects impact AT development. From birth up to six months, healthy term newborns experience steep increases in AT; but a subsequent reduction in AT is observed during infancy. Important determinants of AT in infancy identified in this review included feeding practices and factors shaping the gut microbiome. Low AT accrual rates are maintained up to puberty onset, at which time, the pattern of adiposity expansion becomes sex dependent. As girls experience rapid increases and boys experience decreases in AT, sexual dimorphism in hormone secretion can be considered the main contributor for changes. Eating patterns/behaviors and interactions between dietary components, gut microbiome, and immune cells also influence AT expansion. Despite the plasticity of this tissue, substantial evidence supports that adiposity at birth and infancy highly influences its levels across subsequent life stages. Thus, a unique window of opportunity for the prevention and/or slowing down of the predisposition toward obesity, exists from pregnancy through childhood.

Impulsivity and midlife cardiometabolic risk: The role of maladaptive health behaviors

OBJECTIVE

The present study evaluated distinct facets of impulsivity related to cardiometabolic risk (CMR) to identify specific behavioral mechanisms driving these relationships.

METHOD

Community adults (N = 1,295) between 30 and 54 years old (53% female, 84% White) completed a battery of impulsivity measures, reported their engagement in health behaviors over the past week (i.e., cigarette smoking, alcohol use, physical activity, and dietary intake), and were assessed for CMR factors (i.e., blood pressure, insulin resistance, adiposity, and blood lipids). Structural equation modeling was used to estimate previously established hierarchical models of distinct facets of impulsivity and CMR. Indirect effects through the observed health behaviors were examined for each association between the latent impulsivity factors identified and the latent CMR factor.

RESULTS

Neuroticism/negative emotionality was the only latent impulsivity factor directly related to heightened CMR (β = 0.09, 95% confidence interval [CI] [0.01, 0.16], p = .020). Extraversion/positive emotionality indirectly related to lower CMR through greater physical activity (β = -0.04, 95% CI [-0.06, -0.02], p < .001), and measures of inhibition (β = 0.02, 95% CI [0.001, 0.04], p = .045) and delay discounting (β = 0.08, 95% CI [0.001, 0.15], p = .049) indirectly related to CMR through saturated fat intake.

CONCLUSIONS

These findings indicate that distinct facets of impulsivity differentially relate to CMR through varied behavioral pathways and identify physical activity and saturated fat intake as being particularly important health behaviors to target when tailoring treatment approaches to the unique behavioral characteristics of individuals high on certain facets of impulsivity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Using confidence interval-based estimation of relevance to explore bottom-up and top-down determinants of problematic eating behavior in children and adolescents with obesity from a dual pathway perspective

Prevalence of overweight and obesity in children and adolescents is high, not only in Western countries but also in developing countries. Efforts to improve prevention and treatment programs are needed. Given their essential role in weight problems, knowledge of determinants of problematic eating behavior ('External Eating' and 'Emotional Eating') is crucial for intervention development. Inspired by Appelhans' Dual Process Theory of Eating Behavior, the present study evaluated the importance of top-down regulative capacities and bottom-up reactivity, using the CIBER approach. CIBER is an innovative statistical approach to test the importance of behavior determinants, based on confidence intervals, instead of significance testing of point estimates. Survey data on different aspects of executive functioning (as indices of regulative capacities: Inhibition, Cognitive Flexibility, Emotional Control, Initiation, Working Memory, Planning/Organizing, Organization of materials, and Monitoring) and reward sensitivity (as an index of reactivity) were collected in a large sample of children and adolescents (n = 572) with severe obesity (adjBMI > 180%). Results showed that Emotional Eating is determined by Emotional Control, while External Eating is determined by Reward Sensitivity. The finding that differential mechanisms underlie different aspects of problematic eating suggests the need for using tailored intervention techniques to address altered reactivity and weak regulative capacities.

Implicit food odour priming effects on reactivity and inhibitory control towards foods

The food environment can interact with cognitive processing and influence eating behaviour. Our objective was to characterize the impact of implicit olfactory priming on inhibitory control towards food, in groups with different weight status. Ninety-one adults completed a modified Affective Shifting Task: they had to detect target stimuli and ignore distractor stimuli while being primed with non-attentively perceived odours. We measured reactivity and inhibitory control towards food pictures. Priming effects were observed on reactivity: participants with overweight and obesity were slower when primed with pear and pound cake odour respectively. Common inhibitory control patterns toward foods were observed between groups. We suggest that non-attentively perceived food cues influence bottom-up processing by activating distinguished mental representations according to weight status. Also, our data show that cognitive load influences inhibitory control toward foods. Those results contribute to understanding how the environment can influence eating behaviour in individuals with obesity.

A Mobile Health Intervention System for Women With Coronary Heart Disease: Usability Study

Background

Coronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care.

Objective

The ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants.

Methods

Using a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment.

Results

All 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04).

Conclusions

The mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.

Behavioral and physiological characteristics associated with learning performance on an appetitive probabilistic selection task

Individuals show meaningful variability in food choices. Choices are affected by individual differences in sensitivity to food reward and punishment, so understanding correlates of response to food reinforcement can help characterize food choices. Here, we examined behavioral and physiological correlates of individual differences in how individuals learn from food reward and punishment, as measured by performance on an appetitive probabilistic selection task that used sweet and bitter tastes as reinforcement. Sensitivity to food reward, sensitivity to food punishment, and overall learning performance were measured in 89 adults. Multivariate linear regressions were used to test if variables including body mass index (BMI), external eating, emotional eating, behavioral inhibition/behavioral activation scales (BIS/BAS), and perceived sensitivity to reward and punishment (SPQ/SRQ) were associated with measures of learning performance. External eating (β=-.035, p=.019), BIS (β=-.066, p=.004), and SPQ (β=.003, p=.023) were associated with overall learning performance. BMI (β=-.000, p=.012), emotional eating (β=.055, p=.006), and external eating (β=-.062, p=.004) were associated with sensitivity to food reward. No variables were associated with sensitivity to food punishment. In post hoc analyses, the interaction of sex and SPQ was associated with overall performance (β=-.005, p=.025), such that the relationship was positive in women only (β=.006, p=0.002). Results support that, controlling for key individual characteristics, BMI and susceptibility to food cues are associated with lower sensitivity to food reward, which may affect future food choices and eating behavior.