Dietary Motivation and Hedonic Hunger Predict Palatable Food Consumption: An Intensive Longitudinal Study of Adolescents

The relationship between hedonic hunger and self-stigmatisation in terms of weight and self-esteem in adult people living with obesity

INTRODUCTION

This study aimed to determine the factors influencing the hedonic hunger status of overweight adults and to examine the relationship between hedonic hunger, self-stigmatisation and self-esteem in terms of weight.

METHODS

This cross-sectional study was conducted with 353 people living with obesity who applied to the Endocrine and Internal Medicine Clinic in Samsun, Turkey, between June and October 2022. The data were collected using the Personal Information Form, Power of Food Scale (PFS), Weight Self-Stigmatisation Questionnaire (WSSQ) and Self-Liking/Self-Competence Scale (SLSC) through face-to-face survey method.

RESULTS

About 53.3% of the participants were ≥45 years old, 80.5% were married and 69.1% had previously followed weight loss diet. It was found that those who were aged <45 years, single, those who perceived themselves as overweight, those who had used weight loss diets before and those whose waist-hip ratio were normal had higher hedonic hunger scores (p < 0.05). A negative and significant correlation was found between PSF-Tr general dimension scores and SLSC general dimension, whereas a significant and positive correlation was observed between PSF-Tr general dimension scores and WSSQ general dimension (p < 0.05).

CONCLUSION

As hedonic hunger increased in adults with overweight, self-esteem decreased, and self-stigmatisation in terms of weight increased. Effective interventions are needed to cope with the hedonic hunger that contributes to obesity and to prevent the stigma and low self-esteem experienced by people living with obesity because of their excess weight.

Disentangling between-person and within-person associations of physical symptoms of depression with self-perceived health and life satisfaction: A longitudinal study in Chilean adults

Depression is a major health problem in Chile. Evidence suggests that physical symptoms of depression (PSD) negatively impact self-perceived health and life satisfaction. The aim of this study was to determine the between-person and within-person associations of PSD with self-perceived health and life satisfaction in Chilean adults. The sample consisted of 1424 participants (64.54% female; Mage = 46.77, SD = 14.88) with data in five waves of the Social Longitudinal Study of Chile. Variables were measured through self-report questionnaires. Hypotheses were tested using multilevel analysis. At the within-person level, physical slowing, fatigue, and sleep problems were associated with poorer self-perceived health and lower life satisfaction. At the between-person level, physical slowing and fatigue were associated with poorer perceived health and lower life satisfaction. PSD are associated with self-perceived health and life satisfaction in Chilean adults longitudinally. The study highlights the importance of monitoring PSD changes in Chilean adults.

Psychosocial correlates in patterns of adolescent emotional eating and dietary consumption

Unhealthy eating behaviors, such as consumption of unhealthy diet and emotional eating, are common in adolescence and tend to co-occur. However, how these behaviors are patterned may vary among adolescents. This study identified patterns of dietary consumption and emotional eating behaviors in adolescents and examined the sociodemographic and psychosocial (e.g., self-efficacy beliefs and motivation) covariates associated with these eating patterns. Data were from the Family Life, Activity, Sun, Health and Eating study. Latent class analysis was used to estimate adolescent dietary patterns from dietary consumption (i.e., fruits, vegetables, sugar-sweetened beverages, junk food, etc.) and emotional eating variables (i.e., eating when feeling sad or anxious). The sample included 1,568 adolescents (Mean age = 14.48-years-old, 49% girls, 55% White). A four-class solution best fit the data (e.g., Bayesian Information Criteria [BIC] = 12263.568, three-class model BIC = 12271.622). Four unhealthy eating behavior patterns were identified: poor diet/high emotional eating, mixed diet/high emotional eating, poor diet/low emotional eating, and mixed diet/low emotional eating. Compared to the poor diet/high emotional eating group, the other groups were less likely to include older adolescents, girls, and adolescents who experienced food insecurity, and more likely to have higher self-efficacy for eating fruits and vegetables and limiting junk foods as well as motivation for consuming fruits and vegetables and limiting junk foods. Our findings highlight adolescents' complex dietary patterns that include dietary consumption and emotional eating behaviors. Future studies should examine other potential dietary patterns that include emotional eating. Efforts to address unhealthy patterns of adolescents' dietary consumption and emotional eating behaviors should be expanded.

Hedonic Appetite, Affect, and Loss of Control Eating: Macrotemporal and Microtemporal Associations in Adolescents

OBJECTIVE

Loss of control eating (LOC) is a dysregulated eating behavior relevant to eating disorders and weight-related health concerns. Hedonic appetite and affect (positive/negative) are dynamic microtemporal processes that influence LOC, but they have been studied predominantly in a static, macrotemporal manner. The present study examined associations of hedonic appetite and positive/negative affect, on macrotemporal and microtemporal levels, with LOC in adolescents.

METHODS

Adolescent participants 13-18 years old (n = 43; Mage = 15.1, SD  = 1.6; 69.8% female) completed smartphone surveys for 6 evenings, assessing LOC, hedonic appetite, and positive/negative affect. Scores on items were calculated to create microtemporal and macrotemporal assessments of these constructs. Multilevel models were run to examine associations between hedonic appetite and positive/negative affect with LOC.

RESULTS

Both macrotemporal and microtemporal hedonic appetite were significantly positively related to LOC (β = .73, p < .001; β = .47, p < .001, respectively). Macrotemporal positive affect was significantly negatively associated with LOC (β = -.09, p < .001). Macrotemporal negative affect was significantly positively associated with LOC (β = .13, p < .001). No significant relationships emerged between microtemporal positive/negative affect and LOC.

CONCLUSIONS

Hedonic appetite appears to be associated with LOC on both microtemporal and macrotemporal levels, suggesting that both momentary fluctuations and having higher hedonic appetite than others can be risk factors for LOC. However, affect appears to be associated with LOC only at the macrotemporal level. Findings may inform theoretical work and clinical and research assessment strategies.

Temporal discounting modifies the effect of microtemporal hedonic hunger on food consumption: An ecological momentary assessment study

INTRODUCTION

Steeper delay discounting, or preference for small rewards sooner versus larger rewards later, has been linked to disinhibited eating and obesity. The overconsumption of food may also be motivated by hedonic hunger, or the drive to consume foods for pleasure rather than energy need. The present study hypothesized that hedonic hunger would modify the relation between temporal discounting and palatable food consumption.

METHODS

Seventeen adolescents between the ages of 13-18 (M = 15.12,SD = 1.80) completed a temporal discounting measure at baseline followed by daily ecological momentary assessments of food intake (e.g., self-reported servings of sweet, starchy, fatty, fast foods) and hedonic hunger for 20 days on a mobile phone. Multilevel models examined between-person (BP) and within-person (WP) hedonic hunger, monetary temporal discounting, and their interactions, on food consumption.

RESULTS

The models for sweet, starchy, and fast food consumption had significant interactions between WP hedonic hunger and temporal discounting. For each of these interactions, those with average-or-lower temporal discounting rates were at less risk of consuming sweet, starchy, and fast foods when hedonic hunger was higher than typical while those with high rates of discounting were at higher risk of consuming these types of foods when hedonic hunger was elevated.

CONCLUSION

Increases in daily hedonic hunger may confer risk for sweet, starchy, and fast food consumption. However, preference for larger rewards later may serve as a protective factor against consumption of these palatable foods. Future studies should further investigate this and other reward-driven processes that may influence food consumption.

Obesogenic eating behaviour and dietary intake in German children and adolescents: results from the GINIplus and LISA birth cohort studies

BACKGROUND/OBJECTIVES

The transition to adolescence is characterised by considerable behavioural changes, including diet. This study describes the level of obesogenic eating behaviours in 10- and 15-year-olds, and their association with dietary intake.

SUBJECTS/METHODS

Participants of the 10- and 15-year follow-ups of the German GINIplus and LISA birth cohort studies were included (N₁₀ = 2257; N₁₅ = 1880). Eating behaviours and dietary intake were assessed via self-report questionnaires. Sex-stratified, cross-sectional associations of "external eating", "emotional eating" and "dietary restraint" (the latter at age 15 years only) with dietary intake (17 food groups-categorised into tertiles, macronutrients, and total energy) were assessed using multinomial logistic or multiple linear regression as required, adjusting for covariates and correcting for multiple testing.

RESULTS

Reported levels of eating behaviours were low in both age-groups. External eating was higher in 10-year-old males than females, while all eating behaviours were most pronounced in 15-year-old females. At 10 years, emotional eating was associated with medium vegetable intake in females (Relative Risk Ratio (RRR) = 1.84, p = 0.0017). At 15 years, external eating was associated with total energy (kJ) in females (β = 718, p = 0.0002) and high butter intake in males (RRR = 1.96, p = 0.0019). Dietary restraint in females was inversely associated with total energy (β = -967, p < 0.0001) and omega-3 fatty acids (Means Ratio (MR) = 0.94, p = 0.0017), and positively associated with high fruit (RRR = 2.20, p = 0.0003) and whole grains (RRR = 1.94, p = 0.0013).

CONCLUSION

Obesogenic eating behaviour scores are low among children and adolescents of a predominantly high socioeconomic status population and present only few associations with specific aspects of diet, mainly among adolescent females.

Dual Burden of Malnutrition Among Adolescents With Hunger Aged 12-15 Years in 41 Countries: Findings From the Global School-Based Student Health Survey

Background: Hunger is a pandemic among adolescents, resulting in both underweight and obesity, and posing a substantial health challenge.

Objective: To estimate the dual burden of malnutrition among adolescents with hunger.

Design: Data were from the Global school-based Student Health Survey (GSHS). In total, data from 26,986 adolescents with hunger across 5 regions and 41 countries between 2010 and 2015 were analyzed in this study. Weighted prevalence and mean estimates of underweight, overweight, and obesity were calculated by gender, age, and country. Prevalence and 95% confidence intervals (CI) were calculated for regional and country-level income.

Results: The total prevalence of underweight, overweight and obesity among young adolescents with hunger was 6.2% (95% CI: 4.4–8.0%), 25.1% (95% CI: 20.3–29.9%) and 8.9% (95% CI: 6.5–11.3%), respectively. Southeast Asia had the highest prevalence of underweight (17.2%; 95% CI: 7.3–27.0%). America had the highest regional prevalence of obesity (11.1%; 95% CI: 7.2–15.1%) and overweight (28.9%; 95% CI: 21.9–35.9%). Low income countries had relatively high prevalence of underweight (11.5%; 95% CI: 3.2–19.9%). High income countries had the highest prevalence of obesity (17.4%; 95% CI: 14.9–19.9%) and overweight (38.7%; 95% CI: 32.0–45.4%). The co-existence of underweight and overweight among adolescents with hunger was highest in the Eastern Mediterranean region, and in upper-middle and high-income countries.

Conclusions: There is a dual burden of underweight and obesity among adolescents with hunger aged 12–15 years, which differs between geographical regions. The integration of targeted interventions and policies is required to simultaneously address both underweight and increasing rates of obesity among adolescents with hunger in different regions.

The Use of Food Images and Crowdsourcing to Capture Real-time Eating Behaviors: Acceptability and Usability Study

Background

As poor diet quality is a significant risk factor for multiple noncommunicable diseases prevalent in the United States, it is important that methods be developed to accurately capture eating behavior data. There is growing interest in the use of ecological momentary assessments to collect data on health behaviors and their predictors on a micro timescale (at different points within or across days); however, documenting eating behaviors remains a challenge.

Objective

This pilot study (N=48) aims to examine the feasibility—usability and acceptability—of using smartphone-captured and crowdsource-labeled images to document eating behaviors in real time.

Methods

Participants completed the Block Fat/Sugar/Fruit/Vegetable Screener to provide a measure of their typical eating behavior, then took pictures of their meals and snacks and answered brief survey questions for 7 consecutive days using a commercially available smartphone app. Participant acceptability was determined through a questionnaire regarding their experiences administered at the end of the study. The images of meals and snacks were uploaded to Amazon Mechanical Turk (MTurk), a crowdsourcing distributed human intelligence platform, where 2 Workers assigned a count of food categories to the images (fruits, vegetables, salty snacks, and sweet snacks). The agreement among MTurk Workers was assessed, and weekly food counts were calculated and compared with the Screener responses.

Results

Participants reported little difficulty in uploading photographs and remembered to take photographs most of the time. Crowdsource-labeled images (n=1014) showed moderate agreement between the MTurk Worker responses for vegetables (688/1014, 67.85%) and high agreement for all other food categories (871/1014, 85.89% for fruits; 847/1014, 83.53% for salty snacks, and 833/1014, 81.15% for sweet snacks). There were no significant differences in weekly food consumption between the food images and the Block Screener, suggesting that this approach may measure typical eating behaviors as accurately as traditional methods, with lesser burden on participants.

Conclusions

Our approach offers a potentially time-efficient and cost-effective strategy for capturing eating events in real time.

Hedonic hunger: eating for desire and not calories

Hedonic hunger can be described as a state where an individualexperiences recurrent feelings, thoughts, and desires about foodin the absence of energy deprivation. Living in an obesogenicenvironment where cheap, tasty foods are available in plentifulamounts is one of the major causes of hedonic hunger development.Hedonic hunger can be analyzed using a power of foodscale (PFS) which estimates appetite and not palatable food consumption.The current epidemic of obesity globally (termed as“globesity” by WHO) is seen to be majorly driven by the hedoniceating system and an imbalance in the energy homeostasis system.Previous studies indicate that hedonic hunger and obesityare associated, and a weak but no significant correlation existsbetween BMI and PFS score. It can lead to the development ofvarious lifestyle disorders in the longer run. High levels of pleasure-driven hunger can even lead to detrimental health outcomeslike poor glycaemic control, unhealthy dietary behavior,and increased lipid profile levels which are aggravated explicitlyin cardiovascular diseases. With the adaptation to western dietarylifestyle, people are keener to opt for food options that canbe damaging and harmful when low levels of self-control, dietarymotivation, and healthy dietary habits are absent. Apart from thereward regulation system, which has a direct effect on hedonichunger, certain external factors like emotional eating, meals andmeal preparation, food cravings, sleep, physical activity, stress,social media, portion size, peer influence, an atmosphere of arestaurant can also promote more than required intake of food.This review article summarizes the above findings taking into accountthe plethora of research studies conducted so far.

Associations between hedonic hunger and BMI during a two-year behavioural weight loss trial

Objective

Prospective studies on relationships between hedonic hunger and BMI (Body Mass Index) during weight management are lacking. This study examined if hedonic hunger reduced during a behavioural weight management programme, and if hedonic hunger predicted future BMI.

Methods

Participants were 594 community-dwelling, UK-based adults(396 female; age 56.43 years, s.d. = 12.50, range 20–83 years); 490 participants (82.5%) had obesity. Participants were randomised to a 12- or 52-week behavioural weight management intervention (WW12 or WW52, respectively) or a brief self-help intervention (BI). Relationships between hedonic hunger and BMI over 24 months (baseline, 3, 12, 24 months) were analysed using an autoregressive cross-lagged model.

Results

Hedonic hunger scores decreased from 2.71 (s.d. = .91) at baseline to 2.41 (s.d. = .88) at 3 months (p < .001, CI .22 to .38), remained reduced to 24 months, and were not affected by intervention arm at any time point (p’s>.05). Baseline hedonic hunger scores predicted 3-month scores (B = .76, SE = .03, p < .001, CI .71 to .82), 3-month scores predicted 12-month scores (B = .76, SE = .03, p < .001 CI .72 to .80), and 12-month scores predicted 24-month scores (B = .72, SE = .03, p < .001, CI .64 to .77). Higher hedonic hunger at 3 months predicted higher BMI at 12 months (B = .04, SE = .02, p = .03, CI .01 to .07) but not at 24 months (p>.05). BMI at 12 months was lower in WW52 30.87kg/m², s.d. = 5.02) than WW12 (32.12 kg/m², s.d. = 5.58, p = .02, CI .16 to 2.34) and BI (32.74 kg/m², s.d. = 4.15, p = .01, CI .30 to 3.45). BMI was not affected by intervention at any other time point (p’s>.05).

Conclusion

Hedonic hunger reduced during weight management irrespective of intervention. Early reductions in hedonic hunger appear to be associated with lower BMI in the medium-term. Identifying ways to reduce hedonic hunger during weight loss could aid weight management for some people.

Contribution of Hedonic Hunger and Binge Eating to Childhood Obesity

Background: Studies examining the association between hedonic hunger, that is, having frequent thoughts about food in the absence of an energy deficit, and obesity in youth show mixed results. This may be due to the confounding effect of binge eating, which has been associated with both hedonic hunger and obesity. The purpose of this study was to determine the extent to which hedonic hunger is associated with obesity independent of binge eating in youth. Methods: Data for this cross-sectional study were collected from youth enrolled in a larger study of cardiovascular disease and obesity. Linear regression models were used to assess the association between hedonic hunger measured by Power of Food Scale (PFS) and binge eating measured by Eating Disorder Examination-Questionnaire, on percent of the 95th BMI percentile (BMIp95). Results: Among 269 participants (mean age 12.8 years), 16.4% endorsed binge eating. PFS was positively associated with BMIp95 with a difference in percent of BMIp95 of 5.9% [95% confidence interval (1.5-10.3), p = 0.009]. However, when binge eating was added to the model, the relationship between PFS and BMIp95 was no longer significant. Conclusion: Hedonic hunger, above and beyond binge eating, may not be associated with BMI. Future research should examine whether screening for and targeting binge eating rather than hedonic hunger in weight management care may have more impact on obesity outcomes. Clinical Trial Registration number: NCT01508598.

Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity

The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated a need for further understanding of these weight-loss motivators in the context of SDT. The current study findings highlight the importance of addressing motivational factors and family influences in research and practice related to promoting healthy dietary habits and weight management strategies among adolescents with obesity.

Dutch Preadolescents' Food Consumption at School: Influence of Autonomy, Competence and Parenting Practices

Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents' eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents' food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents' food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents' perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents' healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents' healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.

Longitudinal Prospective Association between Hedonic Hunger and Unhealthy Food and Drink Intake in Adolescents

Hedonic hunger (i.e., extreme responsiveness to food) has been associated with obesity and poor diet, but findings in the existing literature have primarily been cross-sectional. The current study examined hedonic hunger as a prospective predictor of the longitudinal trajectory of unhealthy food and drink intake across adolescence. Ninth grade students from Los Angeles area high schools (analyzed sample N = 3268) completed paper-and-pencil surveys across four annual waves; hedonic hunger was assessed at Wave 1, and unhealthy food and drink intake was assessed at Waves 1-4. Multilevel models showed a significant main effect of hedonic hunger and interactions between hedonic hunger and the linear and quadratic components of time. The association between hedonic hunger and unhealthy food and drink intake was strongest at Wave 1 and weakened over time, yet those with higher hedonic hunger reported greater unhealthy food and drink intake across the four years. Efforts to prevent and intervene upon hedonic hunger and its association with unhealthy food and drink intake during childhood and adolescence are warranted.

The Power of Food: Self-control moderates the association of hedonic hunger with overeating, snacking frequency and palatable food intake

The purpose of the study was to explore whether self-control moderates the associations between hedonic hunger and overeating frequency, snacking frequency and palatable food intake. Data from the first wave of the Swiss Food Panel 2.0 study was analyzed (N = 4774), from the German- and French-speaking part of Switzerland (52% men). Measures included hedonic hunger assessed with the Power of Food Scale (PFS), the short form Self-Control Scale, overeating frequency, snacking frequency, intake of high-fat salty snack foods, and intake of high-sugar foods assessed with a semiquantitative food frequency questionnaire. Higher scores on the PFS and lower self-control capacities were correlated with higher intakes of both high-fat salty snack foods and high-sugar foods (referred to here as palatable foods), higher overeating frequency and higher snacking frequency. Four separate moderation analyses revealed that the positive associations of hedonic hunger with overeating frequency, snacking frequency and palatable food intake were significantly attenuated by self-control. Results of the present study indicate that people who are highly sensitive to the ready availability of palatable foods but also have high levels of self-control exhibit less frequent overeating and snacking, including less frequent intake of unhealthy palatable foods, than those low in self-control. Consequently, self-control may prevent overeating and thus may serve as a protective factor that decreases the risk of becoming overweight in individuals who are highly sensitive to the food environment.

Ecological momentary assessment of eating and dietary intake behaviors in children and adolescents: A systematic review of the literature

The objective of this review was to summarize associations between ecological momentary assessment (EMA)-measured contextual factors and eating and dietary intake behaviors in children and adolescents. The inclusion criteria were availability of the study in English and use of EMA to study eating and dietary intake behaviors among children and/or adolescents (ages<18). Literature searches were conducted in PsycInfo and PubMed databases across all dates until December 2018. A modified Checklist for Reporting EMA Studies was used to assess quality of studies. Eighteen articles from 15 independent studies were included in the systematic review. Contextual factors examined in relation to children's eating in studies included affect and stress; cognitive factors; social and environment factors; behavioral factors; and caregiver-related factors. Studies suggested there is strong evidence that cognitive and social factors have an effect on eating and dietary intake behaviors while the association between affect and eating and dietary intake behaviors remains mixed. Future studies should consider timing of effects, measure choice, individual difference and contextual factors, and developmental context.

Uncontrolled eating: a unifying heritable trait linked with obesity, overeating, personality and the brain

Many eating-related psychological constructs have been proposed to explain obesity and overeating. However, these constructs, including food addiction, disinhibition, hedonic hunger, emotional eating, binge eating and the like all have similar definitions, emphasizing loss of control over intake. As questionnaires measuring the constructs correlate strongly (r > 0.5) with each other, we propose that these constructs should be reconsidered to be part of a single broad phenotype: uncontrolled eating. Such an approach enables reviewing and meta-analysing evidence obtained with each individual questionnaire. Here, we describe robust associations between uncontrolled eating, body mass index (BMI), food intake, personality traits and brain systems. Reviewing cross-sectional and longitudinal data, we show that uncontrolled eating is phenotypically and genetically intertwined with BMI and food intake. We also review evidence on how three psychological constructs are linked with uncontrolled eating: lower cognitive control, higher negative affect and a curvilinear association with reward sensitivity. Uncontrolled eating mediates all three constructs' associations with BMI and food intake. Finally, we review and meta-analyse brain systems possibly subserving uncontrolled eating: namely, (i) the dopamine mesolimbic circuit associated with reward sensitivity, (ii) frontal cognitive networks sustaining dietary self-control and (iii) the hypothalamus-pituitary-adrenal axis, amygdala and hippocampus supporting stress reactivity. While there are limits to the explanatory and predictive power of the uncontrolled eating phenotype, we conclude that treating different eating-related constructs as a single concept, uncontrolled eating, enables drawing robust conclusions on the relationship between food intake and BMI, psychological variables and brain structure and function.