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Weinert T, King JA, Böldt L, Gronow F, Roessner V, Ehrlich S. Increased self-reported delay of gratification in acutely underweight, but not remitted anorexia nervosa. Int J Eat Disord 2022; 55:135-140. [PMID: 34799878 DOI: 10.1002/eat.23644] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/15/2021] [Accepted: 11/07/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Laboratory experiments using delay discounting tasks have delivered some evidence of an increased capacity to delay reward in anorexia nervosa (AN). Overall, however, findings have been inconclusive and no comprehensive studies of self-reported tendency to forgo immediate gratification in favor of long-term rewards exist in AN. METHOD A total of 71 acutely underweight female inpatients with AN (acAN); 52 women long-term weight-recovered from AN (recAN); and 120 healthy control women completed the Delaying Gratification Inventory (DGI). Fifty-two acAN were reassessed after short-term weight rehabilitation. Separate cross-sectional and longitudinal group comparisons tested for differences in DGI subscales (food, physical pleasure, social interaction, money, and achievement) and total scores. RESULTS DGI scores were elevated in acAN even after removing food-related items and accounting for comorbid symptoms. DGI scores remained relatively elevated following short-term weight rehabilitation, but no differences were evident between recAN and HC. DISCUSSION This study delivers self-report evidence supporting the notion of an increased propensity to delay gratification in individuals acutely ill with AN which does not appear to change with partial weight restoration alone. A reduction in the tendency to delay reward may thus be an important cognitive correlate of long-term recovery in AN.
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Affiliation(s)
- Tomas Weinert
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Joseph A King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Luisa Böldt
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Gronow
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, TU Dresden, Dresden, Germany.,Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry and Psychotherapy, Faculty of Medicine, TU Dresden, Dresden, Germany
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2
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Bickel WK, Freitas-Lemos R, Tomlinson DC, Craft WH, Keith DR, Athamneh LN, Basso JC, Epstein LH. Temporal discounting as a candidate behavioral marker of obesity. Neurosci Biobehav Rev 2021; 129:307-329. [PMID: 34358579 DOI: 10.1016/j.neubiorev.2021.07.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 11/30/2022]
Abstract
Although obesity is a result of processes operating at multiple levels, most forms result from decision-making behavior. The aim of this review was to examine the candidacy of temporal discounting (TD) (i.e. the reduction in the value of a reinforcer as a function of the delay to its receipt) as a behavioral marker of obesity. For this purpose, we assessed whether TD has the ability to: identify risk for obesity development, diagnose obesity, track obesity progression, predict treatment prognosis/outcomes, and measure treatment effectiveness. Three databases (Pubmed, PsycINFO, and Web of Science) were searched using a combination of terms related to TD and obesity. A total of 153 papers were reviewed. Several areas show strong evidence of TD's predictive utility as a behavioral marker of obesity (e.g., distinguishing obese from non obese). However, other areas have limited and/or mixed evidence (e.g., predicting weight change). Given the positive relationship for TD in the majority of domains examined, further consideration for TD as a behavioral marker of obesity is warranted.
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Affiliation(s)
- Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA.
| | | | - Devin C Tomlinson
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, USA
| | - William H Craft
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, USA
| | - Diana R Keith
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Liqa N Athamneh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Julia C Basso
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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3
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Veillard ML, Vincent BT. Temporal discounting does not influence body mass index. Physiol Behav 2020; 221:112893. [PMID: 32277987 DOI: 10.1016/j.physbeh.2020.112893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/14/2020] [Accepted: 03/23/2020] [Indexed: 12/30/2022]
Abstract
The prevalence of obesity has driven searches for cognitive or behavioural economic factors related to Body Mass Index (BMI). One candidate is delay discounting: those who prefer smaller sooner rewards over larger but later rewards are hypothesised to have higher BMI. The findings in the literature are mixed however, with meta analyses suggesting only a very small correlation between discounting and BMI. Here we present novel empirical data (N=381) and Bayesian analyses which suggest no such relationship between discounting of either monetary or weight loss rewards and BMI. We also find evidence against our novel proposal that discounting moderates the rate of BMI gain over time. We also present our data in the context of a random effects Bayesian meta-analytical result which does suggest the presence of a small correlation overall. The strength of the correlation is so weak (2.25% shared variance) that its practical significance may be minor to non existent. However because we found decisive evidence for unaccounted for study-level variance, due to study heterogeneity, we argue that we should treat such meta-analytic correlations with extreme caution. While the relationship between discounting and health outcomes such as BMI remain theoretically appealing, our empirical and meta-analytic results suggest we should be cautious in inferring a correlational, let alone a causal, role for discounting processes in driving BMI or moderating BMI gain with age.
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Affiliation(s)
- Megan L Veillard
- Discipline of Psychology, School of Social Science, University of Dundee, Scotland, UK
| | - Benjamin T Vincent
- Discipline of Psychology, School of Social Science, University of Dundee, Scotland, UK.
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4
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Hunter RF, Gough A, Murray JM, Tang J, Brennan SF, Chrzanowski-Smith OJ, Carlin A, Patterson C, Longo A, Hutchinson G, Prior L, Tully MA, French DP, Adams J, McIntosh E, Xin Y, Kee F. A loyalty scheme to encourage physical activity in office workers: a cluster RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background
Increasing physical activity in the workplace can provide physical and mental health benefits for employees and economic benefits for the employer through reduced absenteeism and increased productivity. However, there is limited evidence on effective behaviour change interventions in workplace settings that led to maintained physical activity. This study aimed to address this gap and contribute to the evidence base for effective and cost-effective workplace interventions.
Objectives
To determine the effectiveness and cost-effectiveness of the Physical Activity Loyalty scheme, a multicomponent intervention based on concepts similar to those that underpin a high-street loyalty card, which was aimed at encouraging habitual physical activity behaviour and maintaining increases in mean number of steps per day.
Design
A cluster randomised controlled trial with an embedded economic evaluation, behavioural economic experiments, mediation analyses and process evaluation.
Setting
Office-based employees from public sector organisations in Belfast and Lisburn city centres in Northern Ireland.
Participants
A total of 853 participants [mean age 43.6 years (standard deviation 9.6 years); 71% of participants were female] were randomly allocated by cluster to either the intervention group or the (waiting list) control group.
Intervention
The 6-month intervention consisted of financial incentives (retail vouchers), feedback and other evidence-based behaviour change techniques. Sensors situated in the vicinity of the workplaces allowed participants to monitor their accumulated minutes of physical activity.
Main outcome measures
The primary outcome was mean number of steps per day recorded using a sealed pedometer (Yamax Digiwalker CW-701; Yamax, Tasley, UK) worn on the waist for 7 consecutive days and at 6 and 12 months post intervention. Secondary outcomes included health, mental well-being, quality of life, work absenteeism and presenteeism, and the use of health-care resources.
Results
The mean number of steps per day were significantly lower for the intervention group than the control group [6990 mean number of steps per day (standard deviation 3078) vs. 7576 mean number of steps per day (standard deviation 3345), respectively], with an adjusted mean difference of –336 steps (95% confidence interval –612 to –60 steps; p = 0.02) at 6 months post baseline, but not significantly lower at 12 months post baseline. There was a small but significant enhancement of mental well-being in the intervention group (difference between groups for the Warwick–Edinburgh Mental Wellbeing Scale of 1.34 points, 95% confidence interval 0.48 to 2.20 points), but not for the other secondary outcomes. An economic evaluation suggested that, overall, the scheme was not cost-effective compared with no intervention. The intervention was £25.85 (95% confidence interval –£29.89 to £81.60) more costly per participant than no intervention and had no effect on quality-adjusted life-years (incremental quality-adjusted life-years –0.0000891, 95% confidence interval –0.008 to 0.008).
Limitations
Significant restructuring of participating organisations during the study resulted in lower than anticipated recruitment and retention rates. Technical issues affected intervention fidelity.
Conclusions
Overall, assignment to the intervention group resulted in a small but significant decline in the mean pedometer-measured steps per day at 6 months relative to baseline, compared with the waiting list control group. The Physical Activity Loyalty scheme was deemed not to be cost-effective compared with no intervention, primarily because no additional quality-adjusted life-years were gained through the intervention. Research to better understand the mechanisms of physical activity behaviour change maintenance will help the design of future interventions.
Trial registration
Current Controlled Trials ISRCTN17975376.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ruth F Hunter
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Aisling Gough
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jennifer M Murray
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jianjun Tang
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Sarah F Brennan
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | | | | | - Chris Patterson
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Alberto Longo
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - George Hutchinson
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - Lindsay Prior
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - David P French
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Yiqiao Xin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frank Kee
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
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5
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Hunter RF, Tang J, Hutchinson G, Chilton S, Holmes D, Kee F. Association between time preference, present-bias and physical activity: implications for designing behavior change interventions. BMC Public Health 2018; 18:1388. [PMID: 30567532 PMCID: PMC6300013 DOI: 10.1186/s12889-018-6305-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 12/05/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The decision to initiate or maintain a healthy habit, such as physical activity involves a trade-off between a short-term cost, such as time and effort, which are commonly identified as barriers to physical activity, and a long-term health benefit. Research suggests that individual time preference may be associated with unhealthy behaviors. However, empirical evidence of this for physical activity is scant. This study investigated the relationship between time preference and physical activity, and how this might influence behavior change. METHODS Employees (n = 176; mean age 42.2 years) who participated in a physical activity intervention were invited to take part in a behavioral economic field experiment. Two economic experiments, using multiple price lists and monetary trade-off tables involving real money choices, were conducted face-to-face with participants to measure the two components of time preference, namely present-bias and discount rate. Together with individual risk preferences, these three variables were jointly estimated by maximum likelihood. These three parameters were expressed as a linear function of the levels of physical activity while controlling for socio-demographic variables within the same maximum likelihood framework. RESULTS Those who were present-biased and who had higher discount rates did significantly less physical activity than their patient and non present-biased counterparts. A 3% lower discount rate and 1.14 unit decrement in the present-bias parameter was associated with a 30 min increase of physical activity per week. This negative association was more significant for certain sub-groups, such as younger and married adults and those with higher staff grade and those who have children. Participants who dropped out of the study earlier were more present-biased. CONCLUSIONS Results demonstrated that discount rate and present-biasedness have a significant impact on physical activity levels. Such concepts have been largely overlooked and underutilized in physical activity interventions. Promising implications include 1) utilizing individuals' time preferences to better target interventions; 2) taking account of time preferences in the intervention design; 3) interventions attempting to correct for present-biasedness.
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Affiliation(s)
- Ruth F. Hunter
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Institute of Clinical Science B, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland BT12 6BJ UK
| | - Jianjun Tang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, 100872 China
| | - George Hutchinson
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Institute of Clinical Science B, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland BT12 6BJ UK
- Gibson Institute for Land, Food and Environment, School of Biological Sciences, Queen’s University Belfast, Belfast, Northern Ireland UK
- Institute of Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast, Northern Ireland UK
| | - Susan Chilton
- Business School—Economics, Newcastle University, Newcastle, England UK
| | - David Holmes
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Institute of Clinical Science B, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland BT12 6BJ UK
- Gibson Institute for Land, Food and Environment, School of Biological Sciences, Queen’s University Belfast, Belfast, Northern Ireland UK
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Institute of Clinical Science B, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland BT12 6BJ UK
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6
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Chamberlain SR, A Redden S, Grant JE. Calorie Intake and Gambling: Is Fat and Sugar Consumption 'Impulsive'? J Gambl Stud 2018; 33:783-793. [PMID: 27766464 DOI: 10.1007/s10899-016-9647-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Excessive calorie intake constitutes a global public health concern, due to its associated range of untoward outcomes. Gambling is commonplace and gambling disorder is now considered a behavioral addiction in DSM-5. The relationships between calorie intake, gambling, and other types of putatively addictive and impulsive behaviors have received virtually no research attention. Two-hundred twenty-five young adults who gamble were recruited from two Mid-Western university communities in the United States using media advertisements. Dietary intake over the preceding year was quantified using the Dietary Fat and Free Sugar Short questionnaire (DFS). Clinician rating scales, questionnaires, and cognitive tests germane to impulsivity were completed. Relationships between dietary fat/sugar intake and gambling behaviors, as well as other measures of psychopathology and cognition germane to addiction, were evaluated using correlational analyses controlling for multiple comparisons. Greater dietary fat and sugar intake were associated with lower educational levels and with male gender. Controlling for these variables, higher dietary fat and sugar intake were correlated significantly with worse gambling pathology and anxiety scores. Dietary sugar intake was also significantly associated with higher depressive scores, more alcohol intake, lower self-esteem, and with greater risk of having one or more mental disorders in general. Dietary intake did not correlate significantly with ADHD symptoms, presence of one or more impulse control disorders, Barratt impulsiveness, or cognitive functioning. These data suggest a particularly strong relationship between fat/sugar intake and symptoms of gambling pathology, but not most other forms of impulsivity and behavioral addiction (excepting alcohol intake). Providing education about healthy diet may be especially valuable in gamblers and in community settings where gambling advertisements feature prominently. Future work should explore the mediating mechanisms between calorie intake and gambling symptoms, such as whether this could be driven by environmental factors (e.g. advertising) or common dysfunction of brain reward pathways.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
| | - Sarah A Redden
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 3077, Chicago, IL, 60637, USA
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 3077, Chicago, IL, 60637, USA.
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7
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Sutin AR, Boutelle K, Czajkowski SM, Epel ES, Green PA, Hunter CM, Rice EL, Williams DM, Young-Hyman D, Rothman AJ. Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Psychosocial Domain. Obesity (Silver Spring) 2018; 26 Suppl 2:S45-S54. [PMID: 29575781 PMCID: PMC7055940 DOI: 10.1002/oby.22160] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/02/2018] [Accepted: 02/12/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Within the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, the psychosocial domain addresses how psychosocial processes underlie the influence of obesity treatment strategies on weight loss and weight maintenance. The subgroup for the psychosocial domain identified an initial list of high-priority constructs and measures that ranged from relatively stable characteristics about the person (cognitive function, personality) to dynamic characteristics that may change over time (motivation, affect). OBJECTIVES This paper describes (a) how the psychosocial domain fits into the broader model of weight loss and weight maintenance as conceptualized by ADOPT; (b) the guiding principles used to select constructs and measures for recommendation; (c) the high-priority constructs recommended for inclusion; (d) domain-specific issues for advancing the science; and (e) recommendations for future research. SIGNIFICANCE The inclusion of similar measures across trials will help to better identify how psychosocial factors mediate and moderate the weight loss and weight maintenance process, facilitate research into dynamic interactions with factors in the other ADOPT domains, and ultimately improve the design and delivery of effective interventions.
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Affiliation(s)
- Angelina R Sutin
- Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Kerri Boutelle
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
| | - Susan M Czajkowski
- National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Elissa S Epel
- Department of Psychiatry, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Paige A Green
- National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Elise L Rice
- National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - David M Williams
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
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8
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Sze YY, Slaven EM, Bickel WK, Epstein LH. Delay discounting and utility for money or weight loss. Obes Sci Pract 2017; 3:69-74. [PMID: 28392932 PMCID: PMC5358072 DOI: 10.1002/osp4.72] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 11/05/2022] Open
Abstract
Objective Obesity is related to a bias towards smaller immediate over larger delayed rewards. This bias is typically examined by studying single commodity discounting. However, weight loss often involves choices among multiple commodities. To our knowledge, no research has examined delay discounting of delayed weight loss compared with other commodities. Methods We examined single commodity discounting of money and cross commodity discounting of money and weight loss in a sample of 84 adults with obesity or overweight statuses interested in weight loss. The exchange rate between money and weight loss was calculated, and participants completed two delay discounting tasks: money now versus money later and money now versus weight loss later. Results Participants discounted weight loss more than money (p < 0.001). When participants were divided into those who preferred weight loss (n = 61) versus money (n = 23), those who preferred money over weight loss discounted weight loss even more than individuals that preferred weight loss (p = 0.003). Conclusions Greater discounting of weight loss for those who preferred money suggest that idiosyncratic preferences are related to multiple commodity discounting, and greater discounting of weight loss across all participants provide insight on important challenges for weight control.
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Affiliation(s)
- Y Y Sze
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA
| | - E M Slaven
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA
| | - W K Bickel
- Virginia Tech Carilion Research Institute Roanoke VA USA
| | - L H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA
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9
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Barlow P, Reeves A, McKee M, Galea G, Stuckler D. Unhealthy diets, obesity and time discounting: a systematic literature review and network analysis. Obes Rev 2016; 17:810-9. [PMID: 27256685 PMCID: PMC4988386 DOI: 10.1111/obr.12431] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 04/26/2016] [Accepted: 04/26/2016] [Indexed: 01/26/2023]
Abstract
There is an increasing policy commitment to address the avoidable burdens of unhealthy diet, overweight and obesity. However, to design effective policies, it is important to understand why people make unhealthy dietary choices. Research from behavioural economics suggests a critical role for time discounting, which describes how people's value of a reward, such as better health, decreases with delay to its receipt. We systematically reviewed the literature on the relationship of time discounting with unhealthy diets, overweight and obesity in Web of Science and PubMed. We identified 41 studies that met our inclusion criteria as they examined the association between time discount rates and (i) unhealthy food consumption; (ii) overweight and (iii) response to dietary and weight loss interventions. Nineteen out of 25 cross-sectional studies found time discount rates positively associated with overweight, obesity and unhealthy diets. Experimental studies indicated that lower time discounting was associated with greater weight loss. Findings varied by how time discount rates were measured; stronger results were observed for food than monetary-based measurements. Network co-citation analysis revealed a concentration of research in nutrition journals. Overall, there is moderate evidence that high time discounting is a significant risk factor for unhealthy diets, overweight and obesity and may serve as an important target for intervention. © 2016 The Authors Obesity Reviews published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity (IASO).
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Affiliation(s)
- Pepita Barlow
- Department of Sociology, University of Oxford, Oxford, UK
| | - Aaron Reeves
- International Inequalities Institute, London School of Economics, London, UK
| | - Martin McKee
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Gauden Galea
- Division of Noncommunicable Diseases and Life-course, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - David Stuckler
- Department of Sociology, University of Oxford, Oxford, UK
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10
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Amlung M, Petker T, Jackson J, Balodis I, MacKillop J. Steep discounting of delayed monetary and food rewards in obesity: a meta-analysis. Psychol Med 2016; 46:2423-2434. [PMID: 27299672 DOI: 10.1017/s0033291716000866] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND An increasing number of studies have investigated delay discounting (DD) in relation to obesity, but with mixed findings. This meta-analysis synthesized the literature on the relationship between monetary and food DD and obesity, with three objectives: (1) to characterize the relationship between DD and obesity in both case-control comparisons and continuous designs; (2) to examine potential moderators, including case-control v. continuous design, money v. food rewards, sample sex distribution, and sample age (18 years); and (3) to evaluate publication bias. METHOD From 134 candidate articles, 39 independent investigations yielded 29 case-control and 30 continuous comparisons (total n = 10 278). Random-effects meta-analysis was conducted using Cohen's d as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger tests, meta-regression of publication year and effect size, and imputation of missing studies. RESULTS The primary analysis revealed a medium effect size across studies that was highly statistically significant (d = 0.43, p < 10-14). None of the moderators examined yielded statistically significant differences, although notably larger effect sizes were found for studies with case-control designs, food rewards and child/adolescent samples. Limited evidence of publication bias was present, although the Begg-Mazumdar test and meta-regression suggested a slightly diminishing effect size over time. CONCLUSIONS Steep DD of food and money appears to be a robust feature of obesity that is relatively consistent across the DD assessment methodologies and study designs examined. These findings are discussed in the context of research on DD in drug addiction, the neural bases of DD in obesity, and potential clinical applications.
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Affiliation(s)
- M Amlung
- Peter Boris Centre for Addictions Research,McMaster University/St. Joseph's Healthcare Hamilton,Hamilton,Ontario,Canada
| | - T Petker
- Peter Boris Centre for Addictions Research,McMaster University/St. Joseph's Healthcare Hamilton,Hamilton,Ontario,Canada
| | - J Jackson
- Peter Boris Centre for Addictions Research,McMaster University/St. Joseph's Healthcare Hamilton,Hamilton,Ontario,Canada
| | - I Balodis
- Peter Boris Centre for Addictions Research,McMaster University/St. Joseph's Healthcare Hamilton,Hamilton,Ontario,Canada
| | - J MacKillop
- Peter Boris Centre for Addictions Research,McMaster University/St. Joseph's Healthcare Hamilton,Hamilton,Ontario,Canada
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Healthy eating decisions require efficient dietary self-control in children: A mouse-tracking food decision study. Appetite 2016; 105:575-81. [PMID: 27349708 DOI: 10.1016/j.appet.2016.06.027] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/08/2016] [Accepted: 06/22/2016] [Indexed: 12/15/2022]
Abstract
Learning how to make healthy eating decisions, (i.e., resisting unhealthy foods and consuming healthy foods), enhances physical development and reduces health risks in children. Although healthy eating decisions are known to be challenging for children, the mechanisms of children's food choice processes are not fully understood. The present study recorded mouse movement trajectories while eighteen children aged 8-13 years were choosing between eating and rejecting foods. Children were inclined to choose to eat rather than to reject foods, and preferred unhealthy foods over healthy foods, implying that rejecting unhealthy foods could be a demanding choice. When children rejected unhealthy foods, mouse trajectories were characterized by large curvature toward an eating choice in the beginning, late decision shifting time toward a rejecting choice, and slowed response times. These results suggested that children exercised greater cognitive efforts with longer decision times to resist unhealthy foods, providing evidence that children require dietary self-control to make healthy eating-decisions by resisting the temptation of unhealthy foods. Developmentally, older children attempted to exercise greater cognitive efforts for consuming healthy foods than younger children, suggesting that development of dietary self-control contributes to healthy eating-decisions. The study also documents that healthy weight children with higher BMIs were more likely to choose to reject healthy foods. Overall, findings have important implications for how children make healthy eating choices and the role of dietary self-control in eating decisions.
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