Overhanging skin in postbariatric patients leads to a negative body image. In patients with obesi... more Overhanging skin in postbariatric patients leads to a negative body image. In patients with obesity, negative body image is related to more depressive symptoms and a higher weight. This relationship might also be important in postbariatric patients, because improvement of body image via body contouring surgery (BCS) could lead to better weight loss results. To evaluate the relationship between body image, depressive symptoms, and weight loss in a postbariatric population, focusing on desire for BCS. Outpatient clinic. One thousand twenty-four primary bariatric surgery patients were contacted, and 590 patients agreed to participate and filled in online questionnaires regarding body image (Body Shape Questionnaire and Multidimensional Body-Self Relations Questionnaire-Appearance Scales) and depression (Beck Depression Inventory-II). Differences between patients who had BCS, patients who desired BCS, and patients who did not desire BCS were studied. The mediating role of body image in the association between percentage total weight loss and depressive symptoms was assessed via a 2-mediator model. There was a desire for BCS in 368 patients (62.4%); these patients had significantly lower scores on appearance evaluation and body image satisfaction scales and showed more depressive symptoms. Patients without a desire (n = 157, 26.6%) had lowest rates of depressive symptoms and a more positive body image. Sixty-five patients (11.0%) had undergone BCS. In the patients who desired BCS, percentage total weight loss was negatively affected by depressive symptoms via appearance evaluation and body-area satisfaction. There are striking differences regarding body image satisfaction and depressive symptoms when comparing postbariatric patients and without desire for BCS. Body image satisfaction is associated with less depressive symptoms in all postbariatric patients. In patients who desired BCS, body image is one of the mediators of the relationship between percentage total weight loss and depressive symptoms. Therefore, body image should be taken seriously and be part of outcome assessment in postbariatric patients.
Background Insufficient weight loss and weight regain is seen in 20-30% of the post-bariatric pop... more Background Insufficient weight loss and weight regain is seen in 20-30% of the post-bariatric population. More knowledge about the effect of physical activity and eating style on weight change after Roux-en-Y gastric bypass is essential since behaviour can be modified and thereby results improved. The goal of this study is to determine the relationship between weight change, selfreported physical activity and eating style. Methods Weight, physical activity (PA) and eating style (ES) were assessed before surgery and 15, 24, 36 and 48 months after surgery. A linear mixed model was performed to assess the association between the change in PA and ES and percentage total weight loss (% TWL). Results There were 4569 patients included. Preoperative PA and ES were not related to weight change. Change in PA was positively associated with % TWL at 15, 36 and 48 months follow-up. Change in emotional eating was negatively related to % TWL at all follow-up moments. Change in external eating was only negatively related to weight loss at 24 months follow-up. Change in restrained eating was negatively associated with weight loss up to 36 months follow-up. More restrained eating at 36 months follow-up was related to higher weight regain, and more emotional eating at 48 months to 48-month weight regain. Conclusion Preoperative self-reported PA and ES did not predict weight change after RYGB. Being are more physically active and showing less emotional and restrained eating was related to a higher weight loss. Emotional and restrained eating were related to higher weight regain.
In eating research, it is common practice to group people into different eater types, such as emo... more In eating research, it is common practice to group people into different eater types, such as emotional, external and restrained eaters. This categorization is generally based on scores on self-report questionnaires. However, recent studies have started to raise questions about the validity of such questionnaires. In the realm of emotional eating, a considerable number of studies, both in the lab and in naturalistic settings, fail to demonstrate increased food intake in emotional situations in self-described emotional eaters. The current paper provides a review of experimental and naturalistic studies investigating the relationships between self-reported emotional eater status, mood, and food consumption. It is concluded that emotional eating scales lack predictive and discriminative validity; they cannot be assumed to measure accurately what they intend to measure, namely increased food intake in response to negative emotions. The review is followed by a discussion of alternative i...
Obesity and depression have important health implications. Although there is knowledge about the ... more Obesity and depression have important health implications. Although there is knowledge about the moderators of the depression-obesity association, our understanding of the potential behavioral and cognitive mediators that may explain the relationship between depression and obesity, is scarcely researched. The aim of this study is to investigate the mediating role of emotional eating and dichotomous thinking in the depression-obesity relationship. Data on 205 individuals from a community-based study conducted at Maastricht University, Netherlands were used. Self-reported data on depression, emotional eating and dichotomous thinking were collected and BMI scores were calculated in a cross-sectional research design. Correlations between variables were calculated. The primary analysis tested the hypothesis that depression has an effect on BMI through dichotomous thinking and emotional eating. A two-mediator model was used to predict the direct and indirect effects of emotional eating an...
Working Memory (WM) plays a crucial role in successful self-regulation of behavior, including wei... more Working Memory (WM) plays a crucial role in successful self-regulation of behavior, including weight regulation. Improving WM might therefore be a promising strategy to support weight loss. In the present study, overweight individuals with a desire to lose weight (N = 91) received an online lifestyle intervention, in conjunction with either 25 sessions of gamified WM training (experimental condition) or a sham training (control). Primary outcomes were Body Mass Index (BMI) and food intake at posttest. Secondary outcomes were executive functioning, self-control, eating style, eating psychopathology and healthy eating. Data were analyzed with mixed regression analyses with condition as between-subjects factor (experimental versus control) and time as within-subjects factor (baseline, posttest, FU1 after one month and FU2 after six months). Results revealed that the experimental condition increased their WM span more than control from pretest to posttest, and these gains were retained ...
Human laboratory studies have shown that eating desires are easily learned through classical cond... more Human laboratory studies have shown that eating desires are easily learned through classical conditioning: after a few pairings of an initially neutral stimulus (e.g., a box) with the intake of palatable food (e.g., chocolate), the stimulus elicits increased eating expectancies and eating desires (acquisition). After repeated non-reinforced presentations of the chocolate-associated stimulus, eating expectancies and desires decrease again (extinction). It is commonly assumed that eating desires in daily life are acquired and extinguished in a similar manner, but to date, this has not been empirically tested. In two studies, we examined whether the repeated consumption of chocolate at a specific time of day elicits increased eating expectancies and eating desires over a period of 5 days (study 1) or 15 days (study 2), and relative to a time of day not paired with chocolate intake. Further, it was tested whether acquired responding diminishes again during extinction (study 1). Ecologic...
In experimental studies that investigate reactivity to the sight and smell of highly palatable sn... more In experimental studies that investigate reactivity to the sight and smell of highly palatable snack foods, ad libitum food intake is commonly used as a behavioural outcome measure. However, this measure has several drawbacks. The current study investigated two intake-related measures not yet validated for food cue exposure research involving common snack foods: prospective portion size and latency to eat. We aimed to validate these measures by assessing prospective portion size and eating latencies in female undergraduate students who either underwent snack food exposure or a control exposure. Furthermore, we correlated prospective portion size and latency to eat with commonly used measures of food cue reactivity, i.e., self-reported desire to eat, salivation, and ad libitum food intake. Results showed increases in prospective portion size after food cue exposure but not after control exposure. Latency to eat did not differ between the two conditions. Prospective portion size corre...
International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 2017
Studies on human appetitive conditioning using food rewards can benefit from including psychophys... more Studies on human appetitive conditioning using food rewards can benefit from including psychophysiological outcome measures. The present study tested whether the skin conductance response can function as a measure of differential responding in an appetitive conditioning paradigm including an acquisition and extinction phase, and examined which time window during a trial is most sensitive to conditioning effects. As a secondary aim, the effects of ambiguous vs. non-ambiguous contingency instructions on conditioned responses (skin conductance responses, US expectancies, chocolate desires, and CS evaluations) were assessed. Results indicated differential skin conductance responses in an anticipatory time window and during unexpected omission of the US in early extinction. Interestingly however, anticipatory responses were only found for participants who received ambiguous contingency instructions - possibly indicating a call for additional processing resources in response to the ambigu...
In this study, it was examined whether overweight is associated with food-related obsessions and ... more In this study, it was examined whether overweight is associated with food-related obsessions and compulsions. Participants with a healthy weight ( n = 27) and participants who were overweight ( n = 33) filled out the Yale-Brown-Cornell Eating Disorder Scale, the Eating Obsessive-Compulsive Scale, and the Emotional and Behavioral Reactions to Intrusions Questionnaire to assess frequency, distress, control, and reactance associated with food-related preoccupations and compulsions. Overweight participants showed increased food-related preoccupations, compulsive eating, and heightened emotional and behavioral reactance compared to participants with a healthy weight. Increased food-related obsessive-compulsiveness was also associated with unhealthy eating patterns.
Background: Knowledge is limited on the role the ability to self-regulate plays in the long-term ... more Background: Knowledge is limited on the role the ability to self-regulate plays in the long-term outcome of obesity treatment in children and adolescents with severe obesity. The purpose of this study was to determine whether the ability to self-regulate after an one year intensive, partly inpatient, combined lifestyle intervention is associated with weight loss maintenance in children and adolescents with severe obesity. Methods: One hundred twenty participants (8-19 years) with an average SDS-BMI of 3.41 and their parents/caregivers were included in an intervention study. As primary determinant of weight loss maintenance, general self-regulation ability was evaluated using two behavioral computer tasks assessing inhibitory control and sensitivity to reward. Results: There was no association between inhibitory control at T12 and ΔSDS-BMI between T12 and T24 (β = 0. 0002; CI 95% = −0.0010-0.0014; P = 0.761). There was also no relation between sensitivity to reward at T12 and ΔSDS-BMI between T12 and T24 (β = −0.0028; CI 95% = −0.0075-0.0019; P = 0.244). None of the psychosocial factors that were examined as moderators, showed a statistically significant interaction, except for parental feeding style (P = 0.023). Conclusions: The ability to self-regulate after an intensive, partly inpatient, multidisciplinary one year intervention for severe obesity in children and adolescents was not associated with the ability to maintain the achieved weight loss during the following year. Factors that explain the large range of long term outcomes need to be elucidated. Trial registration: Netherlands Trial Register (NTR1678, registered 20-Feb-2009).
Restrained eaters eat more after exposure to food cues (e.g. Fedoroff et al., 1997), which fits w... more Restrained eaters eat more after exposure to food cues (e.g. Fedoroff et al., 1997), which fits with the predictions of the cuereactivity model (Jansen, 1998). However, Fishbach et al. (2003) reported that exposure to fattening foods can activate dieting goals. These results fit with the predictions of the counteractivecontrol model (Trope and Fishbach, 2000), which states that exposure to temptations activates higher-order goals. Attempting to consolidate these divergent findings, we hypothesized that the salience of the food cue could represent a critical factor. We predicted that focusing attention on salient food cues would result in increased intake (cue reactivity) in restrained eaters, whereas exposure to an incidental food cue would result in decreased intake (counteractive-control), relative to controls. We employed a 3 (attended, incidental, vs. control cue) × 2 (restrained vs. unrestrained eaters) design. As expected, restrained eaters who attended to a food cue ate more than did restrained and unrestrained eaters in the control condition and unrestrained eaters in the attended-cue condition; however, the intake of restrained eaters exposed to the incidental cue did not differ from restrained or unrestrained eaters in the control condition. It appears that the manner of food-cue presentation may be critical in determining eating behaviour-attending to direct food-related cues disinhibits restrained eaters, whereas the presence of incidental food cues in the environment apparently does not disinhibit the eating of restrained eaters (and may activate dieting goals).
Samenvatting Alhoewel de behandeling van eetstoornissen door middel van cue exposure nog in de k... more Samenvatting Alhoewel de behandeling van eetstoornissen door middel van cue exposure nog in de kinderschoenen staat, zijn de eerste gegevens uit klinisch experimenteel onderzoek veelbelovend. Enige tijd geleden presenteerden wij een protocol voor cue exposere bij patiënten met eetbuien. Als vervolg hierop zal in dit artikel per techniek worden ingegaan op een aantal struikelblokken en de mogelijke oplossingen.
Food cue reactivity is a strong motivation to eat, even in the absence of hunger. Therefore, food... more Food cue reactivity is a strong motivation to eat, even in the absence of hunger. Therefore, food cue reactivity might sabotage healthy eating, induce weight gain and impede weight loss or weight maintenance. Food cue reactivity can be learned via Pavlovian appetitive conditioning: It is easily acquired but the extinction of appetitive responding seems to be more challenging. Several properties of extinction make it fragile: extinction does not erase the original learning and extinction is context-dependent. These properties threaten full extinction and increase the risk of full relapse. Extinction procedures are discussed to reduce or prevent the occurrence of rapid reacquisition, spontaneous recovery, renewal and reinstatement after extinction. A translation to food cue exposure treatment is made and suggestions are provided, such as conducting the exposure in relevant contexts, using occasional reinforcement and targeting expectancy violation instead of habituation. A new hypothe...
Attention bias for food could be a cognitive pathway to overeating in obesity and restrained eati... more Attention bias for food could be a cognitive pathway to overeating in obesity and restrained eating. Yet, empirical evidence for individual differences (e.g., in restrained eating and body mass index) in attention bias for food is mixed. We tested experimentally if temporarily induced health versus palatability mindsets influenced attention bias for food, and whether restrained eating moderated this relation. After manipulating mindset (health vs. palatability) experimentally, food-related attention bias was measured by eye-movements (EM) and response latencies (RL) during a visual probe task depicting high-calorie food and non-food. Restrained eating was assessed afterwards. A significant interaction of mindset and restrained eating on RL bias emerged, β = 0.36, t(58) = 2.05, p = 0.045: A health mindset - as compared to a palatability mindset - attenuated attention bias for high-caloric food only in participants with higher eating restraint. No effects were observed on EM biases. T...
Working memory (WM) plays a critical role in cognitive control by shielding self-regulatory goals... more Working memory (WM) plays a critical role in cognitive control by shielding self-regulatory goals from distraction by desire-related thoughts and emotions. This study examined whether training WM increases self-regulation in overweight participants. It was hypothesized that WM training would decrease psychopathological eating-related thoughts, (over)consumption of food in response to emotions and external cues, food intake and body weight. Overweight participants (n = 50) performed 20-25 sessions of WM training or control/sham training. The dependent measures were self-reported eating-related psychopathology, self-reported emotional/external eating behavior, food intake during a bogus taste test, and body weight, assessed before training, immediately following training, and at one-month follow-up. Relative to control, WM training reduced psychopathological eating-related thoughts and emotional eating (but not external eating). These effects were still present at follow-up, one month...
The prevalence of overweight and obesity has increased substantially over the last decades. Weigh... more The prevalence of overweight and obesity has increased substantially over the last decades. Weight loss attempts in overweight individuals are common, though they seldom result in successful long-term weight loss. One very promising treatment is food cue exposure therapy, during which overweight individuals are repeatedly exposed to food-associated cues (e.g., the sight, smell and taste of high-calorie foods, overeating environments) without eating in order to extinguish cue-elicited appetitive responses to food cues. However, only few studies have tested the effectiveness of cue exposure, especially with regards to weight loss. For exposure treatment of anxiety disorders, it has been proposed that inhibitory learning is critical for exposure to be effective. In this RCT, we translated techniques proposed by Craske et al. (2014) to the appetitive domain and developed a novel cue exposure therapy for overeating aimed at maximizing inhibitory learning. The current RCT tested the effec...
Problematic alcohol use is common among university students and personality might account for ind... more Problematic alcohol use is common among university students and personality might account for individual differences in developing this maladaptive behavior. Two personality dispositions implicated in problematic alcohol use are negative urgency and neuroticism. However, the relationship of these traits to problematic alcohol use is unclear. In college students high neuroticism is not directly linked to problematic alcohol use. On the other hand, the experience of emotional distress in people high in neuroticism could impair the capacity for impulse control. Loss of impulse control under conditions of negative affect could trigger impulsive drinking and problematic alcohol use in the long run. We investigated this idea by testing whether negative urgency mediates the relationship of neuroticism to problematic alcohol use. Participants were 60 undergraduate university students who completed the Urgency subscale of the Urgency, (lack of) Premeditation, (lack of) Perseverance, Sensatio...
Overhanging skin in postbariatric patients leads to a negative body image. In patients with obesi... more Overhanging skin in postbariatric patients leads to a negative body image. In patients with obesity, negative body image is related to more depressive symptoms and a higher weight. This relationship might also be important in postbariatric patients, because improvement of body image via body contouring surgery (BCS) could lead to better weight loss results. To evaluate the relationship between body image, depressive symptoms, and weight loss in a postbariatric population, focusing on desire for BCS. Outpatient clinic. One thousand twenty-four primary bariatric surgery patients were contacted, and 590 patients agreed to participate and filled in online questionnaires regarding body image (Body Shape Questionnaire and Multidimensional Body-Self Relations Questionnaire-Appearance Scales) and depression (Beck Depression Inventory-II). Differences between patients who had BCS, patients who desired BCS, and patients who did not desire BCS were studied. The mediating role of body image in the association between percentage total weight loss and depressive symptoms was assessed via a 2-mediator model. There was a desire for BCS in 368 patients (62.4%); these patients had significantly lower scores on appearance evaluation and body image satisfaction scales and showed more depressive symptoms. Patients without a desire (n = 157, 26.6%) had lowest rates of depressive symptoms and a more positive body image. Sixty-five patients (11.0%) had undergone BCS. In the patients who desired BCS, percentage total weight loss was negatively affected by depressive symptoms via appearance evaluation and body-area satisfaction. There are striking differences regarding body image satisfaction and depressive symptoms when comparing postbariatric patients and without desire for BCS. Body image satisfaction is associated with less depressive symptoms in all postbariatric patients. In patients who desired BCS, body image is one of the mediators of the relationship between percentage total weight loss and depressive symptoms. Therefore, body image should be taken seriously and be part of outcome assessment in postbariatric patients.
Background Insufficient weight loss and weight regain is seen in 20-30% of the post-bariatric pop... more Background Insufficient weight loss and weight regain is seen in 20-30% of the post-bariatric population. More knowledge about the effect of physical activity and eating style on weight change after Roux-en-Y gastric bypass is essential since behaviour can be modified and thereby results improved. The goal of this study is to determine the relationship between weight change, selfreported physical activity and eating style. Methods Weight, physical activity (PA) and eating style (ES) were assessed before surgery and 15, 24, 36 and 48 months after surgery. A linear mixed model was performed to assess the association between the change in PA and ES and percentage total weight loss (% TWL). Results There were 4569 patients included. Preoperative PA and ES were not related to weight change. Change in PA was positively associated with % TWL at 15, 36 and 48 months follow-up. Change in emotional eating was negatively related to % TWL at all follow-up moments. Change in external eating was only negatively related to weight loss at 24 months follow-up. Change in restrained eating was negatively associated with weight loss up to 36 months follow-up. More restrained eating at 36 months follow-up was related to higher weight regain, and more emotional eating at 48 months to 48-month weight regain. Conclusion Preoperative self-reported PA and ES did not predict weight change after RYGB. Being are more physically active and showing less emotional and restrained eating was related to a higher weight loss. Emotional and restrained eating were related to higher weight regain.
In eating research, it is common practice to group people into different eater types, such as emo... more In eating research, it is common practice to group people into different eater types, such as emotional, external and restrained eaters. This categorization is generally based on scores on self-report questionnaires. However, recent studies have started to raise questions about the validity of such questionnaires. In the realm of emotional eating, a considerable number of studies, both in the lab and in naturalistic settings, fail to demonstrate increased food intake in emotional situations in self-described emotional eaters. The current paper provides a review of experimental and naturalistic studies investigating the relationships between self-reported emotional eater status, mood, and food consumption. It is concluded that emotional eating scales lack predictive and discriminative validity; they cannot be assumed to measure accurately what they intend to measure, namely increased food intake in response to negative emotions. The review is followed by a discussion of alternative i...
Obesity and depression have important health implications. Although there is knowledge about the ... more Obesity and depression have important health implications. Although there is knowledge about the moderators of the depression-obesity association, our understanding of the potential behavioral and cognitive mediators that may explain the relationship between depression and obesity, is scarcely researched. The aim of this study is to investigate the mediating role of emotional eating and dichotomous thinking in the depression-obesity relationship. Data on 205 individuals from a community-based study conducted at Maastricht University, Netherlands were used. Self-reported data on depression, emotional eating and dichotomous thinking were collected and BMI scores were calculated in a cross-sectional research design. Correlations between variables were calculated. The primary analysis tested the hypothesis that depression has an effect on BMI through dichotomous thinking and emotional eating. A two-mediator model was used to predict the direct and indirect effects of emotional eating an...
Working Memory (WM) plays a crucial role in successful self-regulation of behavior, including wei... more Working Memory (WM) plays a crucial role in successful self-regulation of behavior, including weight regulation. Improving WM might therefore be a promising strategy to support weight loss. In the present study, overweight individuals with a desire to lose weight (N = 91) received an online lifestyle intervention, in conjunction with either 25 sessions of gamified WM training (experimental condition) or a sham training (control). Primary outcomes were Body Mass Index (BMI) and food intake at posttest. Secondary outcomes were executive functioning, self-control, eating style, eating psychopathology and healthy eating. Data were analyzed with mixed regression analyses with condition as between-subjects factor (experimental versus control) and time as within-subjects factor (baseline, posttest, FU1 after one month and FU2 after six months). Results revealed that the experimental condition increased their WM span more than control from pretest to posttest, and these gains were retained ...
Human laboratory studies have shown that eating desires are easily learned through classical cond... more Human laboratory studies have shown that eating desires are easily learned through classical conditioning: after a few pairings of an initially neutral stimulus (e.g., a box) with the intake of palatable food (e.g., chocolate), the stimulus elicits increased eating expectancies and eating desires (acquisition). After repeated non-reinforced presentations of the chocolate-associated stimulus, eating expectancies and desires decrease again (extinction). It is commonly assumed that eating desires in daily life are acquired and extinguished in a similar manner, but to date, this has not been empirically tested. In two studies, we examined whether the repeated consumption of chocolate at a specific time of day elicits increased eating expectancies and eating desires over a period of 5 days (study 1) or 15 days (study 2), and relative to a time of day not paired with chocolate intake. Further, it was tested whether acquired responding diminishes again during extinction (study 1). Ecologic...
In experimental studies that investigate reactivity to the sight and smell of highly palatable sn... more In experimental studies that investigate reactivity to the sight and smell of highly palatable snack foods, ad libitum food intake is commonly used as a behavioural outcome measure. However, this measure has several drawbacks. The current study investigated two intake-related measures not yet validated for food cue exposure research involving common snack foods: prospective portion size and latency to eat. We aimed to validate these measures by assessing prospective portion size and eating latencies in female undergraduate students who either underwent snack food exposure or a control exposure. Furthermore, we correlated prospective portion size and latency to eat with commonly used measures of food cue reactivity, i.e., self-reported desire to eat, salivation, and ad libitum food intake. Results showed increases in prospective portion size after food cue exposure but not after control exposure. Latency to eat did not differ between the two conditions. Prospective portion size corre...
International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 2017
Studies on human appetitive conditioning using food rewards can benefit from including psychophys... more Studies on human appetitive conditioning using food rewards can benefit from including psychophysiological outcome measures. The present study tested whether the skin conductance response can function as a measure of differential responding in an appetitive conditioning paradigm including an acquisition and extinction phase, and examined which time window during a trial is most sensitive to conditioning effects. As a secondary aim, the effects of ambiguous vs. non-ambiguous contingency instructions on conditioned responses (skin conductance responses, US expectancies, chocolate desires, and CS evaluations) were assessed. Results indicated differential skin conductance responses in an anticipatory time window and during unexpected omission of the US in early extinction. Interestingly however, anticipatory responses were only found for participants who received ambiguous contingency instructions - possibly indicating a call for additional processing resources in response to the ambigu...
In this study, it was examined whether overweight is associated with food-related obsessions and ... more In this study, it was examined whether overweight is associated with food-related obsessions and compulsions. Participants with a healthy weight ( n = 27) and participants who were overweight ( n = 33) filled out the Yale-Brown-Cornell Eating Disorder Scale, the Eating Obsessive-Compulsive Scale, and the Emotional and Behavioral Reactions to Intrusions Questionnaire to assess frequency, distress, control, and reactance associated with food-related preoccupations and compulsions. Overweight participants showed increased food-related preoccupations, compulsive eating, and heightened emotional and behavioral reactance compared to participants with a healthy weight. Increased food-related obsessive-compulsiveness was also associated with unhealthy eating patterns.
Background: Knowledge is limited on the role the ability to self-regulate plays in the long-term ... more Background: Knowledge is limited on the role the ability to self-regulate plays in the long-term outcome of obesity treatment in children and adolescents with severe obesity. The purpose of this study was to determine whether the ability to self-regulate after an one year intensive, partly inpatient, combined lifestyle intervention is associated with weight loss maintenance in children and adolescents with severe obesity. Methods: One hundred twenty participants (8-19 years) with an average SDS-BMI of 3.41 and their parents/caregivers were included in an intervention study. As primary determinant of weight loss maintenance, general self-regulation ability was evaluated using two behavioral computer tasks assessing inhibitory control and sensitivity to reward. Results: There was no association between inhibitory control at T12 and ΔSDS-BMI between T12 and T24 (β = 0. 0002; CI 95% = −0.0010-0.0014; P = 0.761). There was also no relation between sensitivity to reward at T12 and ΔSDS-BMI between T12 and T24 (β = −0.0028; CI 95% = −0.0075-0.0019; P = 0.244). None of the psychosocial factors that were examined as moderators, showed a statistically significant interaction, except for parental feeding style (P = 0.023). Conclusions: The ability to self-regulate after an intensive, partly inpatient, multidisciplinary one year intervention for severe obesity in children and adolescents was not associated with the ability to maintain the achieved weight loss during the following year. Factors that explain the large range of long term outcomes need to be elucidated. Trial registration: Netherlands Trial Register (NTR1678, registered 20-Feb-2009).
Restrained eaters eat more after exposure to food cues (e.g. Fedoroff et al., 1997), which fits w... more Restrained eaters eat more after exposure to food cues (e.g. Fedoroff et al., 1997), which fits with the predictions of the cuereactivity model (Jansen, 1998). However, Fishbach et al. (2003) reported that exposure to fattening foods can activate dieting goals. These results fit with the predictions of the counteractivecontrol model (Trope and Fishbach, 2000), which states that exposure to temptations activates higher-order goals. Attempting to consolidate these divergent findings, we hypothesized that the salience of the food cue could represent a critical factor. We predicted that focusing attention on salient food cues would result in increased intake (cue reactivity) in restrained eaters, whereas exposure to an incidental food cue would result in decreased intake (counteractive-control), relative to controls. We employed a 3 (attended, incidental, vs. control cue) × 2 (restrained vs. unrestrained eaters) design. As expected, restrained eaters who attended to a food cue ate more than did restrained and unrestrained eaters in the control condition and unrestrained eaters in the attended-cue condition; however, the intake of restrained eaters exposed to the incidental cue did not differ from restrained or unrestrained eaters in the control condition. It appears that the manner of food-cue presentation may be critical in determining eating behaviour-attending to direct food-related cues disinhibits restrained eaters, whereas the presence of incidental food cues in the environment apparently does not disinhibit the eating of restrained eaters (and may activate dieting goals).
Samenvatting Alhoewel de behandeling van eetstoornissen door middel van cue exposure nog in de k... more Samenvatting Alhoewel de behandeling van eetstoornissen door middel van cue exposure nog in de kinderschoenen staat, zijn de eerste gegevens uit klinisch experimenteel onderzoek veelbelovend. Enige tijd geleden presenteerden wij een protocol voor cue exposere bij patiënten met eetbuien. Als vervolg hierop zal in dit artikel per techniek worden ingegaan op een aantal struikelblokken en de mogelijke oplossingen.
Food cue reactivity is a strong motivation to eat, even in the absence of hunger. Therefore, food... more Food cue reactivity is a strong motivation to eat, even in the absence of hunger. Therefore, food cue reactivity might sabotage healthy eating, induce weight gain and impede weight loss or weight maintenance. Food cue reactivity can be learned via Pavlovian appetitive conditioning: It is easily acquired but the extinction of appetitive responding seems to be more challenging. Several properties of extinction make it fragile: extinction does not erase the original learning and extinction is context-dependent. These properties threaten full extinction and increase the risk of full relapse. Extinction procedures are discussed to reduce or prevent the occurrence of rapid reacquisition, spontaneous recovery, renewal and reinstatement after extinction. A translation to food cue exposure treatment is made and suggestions are provided, such as conducting the exposure in relevant contexts, using occasional reinforcement and targeting expectancy violation instead of habituation. A new hypothe...
Attention bias for food could be a cognitive pathway to overeating in obesity and restrained eati... more Attention bias for food could be a cognitive pathway to overeating in obesity and restrained eating. Yet, empirical evidence for individual differences (e.g., in restrained eating and body mass index) in attention bias for food is mixed. We tested experimentally if temporarily induced health versus palatability mindsets influenced attention bias for food, and whether restrained eating moderated this relation. After manipulating mindset (health vs. palatability) experimentally, food-related attention bias was measured by eye-movements (EM) and response latencies (RL) during a visual probe task depicting high-calorie food and non-food. Restrained eating was assessed afterwards. A significant interaction of mindset and restrained eating on RL bias emerged, β = 0.36, t(58) = 2.05, p = 0.045: A health mindset - as compared to a palatability mindset - attenuated attention bias for high-caloric food only in participants with higher eating restraint. No effects were observed on EM biases. T...
Working memory (WM) plays a critical role in cognitive control by shielding self-regulatory goals... more Working memory (WM) plays a critical role in cognitive control by shielding self-regulatory goals from distraction by desire-related thoughts and emotions. This study examined whether training WM increases self-regulation in overweight participants. It was hypothesized that WM training would decrease psychopathological eating-related thoughts, (over)consumption of food in response to emotions and external cues, food intake and body weight. Overweight participants (n = 50) performed 20-25 sessions of WM training or control/sham training. The dependent measures were self-reported eating-related psychopathology, self-reported emotional/external eating behavior, food intake during a bogus taste test, and body weight, assessed before training, immediately following training, and at one-month follow-up. Relative to control, WM training reduced psychopathological eating-related thoughts and emotional eating (but not external eating). These effects were still present at follow-up, one month...
The prevalence of overweight and obesity has increased substantially over the last decades. Weigh... more The prevalence of overweight and obesity has increased substantially over the last decades. Weight loss attempts in overweight individuals are common, though they seldom result in successful long-term weight loss. One very promising treatment is food cue exposure therapy, during which overweight individuals are repeatedly exposed to food-associated cues (e.g., the sight, smell and taste of high-calorie foods, overeating environments) without eating in order to extinguish cue-elicited appetitive responses to food cues. However, only few studies have tested the effectiveness of cue exposure, especially with regards to weight loss. For exposure treatment of anxiety disorders, it has been proposed that inhibitory learning is critical for exposure to be effective. In this RCT, we translated techniques proposed by Craske et al. (2014) to the appetitive domain and developed a novel cue exposure therapy for overeating aimed at maximizing inhibitory learning. The current RCT tested the effec...
Problematic alcohol use is common among university students and personality might account for ind... more Problematic alcohol use is common among university students and personality might account for individual differences in developing this maladaptive behavior. Two personality dispositions implicated in problematic alcohol use are negative urgency and neuroticism. However, the relationship of these traits to problematic alcohol use is unclear. In college students high neuroticism is not directly linked to problematic alcohol use. On the other hand, the experience of emotional distress in people high in neuroticism could impair the capacity for impulse control. Loss of impulse control under conditions of negative affect could trigger impulsive drinking and problematic alcohol use in the long run. We investigated this idea by testing whether negative urgency mediates the relationship of neuroticism to problematic alcohol use. Participants were 60 undergraduate university students who completed the Urgency subscale of the Urgency, (lack of) Premeditation, (lack of) Perseverance, Sensatio...
Uploads
Papers by Anita Jansen