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Edited by Elliot T. Berkman, University of Oregon, Eugene, OR, and accepted by Editorial Board Member Michael S. Gazzaniga February 25, 2018 (received for review October 9, 2017)
Significance
Despite public health interventions, most individuals in the United States are overweight or obese. Here, we provide evidence for a mechanism-based technique to improve food choices in an “obesogenic” environment filled with temptation. Across two studies, we demonstrate that cognitive strategies decrease craving for unhealthy foods, increase craving for healthy foods, and modulate subjective valuation. Importantly, across four additional studies we show that brief training in such cognitive strategies increases subsequent healthy food choices in the presence of unhealthy alternatives, without explicit instructions to use the strategies, and across individual differences in weight. Furthermore, this training significantly reduces food consumption. Thus, training in cognitive strategies might ultimately advance clinical treatment and public health interventions aiming to prevent and reduce obesity.
Abstract
Obesity rates continue to rise alarmingly, with dire health implications. One contributing factor is that individuals frequently forgo healthy foods in favor of inexpensive, high-calorie, unhealthy foods. One important mechanism underlying these choices is food craving: Craving increases with exposure to unhealthy foods (and food cues, such as advertisements) and prospectively predicts eating and weight. Prior work has shown that cognitive regulation strategies that emphasize the negative consequences of unhealthy foods reduce craving. In Studies 1 and 2, we show that cognitive strategies also increase craving for healthy foods by emphasizing their positive benefits, and change food valuation (willingness to pay) for both healthy and unhealthy foods. In Studies 3 and 4, we demonstrate that brief training in cognitive strategies (“Regulation of Craving Training”; ROC-T) increases subsequent healthy (vs. unhealthy) food choices. This was striking because this change in food choices generalized to nontrained items. Importantly, in Study 5, we show that brief training in cognitive strategies also reduces food consumption by 93–121 calories. Consumed calories correlated with changes in food choice. Finally, in Study 6, we show that the training component of ROC-T is necessary, above and beyond any effect of framing. Across all studies (NTOTAL = 1,528), we find that cognitive strategies substantially change craving and food valuation, and that training in cognitive strategies improves food choices by 5.4–11.2% and reduces unhealthy eating, including in obese individuals. Thus, these findings have important theoretical, public health, and clinical implications for obesity prevention and treatment.
Footnotes
↵1R.G.B. and W.S. contributed equally to this work.
- ↵2To whom correspondence should be addressed. Email: hedy.kober{at}yale.edu.
Author contributions: R.G.B. and H.K. designed the studies; R.G.B. and W.S. collected the data; W.S., S.S., and H.K. analyzed the data; and R.G.B., W.S., S.S., and H.K. wrote the paper.
The authors declare no conflict of interest.
This article is a PNAS Direct Submission. E.T.B. is a guest editor invited by the Editorial Board.
Data deposition: The hypotheses and analysis plan for Study 5 are available through Open Science Framework (https://osf.io/qfhe4). The data reported in this paper have been deposited in Open Science Framework (https://osf.io/5fytx/).
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1717092115/-/DCSupplemental.
Published under the PNAS license.
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Training in cognitive strategies reduces eating and improves food choice
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