We are all familiar with the importance of calories in versus calories out on weight change. Eating an excess of calories, or more calories than we burn in a day, leads to weight gain over time, while eating in a caloric deficit will encourage weight loss. This seems straight forward enough, right? It fails to be that easy when it comes to the obesity epidemic, though and the underlying problems many have to address alongside their nutrition.

Obesity is considered to be a multifactorial issue, and for good reason. It has roots connected to economic, socioeconomic, environmental, cultural backgrounds and more – it isn’t isolated to solely food and exercise. Simply overeating over the holiday season or any short period of time (and subsequently gaining ~5-10 pounds from it) is vastly different from eating in a way that leads to obesity, or even morbid obesity, over a span of years. You cannot equate the two.

Sure, the resulting weight gain stems from eating more energy than our bodies are burning, but there are distinct eating behaviors at the root of this issue that are different from the average (assumingly healthy) person. These are eating behaviors that allow people to be susceptible to chronic overeating and having issues with their relationship with food in general and in this present study we’ll be discussing what these behaviors are as well as the impact they have on how we eat.

 

The 3 eating behavior constructs

There are three kinds of eating behaviors documented by researchers that will be important to know moving forward, some of which we can all identify, or have identified, with at one point or another.

 

These 3 constructs are known as “disinhibition,” “restraint,” and “hunger.”

 

Disinhibition refers to the tendency to overeat in response to different stimuli or triggers, such as being exposed to a wide variety of hyperpalatable foods or being in an emotional or stressful state of mind. Additionally, there are some subscales to this behavior: “habitual” disinhibition, which refers to overeating in response to life circumstances, “emotional” disinhibition, the tendency to overeat due to emotional states, and “situational” disinhibition, which refers to the susceptibility to overeat in response to environmental cues, like social occasions.

Restraint could be defined as the intentional or conscious restriction of food intake in order to manipulate weight loss or prevent weight gain. Subscales for restraint are known as “rigid” restraint, an all-or-nothing approach to the diet, and “flexible” restraint, a more laid-back approach to dieting where “unhealthy” foods are included in moderation, guilt-free.

Hunger, last but not least, is the likelihood to eat in response to physiological symptoms/feelings that tell us we need food. Subscales for this behavior are considered to be either “internal” or “external,” which refers to whether hunger is perceived/regulated by internal or external cues (think physical signs of hunger versus boredom hunger/being around snack items, respectively).

 

The Study

Women from the New England area were recruited to participate in this study via a series of questionnaires. In order to mitigate any variables that would impact the relationship between eating behaviors and weight gain, subjects were excluded from the study if they were in any condition that would influence their body weight, such as eating disorders, smoking, and medical conditions to name a few. Once all exclusions were done, 535 final subjects were used for this study’s analysis in determining the relationship between the aforementioned subscales of eating behavior and reported weight gain and BMI throughout adult life.  

 

The Questionnaires

In order to assess their current health status, height, weight, and general health history, medical and lifestyle history questionnaires were provided to subjects. In addition to this, a three-factor eating questionnaire was used in order to assess eating behavior characteristics of the women, as well as gain some background knowledge on their body weight (and its changes) at six different age intervals spanning adulthood. These age intervals were split up as: 20-29, 30-39, 40-49, 50-55, 56-60, and 60-65 years. The women provided a single estimated weight for each age interval and were asked to exclude pregnancy weight and weight 1-year post-partum if possible.

The eating behavior questionnaire had a series of true/false and multiple-choice questions which were grouped in a way that would allow researchers to calculate the restraint, disinhibition, and hunger scales and their respective subscales.

 

Here are some examples of what was asked:

“I usually eat too much at social occasions, like parties or picnics” (disinhibition);

“I deliberately take small servings in order to control my weight” (restraint);

“I’m always hungry enough to eat at any time” (hunger).

 

Key Findings

Upon analyzing the data, it can be suggested that the strongest and most influential behavioral predictor of adult weight gain, BMI, and obesity is the high level of habitual disinhibition, or the certainty to overeat due to life circumstances. Life circumstances will more often than not come down to the individual which makes this characteristic pretty broad (and thus, the biggest issue dieters may face). For example, this could mean work schedules, stores and foods more easily available and/or convenient, and lifestyle factors.

The second most significant, though not less important, behavior that can impact weight gain was identified as emotional disinhibition. Emotional eating is a very common issue that many may not realize they’re doing, so it makes a lot of sense that this negative coping mechanism would be a detriment long term. It was predicted that high scores of both habitual and emotional disinhibition influenced an approximate ~22 kg (48 pounds) gain over a 20-year time period.

Situational disinhibition, surprisingly, was not really associated with either outcome. Hunger, however, was a more trivial predictor of weight gain within this population with external hunger seeming to be relatively more important compared to internal.

 

A not-so-surprising finding here was that a flexible dietary restraint was shown to predominantly lessen the impact that habitual disinhibition had on weight gain and BMI. This is another instance where employing a flexible approach to one’s diet can be very helpful in the sense that allowing certain foods or food groups in moderation (rather than having an all-or-nothing mentality) ultimately helps eliminate feelings of restriction in the diet while allowing dieters to be flexible when they need to be without the guilt (i.e. schedules, eating out, limited options, etc.).

 

Application

The scope that habitual disinhibition can have is important because it’s an eating behavior that we’re constantly having to navigate on a daily basis. This behavior may be as significant as it is due to the fact that we’re now living in an environment that is surrounded by food; there are so many opportunities within the western diet to eat, and to do so in excess, at that. Combine this food environment with a population of people looking for fast, convenient options (those of which are large portions of hyperpalatable foods), and you have a multitude of variables that together, and independently, are shown to promote caloric intake and subsequently, weight gain.

 

So, what can we do about it?

There’s only so much you can do when it comes to your physical food environment – that’s not going anywhere anytime soon. What we can do, however, is employ some simple, fundamental lifestyle modifications that will bring us closer to our goals and ultimately replace the negative habits we’ve developed over time.

 

When we work with clients, it’s not only about tracking our food and getting to the gym; we have to make realistic lifestyle changes tailored to the individual and their circumstances (their lifestyle, work schedule, dieting history, preferences, etc.). These changes can range from simply preparing more meals at home, removing trigger foods or hyperpalatable snacks from the pantry, writing out our weekly goals, learning about portion sizes and how to make healthy swaps, and making a plan for the week ahead for your physical activity. There are plenty of other methods we can list here, too, depending on the experience level and the goals of the client.

 

Lastly, it’s important to keep in mind that these negative eating behaviors often take years to develop and hammer into one’s lifestyle, so it will likely take some time to change them as well! While perfection seems ideal, it’s not a realistic thing to ask of anyone as mishaps and “off” days occur no matter who you are. Small changes daily and weekly will build up over time, and once combined with consistency and patience, you’ll be setting yourself up for long term success and adherence!

 

References:

Hays, N.P., Roberts, S.B. Aspects of eating behaviors “disinhibition” and “restraint” are related to weight gain and BMI in women. The Obesity Society 2008; 16(1): 52-58.