Strategies to combat obesity typically include dietary counseling and self-discipline. A new approach from Rush University Medical Center views obesity as a result of neurobehavioral processes; that is, eating responses depend on how the brain responds to cues in the environment.
Designed by preventive medicine and behavioral experts, the new model is reviewed in the Journal of the American Dietetic Association.
“Typically, overweight and obese patients receive education about dietary contributions to weight gain, and they are simply encouraged to fight the powerful urge to eat the delicious foods that are available almost everywhere in the environment, and instead, make dietary choices consistent with weight loss,” said Brad Appelhans, Ph.D., lead author of the article.
“Yet, we know this approach rarely works. Even highly motivated and nutritionally informed patients struggle to refrain from highly palatable foods that are high in sugar, salt and unhealthy fats.”
The perception that individuals become or remain obese because of unhealthy personal choices or a lack of willpower tends to stigmatize them and is unlikely to motivate them to lose weight. Researchers believe the new model clarifies how personal choice is affected by biological and environmental factors.
Experts believe the three neurobehavioral processes consistently implicated in obesity and overeating are food reward, inhibitory control and time discounting.
- Food Reward – Food reward includes both the experience of pleasure one receives from eating and the motivational drive to obtain and consume highly palatable foods. Those with greater sensitivity to reward have stronger food cravings for sweet and fatty foods. This biologically-based sensitivity, coupled with easy access to delicious snacks and fast food outlets, makes one highly vulnerable to overeating and weight gain.
- Inhibitory Control – Beyond the intensity of food cravings is the ability to suppress urges to eat high-calorie foods. Controlling behavior despite a strong motivation to eat is largely influenced by the brain’s prefrontal cortex, which is considered critical for self-control, planning and goal-directed behavior. The dorsolateral region of the prefrontal cortex is believed to be responsible for the decision to choose healthy food options over tastier options.
- Time Discounting – A third factor that likely contributes to the low success rates of dietary interventions for obesity is the human tendency to devalue delayed rewards.
“Most of us would rather receive $200 today rather than $300 a year from now,” said Appelhans.
Similarly, the immediate pleasure from eating has a greater effect on decision making than the more delayed health benefits of weight loss.
“Obesity is heavily influenced by genetic vulnerabilities and a toxic food environment,” said Appelhans. “However, counselors can help patients control their weight through strategies focused on the interaction between the brain and the environment, rather than the traditional approach of encouraging patients to simply ignore or fight food cravings and eat fewer calories than they expend.”
A few strategies recommended by the researchers include:
- In order to combat food reward, patients can remove high fat foods they crave from personal environments such as the home and workplace to prevent the activation of the reward circuitry;
- Limit the impact of reward on food choice by shopping with a grocery list or using online grocers;
- Practice stress management techniques since stress promotes overeating and obesity by enhancing food reward processing;
- Avoid situations such as buffets and restaurants that challenge inhibitory control;
- Focus on achieving short-term behavioral goals, such as cooking a healthy dinner on three nights of the week rather than focusing on long-term weight loss goals.
Source: Rush University Medical Center