Behavioral Weight Loss and Choice

Behavioral weight loss (BWL) therapy is recommended as the treatment of mild and moderate obesity. This approach, which helps individuals to make healthier choices for eating and physical activity a part of their regular lifestyles, typically produces weight losses averaging 7–10% of initial body weight at 6–12 months, although the long-term success of these interventions is lower.

It is still unclear if or how BWL programs increase “self-control” over food choices when faced with a concrete challenge, i.e. selection of healthier options over tastier but less healthy food choices. Understanding the way BWL works can help with our own everyday food choices. So far, the questions about BWL mechanism are open, but there are 3 key points that should be considered: 1) Changes in perception of the healthiness of foods 2) Changes in taste perceptions 3) Changes in the relative importance of health versus taste when making decisions Self-control appears to be the flexible element of establishing a therapeutic approach to obesity and requires specific behavioral techniques to work with. Some of them are self-monitoring, stimulus control, problem-solving, goal setting and assertiveness training. Each of them contributes to healthy food decision-making. Use of self-control increases the rate of long-term weight loss maintenance.

There is solid evidence to support the claim that BWL enhances the valuation of health and diminishes the valuation of taste. But there is one more important point of view – neurobiological studies. These studies identify a region of the brain that codes both health and taste value in healthy eaters, but only tastes in unhealthy eaters. Also, a control-based region that was more active for healthy eaters on trials requires self-control. These regions may also differ during food choices of individuals with obesity and normal weight individuals. Further work on the question about choice making mechanisms is needed. But what we know for now is that behavioral therapy should be consistent to give sustainable results and future neurobiological studies promise very interesting results.

Source: Appetite journal, 2017. Authors: Kathryn E. Demosa, Jeanne M. McCafferya, J. Graham Thomasa, Kimberly A. Maillouxa, Todd A. Hareb, Rena R. Winga – Brown University, University of Zurich.