Controlling food cues response may keep the weight off

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A new weight loss intervention focuses on people’s response to food cues. smodj/Getty Images
  • Researchers investigated the effects of a new weight-loss intervention that helps regulate response to food cues.
  • The intervention resulted in similar weight loss to an existing treatment alongside less weight regain after treatment.
  • The researchers say the new intervention may be used as an alternative weight loss treatment.

Around 74% of United States adults live with overweight or obesity. Current treatments for weight loss include behavioral weight loss (BWL) programs or lifestyle intervention programs.

While these interventions produce moderate weight loss results, people often regain weight after they end. Maintaining weight-loss is a major challenge for weight-loss interventions.

Data behind the Behavioral Susceptibility Theory (BST) suggests that responses to food and satiety are highly heritable and are shaped by environmental and individual-level factors, including Pavlovian and operant learning, memory, and neural changes related to diet.

A new intervention based on improving the management of food and satiety responses may help people maintain weight loss.

In a recent study, researchers conducted a randomized clinical trial for a newly-developed weight-loss intervention called “Regulation of Cues” (ROC) that targets response to food and satiety.

They found that ROC-based interventions may help those with high food responsiveness maintain weight loss.

“ROC trains internal cues to manage overeating rather than external management strategies, such as self-monitoring food intake,” study co-author Dr. Kerri Boutelle, professor of pediatrics and psychiatry at the University of California, San Diego, told Medical News Today.

The study was published in the journal Nutrition, Obesity, and Exercise.

For the study, the researchers recruited 271 adults with a mean age of 47 years old and a mean body mass index (BMI) of 34.6. A BMI of 25–30 is generally considered overweight, whereas a BMI of 30 or above indicates obesity.

The participants were split into four groups: ROC, BWL, ROC combined with BWL (ROC+), and an active comparator group (AC).

ROC included four components: psychoeducation to increase awareness of situations, thoughts, models, and environments that lead to overeating; experiential learning, coping skills, and self-monitoring.

For example, participants were taught how to monitor hunger, cravings, and satiety before being “exposed” to highly-craved foods to practice their new knowledge and skills.

Participants in the BWL group were provided individualized calorie targets and were given behavior change recommendations including:

  • Self-monitoring
  • Meal planning
  • Cognitive restructuring relapse prevention skills

Meanwhile, the AC group underwent training in:

  • Dietary intake
  • Stress as a risk factor for weight gain
  • Mindfulness-based stress reduction
  • Sleep hygiene
  • Time management

Each program was delivered via 26 90-minute group treatments over a 12-month period. All participants were also asked to engage in at least 150 minutes of moderate or vigorous physical activity per week and to achieve at least 10,000 steps per day.

The researchers monitored the participants for 2 years, including the treatment period and the following year.

At post-treatment assessment, those in ROC, ROC+, and BWL groups experienced more significant reductions in BMI than those in the AC group.

This was notable, wrote the researchers, as ROC did not involve caloric restriction.

The ROC+ group experienced the greatest reduction in body fat post-treatment, followed by BWL, ROC, and then AC.

The researchers further noted that while ROC+, BWL, and AC groups experienced weight regain mid-treatment, the weight of those in the ROC group stabilized from this point.

The researchers also noted that participants who scored higher on food responsiveness lost more weight when in ROC and ROC+ groups than in the BWL group.

This, they wrote, means that ROC-based treatments may be especially effective for those who have trouble resisting food.

To explain the results, the researchers noted that ROC and BWL are substantially different approaches to weight loss. Whereas ROC promotes regulating the internal response to food cues, BWL regulates external factors such as food intake.

When asked what food cues are, Dr. Boutelle said that they include sensory stimuli such as billboards and the sound of the ice cream man bell alongside associative memories linked to experiences of food, like “visiting grandma’s house.”

The researchers wrote that ROC’s focus on learning to tolerate food cues might require less cognitive effort over time than avoiding them, as in BWL, which may explain the ROC’s sustained weight-loss effects.

The researchers concluded that ROC and ROC+ may be used as alternative interventions for people with overweight and obesity who have high levels of food responsiveness.

The study has some limitations. Dr. Jena Shaw Tronieri, assistant professor of psychiatry at the University of Pennsylvania, not involved in the study, told MNT:

“These results were produced by an intensive intervention (frequent visits) delivered by highly trained providers to patients who were motivated to lose weight.”

“As with any intensive behavioral weight loss treatment, it can be challenging to find providers with the resources, time, and training to deliver intensive interventions in real-world settings. This can be particularly challenging for novel treatment methods that employ psychological strategies.”

“We would need a follow-up study to confirm the preliminary finding that individuals with high food responsiveness may benefit more from ROC, or to test whether that feature could be used to match participants to the treatment that will be most effective for them,” she explained.

“I would also be very interested in seeing a follow-up report of how the groups compared on additional primary outcomes like percent weight loss and binge eating at each of the time points,” Dr. Tronieri concluded.