Evaluation of the Influence of Hedonic Hunger and Cognitive Restraint on Food Intake During a Behavioral Weight Loss Trial
Authors:   , Blythe Hannah Elizabeth , Lowe Michael R 
Published: January 2024

Obesity, which has risen to epidemic levels since the 1980s in the United States, is associated with a number of negative health outcomes. Although surgical procedures and medications have produced considerable long-term weight losses and improved health outcomes, behavioral weight loss treatments have been less effective at doing so. The high prevalence of weight regain after one completes behavioral weight loss treatment indicates that researchers need to understand how to better promote weight loss maintenance. This study investigated two opposing eating-related motivations that might shed further light into the difficulties of losing weight and maintaining the loss. The first is hedonic motivation, which is highly associated with loss of control (LOC) eating episodes. The second is efforts at volitional control over the amount or type of foods consumed, or cognitive restraint. Hedonic hunger, as measured by the Power of Food Scale (PFS), and cognitive restraint, as measured by the TFEQ-18, are typically uncorrelated, so each has the potential to predict changes in food intake independently of the other. This project analyzed 1) if there were associations between baseline levels of hedonic hunger, cognitive restraint, or their interaction and baseline measures of food intake (such as high-fat or high-fiber foods) and the home food environment (HFE) (such as the healthiness of the contents of one's kitchen) and 2) whether baseline levels of hedonic hunger, cognitive restraint, or their interaction predicted changes in food intake or the HFE over the course of a behavioral weight loss treatment. These analyses were conducted using both multiple linear regression and multilevel regression with an existing dataset from a randomized controlled weight loss trial that included 262 participants. The vast majority of the analyses conducted produced no significant findings from main or interaction effects. However, there were main effects of cognitive restraint on baseline kilocalorie consumption, such that those with the highest levels of cognitive restraint consumed the least number of calories. There were also main effects of cognitive restraint on baseline Healthy Kitchen scores, such that those with the highest levels of cognitive restraint scored the highest on the Healthy Kitchen scores at baseline. In the multilevel model which examined the interaction effects of hedonic hunger and cognitive restraint on overall Home Food Inventory (HFI) scores over the course of treatment, a three-way interaction between linear time, hedonic hunger and cognitive restraint was observed. A graph of these variables over the course of treatment illustrated that participants with PFS scores below the median and cognitive restraint scores above the median continued to demonstrate improvements in the obesogeneity of their HFEs over the entire 12 months of the weight loss treatment. Possible explanations for the lack of expected significant findings are discussed, which include limitations of the outcome variables that were collected and the accuracy and generalizability of the measurements that were used.