Deconstructing Ingestive Behaviour

As someone with an interest in ingestive biology, I continue to be amazed by the complexity of eating behaviour.

Three commonly recognized eating behaviour constructs are “disinhibition”, “cognitive restraint” (rigid or flexible) and “hunger” (internal or external).

Of these only “disinhibition” has been consistently shown to be strongly associated with adult weight gain.

There are actually three forms of disinhibition:

1) habitual disinhibition: the tendency to overeat in daily life

2) emotional disinhibition: the tendency to overeat in response to emotional states like anxiety or depression

3) situational disinhibition: the tendency to overeat in response to specific situations, e.g. social occasions

A recent study by Nicholas Hays and Susan Roberts from the University of Arkansas, published in OBESITY, examined the relationship between 20 year weight gain and eating behaviour subscales using the Eating Inventory (also often referred to as the Three-Factor Eating Questionnaire) in 535 women aged 55-65 years.

While “habitual” disinhibition showed the strongest association with weight gain, “emotional” disihibition showed only a modest association, while “situational” disinhibition was largely unrelated to weight gain. Flexible restraint significantly attenuated the effect of habitual disinhibition on weight gain.

As acknowledged by the authors, this study has several limitations including the fact that the weight data are self-reported and retrospective and that the participants’ ingestive behaviour may have changed over time.

Nevertheless, if true, the paper raises a significant issue in terms of the focus of dietary counseling.

Thus far, dietary counseling has often tended to focus on situational disinhibition (e.g. dealing with eating on social occasions, in restaurants, etc.) or emotional disinhibition (e.g. coping strategies to avoid emotional eating). According to the findings of this paper, it would be far more appropriate to focus attention on reducing habitual overeating i.e. eating in “everyday” situations.

Strategies shown to help reduce habitual disinhibition include cognitive behavioural therapy, reducing variety and treatment with sibutramine.

It may be time for studies to expressly target habitual disinhibition in individuals who display this ingestive behaviour.

Obviously, this does not mean that for some people “emotional” or too frequent “situational” disinhibition cannot also significantly contribute to their weight gain.

Once again – one size is unlikely to fit all – but, providing the right dietary counseling requires making the right “diagnosis”,