Background: Food is a powerful reinforcer that motivates people to eat. The relative reinforcing value of food (RRVfood) is associated with obesity a

Obesity is, in part, a result of positive energy balance or energy intake exceeding physiological needs. Excess energy intake is determined by a series of food choices over time. These choices involve both motivational and executive function processes. Problems arise when there is excessive motivation to eat and low impulse control, a situation we have termed reinforcement pathology. Motivational and executive function processes have also been implicated in the development of drug dependence and addiction. In this review we discuss the application of reinforcement pathology to obesity, and implications of this approach for obesity treatment.

Objective: Food reinforcement is cross‐sectionally related to BMI and energy intake in adults, and prospectively predicts weight gain in children, but there has not been any research studying food reinforcement as a predictor of adult weight gain.Design and Methods: This study examined whether the relative reinforcing value of food versus sedentary activities, as measured on a progressive ratio schedule, predicts 12‐month weight gain in a sample of 115 nonobese (BMI < 30) adults. Dietary disinhibition and dietary restraint were also examined as potential moderators of this relationship.Results: In a hierarchical regression controlling for baseline age and weight, dietary hunger, income, sex, and minority status, food reinforcement and predicted weight gain (P = 0.01) significantly increased the variance from 6.3% to 11.7% (P = 0.01). Dietary disinhibition moderated this relationship (P = 0.02) and increased the variance an additional 4.7% (P = 0.02), such that individuals with high food reinforcement had greater weight gain if they were also high in disinhibition.Conclusions: These results suggest that food reinforcement is a significant contributor to weight change over time, and food reinforcement may have the biggest effect on those who are most responsive to food cues.

Objective Food reinforcement and delay discounting (DD) independently predict body mass index (BMI), but there is no research studying whether these variables interact to improve prediction of BMI. Methods BMI, the relative reinforcing value of high (PMAX_HED) and low (PMAX_LED) energy dense food, and DD for $10 and $100 future rewards (DD₁₀, DD₁₀₀) were measured in 199 adult females. Results PMAX_HED (P = 0.017), DD₁₀ (P = 0.003), and DD₁₀₀ (P = 0.003) were independent predictors of BMI. The interaction of PMAX_LED × DD₁₀ (P = 0.033) and DD₁₀₀ (P = 0.039), and PMAX_HED × DD₁₀ (P = 0.038) and DD₁₀₀ (P = 0.045) increased the variance accounted for predicting BMI beyond the base model controlling for age, education, minority status, disinhibition, and dietary restraint. Based on the regression model, BMI differed by about 2 BMI units for low versus high food reinforcement, by about 3 BMI units for low versus high DD, and by about 4 BMI units for those high in PMAX_HED, but low in DD versus high in PMAX_HED and high in DD. Conclusion Reducing DD may help prevent obesity and improve treatment of obesity in those who are high in food reinforcement.