Attentional retraining can reduce chocolate consumption.

Abstract

There is emerging evidence that attentional biases are related to the consumption of substances such as alcohol and tobacco, and that attentional bias modification can reduce unwanted consumption of these substances. We present evidence for the first time that the same logical argument applies in the food and eating domain. We conducted two experiments which used a modified dot probe paradigm to train undergraduate women to direct their attention toward ('attend') or away from ('avoid') food cues (i.e., pictures of chocolate). In Experiment 1, attentional bias for chocolate cues increased in the 'attend' group, and decreased in the 'avoid' group.Experiment 2 showed that these training effects generalised to novel, previously unseen, chocolate pictures. Importantly, attentional re-training affected chocolate consumption and craving. In both experiments, participants in the 'avoid' group ate less chocolate in a so-called taste test than did those in the 'attend' group.Additionally, in Experiment 2, but not in Experiment 1, the 'attend' group reported stronger chocolate cravings following training, whereas the 'avoid' group reported less intense cravings. The results support predictions of cognitive-motivational models of craving and consumption that attentional biases play a causal role in consumption behaviour. Furthermore, they present a promising avenue for tackling unwanted food cravings and (over)eating. Fedoroff, Polivy and Herman (1997, 2003) showed that seeing and smelling freshly baked chocolate-chip cookies increased cravings for, and subsequent consumption, of these cookies. Similarly, Painter, Wansink and Hieggelke (2002) found that office workers ate more chocolates if these were in plain view on the desk than if they were in a drawer. Thus the omnipresence of densely calorific food and associated food images has been accepted as a contributing factor to widespread overeating and the increasing rates of obesity (Westerterp & Speakman, 2008). KeywordsOne influential general theory that provides a coherent account for the observed link between cue exposure and consumption behaviour is Robinson and Berridge's (1993) incentive sensitisation model of craving and addiction. In this model, reward-related cues in the environment, such as drug-associated stimuli, acquire motivational properties, or incentive salience, through classical conditioning (i.e., repeated association between the cue and intake of the rewarding substance).Consequently, these cues come to be perceived as attractive and 'wanted'. As a result, reward-related cues automatically capture (i.e., bias) attention, stimulate craving, and guide behaviour toward substance acquisition and consumption. These processes are regulated by the dopaminergic system, and occur outside of conscious awareness. If the logic of the Incentive Sensitization model is correct and applies to food and eating, then one potential way to curb unwanted (over)consumption of food or other substances might be to modify the underlying attentional processes proposed...

Attentional bias modification based on visual probe task: methodological issues, results and clinical relevance

“…Moreover, attentional retraining affected chocolate consumption and craving, and participants in the avoid group ate less chocolate in a so-called taste test than did those in the attend group. 62,65 Similar encouraging results were found in two other recent studies. 63,64 In the first, groups were trained either to attend to healthy food or to attend to unhealthy food, and 33 Avoid (-)/control Yes No Amir et al 6 Avoid (-)/control Yes Yes Hazen et al 26 Avoid (-)/control Yes Yes Heeren et al 27 Avoid (-)/control Yes Yes See et al 28 Avoid (-)/control Yes Yes Heeren et al 29 Avoid (-)/control Yes No MacLeod et al 7 Avoid (-)/attend (+) Yes Yes Browning et al 19 Avoid (-)/attend (+) Yes Yes MacLeod et al 34 Avoid (-)/attend (+) Yes Yes Van Bockstaele et al 35 Avoid (-)/attend (+) Yes No Van Bockstaele et al 36 Avoid (-)/attend (+) Yes No Eldar et al 37 Avoid (-)/attend (+) Partly No O'Toole et al 38 Avoid (-)/attend (+) Partly No Heeren et al 39 Attend (-)/control Yes Yes Krebs et al 40 Attend (-)/control Yes Yes Hayes et al 41 Attend (+)/control Yes Yes Li et al 42 Attend (+)/control Yes Yes Taylor et al 43 Attend (+)/control Yes Yes Wadlinger et al 44 Attend (+)/control Yes Yes Cowart et al 46 Avoid (-) Not applicable Not applicable Amir et al 45 Avoid (-) Yes Yes Brosan et al 47 Avoid (-) Yes Yes Heeren et al 48 Avoid (-)/attend (+)/control Yes Yes Klumpp et al 49 Avoid (-)/attend (+)/control No No Boettcher et al 50 Attend ( 51 Avoid (-)/attend (+) Yes Yes Schoenmakers et al 10 Avoid (-)/control Yes No Schoenmakers et al 53 Avoid (-)/control Yes Partly Kerst et al 54 Avoid (-)/control Yes Partly Lopes et al …”

“…Six studies were identified, [62][63][64][65][66][67] and their tasks did not vary substantially, as they all a SOA of 500 ms and 12-20 pairs of food as a stimulus, although five used pictures and one used words. The three studies that compared attend and avoid groups 62,65,66 found AB changes and a significant impact of training. In the study with obese participants, AB for food increased in the attend group and decreased in the avoid group, and the effects generalized to an independent measure of attentional bias.…”

Worry or craving? A selective review of evidence for food-related attention biases in obese individuals, eating-disorder patients, restrained eaters and healthy samples

“…Evidence for food-related attention biases 111 craving or hunger, only Kemps et al (70) observed a change in craving for chocolate in line with change in attention bias for chocolate. The other studies did not find an effect of attention bias (modification) on self-reported craving.…”

Attentional bias to food-related visual cues: is there a role in obesity?

“…One such factor is the present 'obesogenic' environment that is characterised by a wealth of highly palatable, energy-dense foods (3) . These foods are heavily represented in the visual environment for example, through advertising and it has been suggested that frequent exposure to these forms of food-related cues may impact on eating behaviours and food choices (4)(5)(6) .…”

“…One such factor is the present 'obesogenic' environment that is characterised by a wealth of highly palatable, energy-dense foods (3) . These foods are heavily represented in the visual environment for example, through advertising and it has been suggested that frequent exposure to these forms of food-related cues may impact on eating behaviours and food choices (4)(5)(6) .According to the theory of incentive sensitisation, 'addictive substances' modify reward-related pathways in the brain leading to hypersensitisation of rewardrelated stimuli (7) . This results in increased salience to reward-related stimuli resulting in these stimuli becoming more 'attention grabbing'.…”