Exploring the Experiences of People with Obesity Using Portion Control Tools—A Qualitative Study

Abstract

Large portion sizes increase consumption and eating smaller portions is recommended as a weight control strategy. However, many people report difficulties enacting this advice. This study examined the experience of individuals using two commercially available portion-control tools to try to manage their weight. In a crossover design, 29 adults with obesity (18 women) who had attended a previous weight loss intervention in the community were invited to use two portion-control tool sets over a period of four weeks (two weeks each) and to complete a semi-structured questionnaire about their experience. The tools were a guided crockery set (sector plate, calibrated bowl, and calibrated glass) and a set of calibrated serving spoons (one for starch, one for protein, and one for vegetables). Data were analyzed using thematic framework analysis. A key theme was related to the educational benefits of the tools, such as generating awareness, guidance, and gaining an independent ability to judge appropriate portions. Other key themes were tool usability, acceptability, and feasibility of usage. Barriers identified by participants included unclear markings/instructions and the inconvenience of using the tool when eating away from home. Overall, the tools were perceived to be educationally useful, easy to use, and potentially effective for learning to control portions, which suggested that these instruments could help in weight management interventions alongside other strategies. Elements of the tool design could influence the ability of participants to adhere to using the tool, and hence allow the educational effect to be mediated.

Impact of Portion Control Tools on Portion Size Awareness, Choice and Intake: Systematic Review and Meta-Analysis

“…We observed a medium size effect for four types of calibrated plates mostly including printed guidelines [59,74,76] or indented sectors [75], which was confirmed by self-reported data from a field study [77]. Thanks to their design, these plates may be useful in controlling portion sizes from specific meal components that tend to be overconsumed (i.e., starch, protein) while at the same time inducing larger servings of desirable foods such as fruit and vegetables, eventually acting as an educational aid for appropriate consumption [77,78]. The same impact could potentially be derived from portion control serving utensils such as calibrated serving spoons [77], although more evidence is needed in regards to these utensils.…”

“…The same impact could potentially be derived from portion control serving utensils such as calibrated serving spoons [77], although more evidence is needed in regards to these utensils. While the design of this type of tools might help learning what a suitable amount of food should look like and avoid excessive amounts being initially placed on the plate, "piling up", second helpings and going over the depicted section or sector is still possible [78]. This underscores the importance of including an educational component in the design of any portion control tool for it to be successful, especially in the long term.…”

“…This underscores the importance of including an educational component in the design of any portion control tool for it to be successful, especially in the long term. Continuous use of portion control tools may be challenging in some individuals due to lifestyle demands (i.e., eating on the go, with relatives, on holiday), or they may feel that they have already learned to proportionate their meals [78]. On the other hand, calibrated tableware has been reported to be well accepted and perceived as easy to use and effective to promote behaviour change [74,[76][77][78].…”

“…Continuous use of portion control tools may be challenging in some individuals due to lifestyle demands (i.e., eating on the go, with relatives, on holiday), or they may feel that they have already learned to proportionate their meals [78]. On the other hand, calibrated tableware has been reported to be well accepted and perceived as easy to use and effective to promote behaviour change [74,[76][77][78]. Despite this, its impact on learning has often been masked by additional weight management strategies applied alongside the tool [59,74,76].…”

Development and validation of a new methodological platform to measure behavioral, cognitive, and physiological responses to food interventions in real time

“…At the time of serving (pathway A in Fig. 1 ), this visual feedback could increase attention and act as a basis for the generation of lasting visual memories which may then help to update beliefs about what constitutes a normal portion size (Almiron-Roig, Majumdar, et al, 2019b ; Haynes et al, 2019 ; Robinson & Kersbergen, 2018 ). This may be mediated by anchoring effects, that is, any amount that appears normal in size may guide decisions on how much to self-serve and in some cases may contribute to meal termination (Haynes et al, 2019 ).…”