Using behavioral economics to understand reinforcement mechanisms of loss-of-control eating: An ecological momentary assessment approach.

Abstract

Loss-of-control eating (LOCE) is the subjective inability to stop eating once one has started or to refrain from food consumption. State-level affect, food craving, and reward dysfunction have all been implicated as vulnerabilities to recurrent LOCE, mostly studied in the context of binge eating (i.e., LOCE with objective overeating). Hypothetical purchase tasks are a behavioral economic approach to assessing the reward value of a given behavior or commodity, which have typically been used in substance use literature. The current study tested a momentary mediation model in which positive and negative affect at Time 1 was hypothesized to predict Time 2 food demand (assessed using three variables from an ambulatory food purchase task), in turn leading to LOCE at Time 3 by way of Time 2 craving (affect → food demand → craving → LOCE). This model was assessed using a 10-day ecological momentary assessment protocol in 78 community adults with recurrent LOCE (87% female, 71% White). At the within-subjects (i.e., momentary) level, LOCE was predicted by prior food craving. Food reward value metrics additionally mediated the LOCE antecedent of negative affect, but not positive affect. Interestingly, between subjects, the relationship between craving and LOCE was unexpectedly negative, and only negative affect was associated with subsequent LOCE, by way of time two craving but not time two food reward value. Clinical implications and future directions are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).