A reinforcer pathology model of health behaviors in individuals with obesity.

Objective: Research concerning trans-disease processes aims to ascertain an underlying mechanism of several seemingly dissonant behaviors, pathological conditions, or both. The theory of reinforcer pathology posits that excessive delay discounting and the maladaptive overvaluation of a particular commodity underlie a variety of dysfunctional health behavior ranging from substance abuse to overeating and financial responsibility. The present study extends recent health behavior research by examining the extent delay discounting and food valuation correlate with engagement in a latent factor model of health and financial behaviors among healthy-weight participants and participants with obesity using the Health Behaviors Questionnaire. Method: A total of 700 participants (n = 340, body mass index [BMI] < 30; n = 360, BMI > 30 kg/m2) were recruited using Amazon Mechanical Turk. Participants completed a monetary delay discounting assessment, the Health Behaviors Questionnaire, and 2 measures of food valuation: Behavioral economic demand and the Power of Food Scale (PFS).
Results: Utilizing structural equation modeling, both delay discounting and food valuation significantly correlated with engagement in health and financial behavior for both groups. The comparison of latent factors between groups indicated that participants with obesity were less likely to engage in multiple health behaviors and that these differences can be partially attributed to differences in delay discounting and food valuation.
Conclusion: These results replicate previous research and further support the role of delay discounting as a trans-disease process. Given these results, trans-disease interventions, such as episodic future thinking, designed to specifically target reinforcer pathology may have a profound effect on overall functioning. (PsycInfo Database Record (c) 2020 APA, all rights reserved).