Our Research

Delay of Gratification

Delay of gratification is the ability to wait for a larger reward in the future, rather than accepting a small reward now.  A great example would be someone who decides not to smoke now, in favor of better health in the future. A famous study by psychologist Walter Mischel showed us that this ability is present and definable even in children. In his study, he placed a marshmallow in front of a child and told them they could either eat the mallow now, or wait a short while and have two mallows. The children that were able to wait for two mallows ended up having greater long-term success in life (better coping skills, social adjustment, higher grades, etc…), whereas the children who chose to eat the one mallow now had worse long-term outcomes in life. Being able to control your impulses is an important skill that is stable over can time, but can be learned and sharpened with practice.

Reinforcing Value

Reinforcing Value refers to how rewarding you find different activities. For example, someone may find reading the newspaper very reinforcing whereas someone else may find riding a bike reinforcing. You can measure how reinforcing people find different things by finding out how hard someone is willing to work to gain access to their favorite activity. For example, a child may work very hard to eat apple slices, but wouldn’t put much effort into being able to eat cookies.

Episodic Future Thinking

Episodic Future Thinking refers to your ability to imagine specific future events. For example, “In four weeks, I am at the big game, rooting for our team, sitting with my friends, and laughing at a joke.” Thinking about the future in a very clear and detailed manner helps people to engage in behaviors that promote longevity, such as eating healthier, exercising, or saving money.

Habituation

Habituation is how quickly someone gets used to something in their environment. For example, you probably don’t even notice how the socks feel on your feet right now because you have habituated to the feeling. The same goes for food- people and animals can habituate to eating certain foods. If I were to make soup for dinner, I will probably eat the soup until I am tired of eating the same thing. People who habituate faster have better long-term outcomes in life, whether it is your ability to identify and ignore irrelevant information, or tire of eating the same foods over time.

Family-Based Weight Control

Family-based weight control is a family approach to achieving and maintaining weight loss. By involving the whole family, it becomes easier to make a weight loss plan and stick to it. Research has shown that family weight control is much more effective than individual attempts, especially for maintaining your achievements for decades in the future!

With over 300 publications throughout his career, Dr. Epstein has an extensive and renowned scientific basis in behavioral medicine. Below are some of his more recent publications:

Hallmark Works (collapsible to reveal the articles contained within)

 

Epstein, LH, Valoski, A, Wing, RR, McCurley, J. (1994). Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology, 13, 373-383.

A 10-year follow-up of families in a behavioral intervention for weight loss found that focusing on a parent and child pair for weight loss was more effective for long-term success than focusing on either a parent or child alone. Weight-loss success can also be maintained better when people engage in an exercise program. This study highlights the importance of family support for eating and activity change.

Epstein, LH, Paluch, RA, Roemmich, JN, Beecher, MD (2007). Family-based obesity treatment, then and now: Twenty-five years of pediatric obesity treatment. Health Psychology, 26, 381-391.

This study compared family-based obesity programs initiated 20-25 years ago to programs created today. Results showed that older family-based programs remained effective over time, but children are heavier today than 25 years ago and live in environments promoting unhealthy lifestyles and eating behaviors. Taking this into account, newer interventions may be more powerful, since they account for the current status of the child’s environment. Looking to the future, there may be a need for more powerful interventions to help combat youth obesity among more overweight children.

Epstein, LH, Valoski, A, Win, RR, McCurley, J (1990). Ten-year follow-up of behavioral, family-based treatment for obese children. The Journal of the American Medical Association, 264, 2519-2523.

This article looks at the effect of a family-based behavioral weight control program, which focuses on eating behavior, exercise, and behavior modification. Over time, the children who were part of the family-based program, where parents and children worked together for program rewards, had better weight outcomes than children who were rewarded separately from their family, or families who were rewarded just for program attendance. This study is important for illustrating the impact that working collaboratively as a family toward a goal can have on improving your health outcomes.

Epstein, LH, Myers, MD, Raynor, HA, Saelens, BE (1998). Treatment of Pediatric Obesity. Pediatrics, 101, 554-570.

This paper is an overview of pediatric obesity treatments. It highlights important contributions and developments, as well as identifying characteristics of successful treatment and maintenance interventions. Treatment of pediatric obesity is comprised of three major factors: diet, activity and behavior change. When all three components are used together, there is a greater likelihood of treatment success.

Epstein, LH, Valoski, A, Koeske, R, Wing, RR (1986). Family-based behavioral weight control in obese young children. Journal of the American Dietetic Association, 86, 481-484.

This study was a one-year weight control program for obese children ages 1-6. The year-long program involved three components: diet, exercise and child management. Relative body weight decreased significantly from the start of the study to one and two years after, and height increased normally over time. This suggests that obesity can be treated successfully in very young children without detrimental effects on growth or nutrient intake.

Epstein, LH, Paluch, RA, Gordy, CC, Dorn, J (2000). Decreasing sedentary behaviors in treating pediatric obesity. Archives of Pediatrics & Adolescent Medicine, 154, 220-226.

This two-year study asked families in a family-based behavioral weight control program to either decrease their child’s sedentary activity, or increase their child’s physical activity. By the end of the study, it was found that both options were associated with decreases in percent overweight, body fat, and increased fitness. Overall, decreasing a child’s sedentary behavior, in addition to diet and behavior change, was as effective as increasing physical activity.

Epstein, LH, Gordy, CC, Raynor, HA, Beddome, M, Kilanowski, CK, Paluch, RA (2001). Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obesity, 9, 171-178.

This study asked families in a family-based behavioral weight control program to either increase their fruit and vegetable intake, or decrease their high-fat/high-sugar intake over the course of one year. After one year, it was discovered that families asked to increase their fruit and vegetable intake did so, and decreased their high-fat/high sugar intake. The families asked to decrease their high-fat/high sugar intake did so, but did not substitute by increasing fruits and vegetables. Additionally, families with the greatest change in weight were the ones asked to increase their fruit and vegetable intake.

Epstein, LH, Dearing, KK, Temple, JL, Cavanaugh, MD (2008). Food reinforcement and impulsivity in overweight children and their parents. Eating Behaviors, 9, 319-327.

This study had children ages 8-12 years old and their parents from 50 families recruited for participation in a pediatric family-based behavioral weight control program. This study suggests that food reinforcement (how hard someone is willing to work for food) may be more similar between parents and children than behavioral impulsivity.

Carr, K, Daniel, TO, Lin, H, Epstein, LH (2011). Reinforcement pathology and obesity. Current Drug Abuse Review, 4, 109-196.

This paper examined a possible contributor to obesity called “food reinforcement pathology.” Food reinforcement is the amount of effort someone is willing to put forth to get food. If they are willing to put in a lot of effort to get food, they have high food reinforcement. Someone who finds food very reinforcing and is also very impulsive may have food reinforcement pathology because they are very motivated to get food and they are not likely to stop themselves. This may occur because of the way our brains balance certain electrical signals in different brain structures. The paper predicts that decreasing a person’s impulsivity may help them better regulate their weight.

Daniel, TO, Stanton, CM, Epstein, LH (2013). The future is now: comparing the effect of episodic future thinking on impulsivity in lean and obese individuals. Appetite, 71, 120-125.

Delay of gratification is when a person waits for bigger rewards in the future instead of opting for a small reward now. The inability to delay gratification, or impulsive decision making, is known to be related to obesity. One way to improve delay of gratification is to think about the future. It was previously shown that obese individuals who thought about future events were able to reduce their delay discounting and decrease their food intake, but would this be the case for lean individuals as well? Results showed that thinking of future events is just as effective at reducing impulsive decision making in obese individuals as it is in lean individuals.