Annals of Behavioral Medicine

, Volume 30, Issue 3, pp 201–209 | Cite as

The challenge of identifying behavioral alternatives to food: clinic and field studies

  • Leonard H. Epstein
  • James N. Roemmich
  • Richard I. Stein
  • Rocco A. Paluch
  • Colleen K. Kilanowski


Background: One of the basic principles of behavioral economics interventions is identification of alternative behaviors to compete with the reinforcing value of a highly rewarding commodity.Purpose: Two experiments that attempt to increase alternatives to eating in obese youth are presented.Methods: A randomized, controlled trial was used in Study 1 to compare a comprehensive family-based behavioral treatment program or an experimental treatment that incorporated reinforcing children for engaging in alternative behaviors to eating for 41 overweight 8-to 12-year-old children. Study 2 used a within-subject design with baseline, enriched environment and a second baseline phase to determine the influence of providing activities that compete with eating for 13 overweight 8-to 12-year-old children. Measurements included body mass index (BMI) change, alternatives to eating, eating, and physical activity.Results: In Study I both treatments were associated with significant (p < .05) and maintained reductions in z-BMI over the 24 months of observation. The experimental group showed a significantly (p < .05) greater increase in alternatives to eating, and both groups showed significant (p < .05) increases in physical activity. In Study 2 alternative behaviors to eating were increased by almost I hr/day (p < .001) but were not associated with significant changes in energy intake or physical activity.Conclusion: These results suggest that using the methods studied, increasing behaviors that could compete with eating did not influence relative weight in a clinical outcome study or energy intake in a controlled field study.


Physical Activity Energy Intake Sedentary Behavior Behavioral Medicine Booster Session 
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Copyright information

© The Society of Behavioral Medicine 2005

Authors and Affiliations

  • Leonard H. Epstein
    • 1
  • James N. Roemmich
    • 1
  • Richard I. Stein
    • 1
  • Rocco A. Paluch
    • 1
  • Colleen K. Kilanowski
    • 1
  1. 1.Department of PediatricsUniversity at BuffaloUSA

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