Relative reinforcing value of food and delayed reward discounting in obesity and disordered eating: A systematic review

- Behavioral economics can help clarify risk factors contributing to obesity.
- Relative reinforcing value of food (RRVfood) likely contributes to obesity.
- Delayed reward discounting (DRD), impulsivity index, may contribute to obesity.
- Findings on RRVfood and DRD in obesity and dysregulated eating are mixed.
- Systematic review may clarify the role of RRV and DRD in dysregulated eating.

Understanding the food choice decision-making may help identify those at higher risk for excess weight gain and dysregulated eating patterns. This paper systematically reviews the literature related to eating behavior and behavioral economic constructs of relative reinforcing value of food (RRVfood) and delayed reward discounting (DRD). RRVfood characterizes how valuable energy-dense food is to the individual, and DRD characterizes preferences for smaller immediate rewards over larger future rewards, an index of impulsivity. Literature search on PubMed was conducted using combination of terms that involve behavioral economics and dysregulated eating in youth and adults. Forty-seven articles were reviewed. There is consistent evidence that obese youth and adults exhibit higher RRVfood. There is a need for more research on the role of RRVfood in eating disorders, as an insufficient number of studies exist to draw meaningful conclusions. There is accumulating evidence that obese individuals have higher DRD but the study of moderators of this relationship is crucial. Only a small number of studies have been conducted on DRD and binge eating, and no clear conclusions can be made currently. Approximately half of existing studies suggest lower DRD in individuals with anorexia nervosa. Research implications and treatment application are discussed.