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1. The relationship between dieting, restrained eating and weight control

I have a long-standing interest in the relationship between dieting, restrained eating and body weight.  My work has led to the following conclusions.  Though often viewed as interchangeable in the literature, restrained eating and dieting are different constructs associated with different behavioral effects (Lowe, 1993, Lowe and Kral, 2006, Lowe and Levine, 2005).  Restrained eating usually reflects an effort to prevent overeating and weight gain, not an effort to lose weight or to become skinny (Chernyak and Lowe, 2010, Stice et al., 2007).  Dieting, on the other hand, usually reflects an effort to reduce calories to lose weight.  Dieters may succeed in losing weight but relatively few succeed in keeping it off, which means that 1) most dieters develop a history of repeatedly losing and regaining weight, and 2) that having a history of weight loss dieting actually predicts accelerated weight gain over time).  On the other hand, a very small percentage of young women diet too vigorously, lose substantial weight and develop an eating disorder (e.g., Butryn et al., 2006, Lowe et al., JCCP, in press).

2. Obesity and the prevention of weight gain and weight regain

Approximately two-thirds of American adults are overweight or obese and the prevalence of obesity in children has tripled in the past several decades.  Thousands of research studies have found that medically significant weight losses can be achieved by lifestyle change programs but lost weight is typically regained once treatment ends.  In the past 12 years we have received several NIH grants to study the prevention of weight gain and, after a weight loss, the prevention of weight regain. The first grant, the results have been published, involved a significant departure from the traditional "lifestyle change" approach for prevention of weight regain by concentrating on reducing the energy density (the number of calories per gram of food consumed) of participants' long-term diets (Lowe et al., Obesity, 2008). The results of this study suggest that focusing on reducing the energy density of the diet is a promising way of improving weight loss maintenance.
A second grant examined long-term modifications to worksite cafeterias to improve nutritional intake and prevent weight gain among patrons. We collaborated on this grant with the Sodexo Corporation, one of the largest providers of food services in the world. We developed a computerized system whereby food purchases of study participants could be automatically tracked on a daily basis. Over a six month period the intervention produced significant reductions in caloric intake during lunch and a significant reduction in the percentage of calories from fat (Lowe et al., 2010). 

A third grant was a 5-year study examining new ways of preventing weight regain following weight loss. Participants were overweight patients referred from primary care practices. This project tested two different nutritional strategies (increasing structured eating via use of meal replacements, and lowering the caloric density of the diet) in order to avoid or minimize weight regain after weight loss. The data from this study showed that a program focusing on making multiple changes to the home food environment to reduce the caloric density of the diet produce the best weight loss maintenance at a two-year follow-up (Lowe et al., TOS abstract). 

A fourth grant in this category focuses on prevention of weight gain in female college freshmen. This study is being done in collaboration with Eric Stice, Ph.D.  It targets students vulnerable to weight gain. It utilizes group interventions to capitalize on the motivational power of groups. The content of the groups is aimed at modifying participants' food choices and the foods they keep in their living spaces.  We recently finished this project and are in the process of data analysis. 

A fifth grant is a 5-year study that is comparing three treatments aimed at improving the long-term maintenance of weight loss.  The main intervention of interest (called “Nutritrol” for the nutritional control of body weight) focuses on modifying foods in participants’ home food environments (Lowe, 2003)  so that self-control becomes more feasible and automatic.  This project began in April, 2009 and data collection is about half-way finished. 

We also have received what appears to a fundable score on a new NIH grant that will compare a) standard behavioral treatment, b) Nutritrol, and c) Nutritrol plus an Acceptance and Commitment (ACT) treatment that has been developed by Evan Forman and Meghan Butryn over the past few years.  Dr. Butryn is principal investigator on this grant and Dr. Forman and I are co-investigators.  This project should get underway in January, 2010.

3. Eating disorders research

Most of our eating disorders research has been conducted in collaboration with the Renfrew Center for eating disorders, where Dr. Lowe has been a research consultant, and a member of their Research Committee, for 6 years.  Renfrew is the largest treatment center for eating disorders in the country and therefore offers the unique ability to collect data on a large number of eating disordered patients in a relatively short time.  The quality and quantity of data collected from Renfrew patients during and after treatment has improved substantially during the past several years.  The improvements have created many opportunities for my team to collect data for masters and dissertation research projects and for additional studies described below.  \

I have been conducting research investigating the role of both weight suppression (the discrepancy between one’s highest adult body weight and current weight) and current dieting (an ongoing effort to lose, or avoid gaining, weight) in bulimia nervosa for the past 15 years (Butryn et al., 2006; Butryn et al., 2011; Chernyak & Lowe, 2010, Gleaves et al., 2000; Herzog et al., 2010, Juarascio et al., in press, Lowe et al., 1996; Lowe et al., 1998; Safer et al., 2004; Lowe et al., 2006; Lowe et al., 2007, Lowe et al., 2011, Lowe et al., in press, Thomas et al., 2011). My research on weight suppression, dieting and eating disorders has raised questions about the prevailing psychosocial and cognitive-behavioral models of how dieting may initiate and maintain bulimia nervosa. This new model also has significant treatment implications that we hope to begin examining in the future.

4. Integrating biology and psychology in eating disorder and obesity research

In the past several years I have become increasingly involved in research to understand how biological and psychological factors combine to influence eating disorders and obesity. One such effort has involved differentiating between homeostatic and hedonic eating motives and describing the implications of this distinction for the wisdom of dieting (Lowe & Butryn, 2007; Lowe & Levine, 2005). A second focus is understanding how behavioral and metabolic aspects of restrained eating combine to produce a predisposition toward weight gain in restrained eaters (Lowe & Kral, 2006), Stice et al., 2007, Psychological Assessment). A third set of studies is examining neurophysiological correlates of both restrained eating and binge eating using fMRI and EEG (Coletta et all, 2009, Lowe et al., 2009, Ochner et al., 2009).

5. Research on the "hedonic hunger" and the Power of Food Scale

To better understand the predisposition that may make some people more susceptible to food-related temptations, my research team has developed a new measure of the psychological impact of the food environment called the Power of Food Scale (PFS). There are a number of existing measures that assess restrained eating or overeating induced by various emotional or social stimuli, but there is no measure of individual differences in the psychological impact of an obesogenic environment.  Two papers provide preliminary psychometric support for the PFS (Capelleri et al., 2009, Lowe et al., In press) and three others examine its usefulness for understanding eating motivations and weight problems (Forman et al., 2007; Schultes et al., 2010, Appelhans et al., in press).  We are continuing with research to further test the validity and clinical application of the PFS.