Abstract
BACKGROUND: Experimental studies reveal that deficits in food-related inhibitory control, rather than general impulsiveness, are closely linked to overweight and obesity. To date, the real-world implications remain unknown, and it is unclear whether these results are supported in the clinical field. OBJECTIVE: To examine the effectiveness of a mobile health (mHealth) intervention with cognitive and behavioral therapeutic elements in altering impulsiveness and food-related inhibitory control. METHODS: Prespecified secondary outcome analysis of a randomized controlled trial. Participants with overweight/obesity (BMI: M = 33.35 kg/m(2), SD = 3.79 kg/m(2), N = 213) were randomly assigned to either a 12-week mHealth intervention (n = 116) or wait-list control group (n = 97). The Barratt-Impulsiveness-Scale (BIS-15) and the Food-Related Inhibitory Control Scale (FRIS) were administered at baseline (T0) following the intervention (T1), at 9 and 15 month post baseline (T2, T3). Multi-level analyses were calculated. RESULTS: Compared to the control group, the intervention group reported higher food-related inhibitory control on several subscales of the FRIS: In Withholding in Social Situations at T1 (95% CI: 0.06-0.46) and T2 (95%CI: 0.09-0.50), Action Cancellation at T1 (95%CI: 0.05-0.45), Resisting despite Craving at T1 (95% CI: 0.07-0.49), Withstanding Rewarding Food at T2 (95%CI: 0.08-0.55) and Action Withholding at T3 (95% CI: 0.01-0.55). No differences were found for trait impulsiveness (T1: 95%CI: -1.91-0.47; T2: 95%CI: -1.65-0.84; T3: 95%CI: -0.88-1.67). CONCLUSIONS: Food-related inhibitory control, rather than global measures of impulsiveness, addresses the critical association between inhibitory control and health-conscious dietary choices and can be improved by mHealth intervention. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04080193.