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Learning theorists suggest extinction learning to be a central mechanism in weight loss success; however, empirical studies are scarce. In this pilot study, it was examined whether individual differences in extinction learning predict outcome after weight loss treatment. Overweight and obese individuals first completed a laboratory conditioning task in which individual differences in extinction learning were assessed. Next, they were randomised to one of two weight loss interventions: cue exposure therapy (CET), which is considered the clinical analogue of laboratory extinction, or a control lifestyle intervention. In line with expectations, better extinction learning in the laboratory task was associated with more weight loss at both post-treatment (CET only) and follow-up (both interventions) measurements. In contrast, two other indices of treatment success (reduction in overeating expectancies and ad libitum food intake during a laboratory taste test) showed no associations with pre-treatment extinction learning. It is suggested that extinction learning may be a core mechanism underlying weight loss success, and hence, an important target for new obesity interventions., (© 2020 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.)

Findings of a few recent studies suggest that obesity is characterized by deficits in appetitive learning about food cues. This could point towards an increased tendency in obese individuals to overgeneralize appetitive responding to stimuli that resemble the conditioned food cue - possibly explaining frequent eating desires and overeating in obesity. The current study aimed to investigate whether obese individuals 1) indeed exhibit appetitive learning deficits and 2) show overgeneralization of conditioned appetitive responses. Obese and matched healthy-weight females (N = 85) completed a differential appetitive conditioning task using food as rewards. First, appetitive responding to a novel stimulus was learned (acquisition phase), after which stimuli with varying resemblance to the food-associated stimulus were presented (generalization phase). Cue-elicited eating expectancies, eating desires, stimulus evaluations, and actual food intake were examined. Results indicated successful acquisition of appetitive responding across all outcome measures. The acquired responses also generalized, indicating that generalization can function as an additional mechanism by which learned food cues can promote food consumption. The data further suggested that overweight and obesity are not characterized by appetitive learning deficits nor by overgeneralization, but that a subgroup of obese individuals (those high in trait anxiety) may be more prone to overgeneralization of appetitive responding., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: This study tested the role of habituation of eating desires and violation of overeating expectancies during food cue exposure in obese women., Method: 52 obese females were randomised into a two-session exposure condition aimed at habituation, a two-session exposure condition aimed at expectancy violation, or a no-treatment control condition. Eating in the absence of hunger of foods included during cue exposure (i.e., exposed foods) and foods not included during cue exposure (i.e., non-exposed foods), and duration of exposure were measured., Results: Both cue exposure conditions ate significantly less of the exposed foods compared to the control condition, though there were no differences between both types of exposure. No differences were found between conditions regarding the eating of non-exposed foods. In addition, the duration of exposure was not different between both cue exposure conditions., Conclusions: While food cue exposure in obese women led to less eating of exposed foods, focusing on either habituation of eating desires or expectancy violation did not matter. It is discussed why exposure works., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Overweight and obese individuals show increased psychological and physiological reactivity to food cues and many of them have difficulties in achieving long-term weight loss. The current study tests whether abnormalities in the learning and extinction of appetitive responses to food cues might be responsible for this. Overweight/obese and healthy weight women completed a differential appetitive conditioning task using food as rewards, while eating expectancies, eating desires, conditioned stimulus evaluations, salivation, and electrodermal responses were assessed during an acquisition and extinction phase. Results suggested reduced discriminative conditioning in the overweight/obese group, as reflected by a worse acquisition of differential eating desires and no successful acquisition of differential evaluative responses. Some evidence was also found for impaired contingency learning in overweight and obese individuals. No group differences in conditioned salivation and skin conductance responses were found and no compelling evidence for differences in extinction was found as well. In sum, the current findings indicate that overweight and obesity may be characterized by reduced appetitive conditioning. It is suggested that this could be causally related to overeating via stronger context conditioning or a tendency towards overgeneralization in overweight and obese individuals., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The prevalence of overweight and obesity has increased substantially over the last decades. Weight loss attempts in overweight individuals are common, though they seldom result in successful long-term weight loss. One very promising treatment is food cue exposure therapy, during which overweight individuals are repeatedly exposed to food-associated cues (e.g., the sight, smell and taste of high-calorie foods, overeating environments) without eating in order to extinguish cue-elicited appetitive responses to food cues. However, only few studies have tested the effectiveness of cue exposure, especially with regards to weight loss. For exposure treatment of anxiety disorders, it has been proposed that inhibitory learning is critical for exposure to be effective. In this RCT, we translated techniques proposed by Craske et al. (2014) to the appetitive domain and developed a novel cue exposure therapy for overeating aimed at maximizing inhibitory learning. The current RCT tested the effectiveness of this 8-session cue exposure intervention relative to a control intervention in 45 overweight adult (aged 18-60) females at post-treatment and 3-month follow-up, of which 39 participants completed the study. Weight loss, eating psychopathology, food cue reactivity, and snacking behaviour were studied as main treatment outcomes, and mediators and moderators of treatment effects were studied. The presented study design represents an innovative effort to provide valuable clinical recommendations for the treatment of overeating and obesity., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The present study investigated whether a single-session of food cue exposure for overweight women would decrease 'if CS then US' expectancies, cue reactivity and eating in the absence of hunger (EAH). EAH was measured in a behavioural paradigm that enabled to also investigate whether the cue exposure effects were specific for exposed foods or would generalise to food items that were not present during exposure. Overweight women were randomly assigned to either the cue exposure intervention or a control intervention that focused on body image. In line with the hypotheses, results showed that cue exposure induced a significant decrease in 'if CS then US' expectancies, in contrast to the control intervention. It was also found that, compared to the control intervention, desires to eat initially increased during cue exposure while gradual extinction was observed towards the end of the intervention. No extinction of increased salivation responses was found. Regarding EAH, the intake of the exposed food item was significantly less in the exposure condition than in the control condition, whereas total caloric food intake was not different between conditions, indicating that cue exposure was effective in reducing intake but did not generalise to the intake of other food items., (Copyright © 2015 Elsevier Ltd. All rights reserved.)