Symposium 124 - From Rigid Rules to Flexible Eating: New and Novel Assessments of Eating Flexibility

Chair(s)

• JH

  Julia Hormes, Ph.D. (she/her/hers)

  Associate Professor
  University at Albany, State University of New York
  Albany, New York

Discussant(s)

• AT

  Alix Timko, Ph.D. (she/her/hers)

  Assistant Professor of Psychology
  University of Pennsylvania
  Philadelphia, Pennsylvania

Presenter(s)

• MC

  Marita Cooper, Ph.D. (she/her/hers)

  Research Postdoctoral Fellow
  Children’s Hospital of Philadelphia
  Philadelphia, Pennsylvania
• KE

  Kuschner Emily, Ph.D. (she/her/hers)

  Children’s Hospital of Philadelphia
  Philadelphia, Pennsylvania
• MM

  McKenzie Miller, M.A. (she/her/hers)

  Graduate Student
  University at Albany, State University of New York
  Albany, New York
• GH

  Grace Haase, B.A. (she/her/hers)

  Research Coordinator
  Children's Hospital of Philadelphia
  PHILADELPHIA, Pennsylvania

The assessment of eating behavior is deceptively complex. Historically, assessment measures have focused on the quality, quantity, or restrictive (i.e., elimination of certain types of foods from the diet) aspects of food intake. Assessment methodology has typically been self-report or interview based, with a reliance on food frequency questionnaires, food diaries, and 24-hour recall interviews. Technological advances include electronic versions of these assessment types – including ecological momentary assessment.  Many assessments are disorder-specific and tailored to particular conditions characterized by or associated with disruptions in food intake. In these contexts, assessments often focus on quantifying certain elements of food (such as texture, color, macronutrient content) or the overall volume of food (including reasons why volume may be reduced). 

In the context of eating challenges that warrant treatment, type and volume of food intake have generally been a key treatment focus; however, flexibility around the characteristics and volume of food consumed has received increasing attention. Flexibility is a key aspect of executive functioning and is related to one’s ability to adapt quickly and “switch” effectively in response to changes in environmental contingencies. In eating behavior, flexibility can be conceptualized as the ability or willingness to try new, feared, or nonpreferred foods, to eat different foods than planned, or to eat in opposition to rigid rules regarding what is good, acceptable, or healthy. There is an increasing body of research focused on interventions to target underlying (in)flexibility in the context of eating challenges that define or are highly co-occurring with DSM-5/ICD-10 diagnosis (such as Eating Disorder or Autism Spectrum Disorder). If flexibility in eating behavior is a treatment target rather than type and volume of food intake, it is essential that we develop sensitive and meaningful measures of flexible eating not historically captured.

This symposium explores three new methods to assess flexibility around food choice and eating and eating in clinical and at-risk populations. We discuss the rationale for their development, preliminary evaluation of psychometric properties, and their relation to eating behavior. Of particular importance is how these assessment tools can increase our understanding of eating behavior and be used to assess both process and outcome in treatment. The need for novel assessments will be highlighted. We will discuss how the research question, the type of eating behavior, and the population of interest inform assessment of eating behavior.