Food and Behavior Modification

By Gabrielle Finora and the team at LCWNS

In our society, food often serves as a powerful motivator, whether it is withheld as a punishment or provided as a reward. This strategy is commonly employed with children to help make challenging and intimidating tasks more appealing, such as visiting the doctor or finishing a meal they do not particularly like. After all, what child would say no to the offer of McDonald’s or ice cream afterward? However, relying on food as a tool for behavior motivation can have detrimental effects on our overall eating habits and contribute to the development of disordered eating patterns. In this blog, we will delve into the dangers of using food as positive reinforcement and explore healthier alternatives for fostering positive behaviors.

Our childhood experiences can shape our personalities, and our relationship with food is no exception. Using food as a means of behavior reinforcement is known to disrupt the natural cycles of hunger and satiety, as it encourages eating even when one is not truly hungry. This pattern of behavior rewards emotional eating outside of mealtimes and creates an association between food and accomplishment, which has been linked to binge and emotional eating later in life (Novak & Bradley, 2019).

The role of parenting in shaping eating patterns that persist into adulthood cannot be underestimated. Empirical studies have provided evidence of how using food as a positive reward can impact a child’s eating habits. A longitudinal study involving 207 children, evaluated at 2, 3.7, and 5 years of age, found that food used as a reward for good behavior at 3.7 years predicted higher food fussiness at 5 years. Interestingly, higher levels of food fussiness at 3.7 years predicted parents using more rewards for eating specific foods at 5 years (Mallan et al., 2018). These findings highlight how using food as reinforcement can contribute to picky eating behaviors.

Another longitudinal study involving 3642 children assessed at 4 years and 9 years found that approximately two-thirds of parents used food rewards at 4 years. This number decreased to about 50% by the time the children reached 9 years. Notably, the use of food rewards at age 4 was associated with a higher prevalence of picky eaters later on. One possible explanation for why fussiness may increase with the use of food rewards is that it tends to increase the likability of rewarded foods while decreasing the likability of healthier options. Children generally prefer highly palatable foods such as baked goods and fast food, which contain high levels of sugar, fat, and salt. Fruits, vegetables, or other healthy options can appear less appealing in comparison (Jansen et al., 2020).

This topic has great importance to autism spectrum disorder (ASD). Children and adults with ASD may have feeding problems, including rituals, food refusal, selective eating patterns, and limited preferred foods. These factors increase the link between ASD and chronic weight-related health conditions, along with other external factors like lack of support for families and the individual, as well as medication effects. While food is often used as a reward for preferred behaviors in children and adults with ASD, Dr. Carol Curtin and other researchers released 23 strategy recommendations to promote healthy eating, including:

• In the home:
  • Include the family member in the food preparation if possible
  • Introduce new foods accompanied by foods the child or adult already likes
  • Increase structure around mealtimes like adjusting scheduling based on medications and removing distractions like TVs or phones.
• In childcare, preschool or school:
  • Use physical activity, like dancing, outdoor time, or interactive video games as a reward instead of food.
  • “Include healthy eating goals and alternatives to food rewards in IEPs and Transition Plans”.
• With in-home support staff:
  • Help staff find alternatives to using food as a reward
  • Ask staff to model healthy eating behaviors
  • Bring soda and/or fast food in unlabeled containers

In conclusion, while using food as a reinforcement strategy may not always lead to altered eating patterns later in life, it is essential to be mindful of its potential impact. It is crucial to strike a balance between incorporating treats and rewards into our lives for enjoyment and maintaining a healthy relationship with food. However, if you notice that troubling eating patterns are taking control of your life, make sure to speak with a therapist or a registered dietitian. Relationships we form with food are powerful and can last a lifetime but can be tended to with the right health care team.