Breaking habits or breaking habitual behaviours?: Old habits as a neglected factor in weight loss maintenance

Benjamin Gardner; Rebecca Richards; Phillippa Lally; Amanda Rebar; Tanya Thwaite; Rebecca J Beeken

doi:10.1016/j.appet.2021.105183

Breaking habits or breaking habitual behaviours? Old habits as a neglected factor in weight loss maintenance

Benjamin Gardner, Rebecca Richards, Phillippa Lally, Amanda Rebar, Tanya Thwaite, Rebecca J Beeken

Psychology

Centre for Pain Research, University of Bath, Department of Experimental Psychology, University of Oxford, Department of Anaesthesiology & Pain Medicine, University of Washington, Clinical Health Psychology, University College London, and University College London Hospitals, and Psychology Department, Kings College London.
King's College London
University of Cambridge
Univ London, Birkbeck University London, University College London, University of London Royal Veterinary College, University of London, St Georges University London, Imperial College London, Kings College London, Royal Holloway University London, Queen Mary University London, Div Populat Hlth Sci & Educ
Central Queensland University
Leeds Teaching Hosp Trust, University of Leeds, Leeds Gen Infirm

Research output: Contribution to journal › Review article › peer-review

33 Citations (Scopus)

Abstract

Maintaining weight loss requires long-term behaviour change. Theory and evidence around habitual behaviour - i.e., action triggered by impulses that are automatically activated upon exposure to cues, due to learned cue-action associations - can aid development of interventions to support weight loss maintenance. Specifically, weight loss is more likely to be sustained where people develop new habits that support weight management, and break old habits that may undermine such efforts. Interventions seeking to break 'bad' weight-related habits have focused on inhibiting unwanted impulses or avoiding cues. This paper draws attention to the possibility that while such approaches may discontinue habitual behaviour, underlying habit associations may remain. We use evidence from existing qualitative studies to demonstrate that, left unchecked, unwanted habit associations can render people prone to lapsing into old patterns of unhealthy behaviours when motivation or willpower is momentarily weakened, or when returning to familiar settings following temporarily discontinued exposure. We highlight six behaviour change techniques especially suited to disrupting habit associations, but show that these techniques have been underused in weight loss maintenance interventions to date. We call for intervention developers and practitioners to adopt techniques conducive to forming new habit associations to directly override old habits, and to use the persistence of unwanted habit associations as a potential indicator of long-term weight loss intervention effectiveness.

Original language	English
Article number	105183
Pages (from-to)	105183
Journal	Appetite
Volume	162
Early online date	27 Feb 2021
DOIs	https://doi.org/10.1016/j.appet.2021.105183
Publication status	Published - 1 Jul 2021

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10.1016/j.appet.2021.105183

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title = "Breaking habits or breaking habitual behaviours?: Old habits as a neglected factor in weight loss maintenance",

abstract = "Maintaining weight loss requires long-term behaviour change. Theory and evidence around habitual behaviour - i.e., action triggered by impulses that are automatically activated upon exposure to cues, due to learned cue-action associations - can aid development of interventions to support weight loss maintenance. Specifically, weight loss is more likely to be sustained where people develop new habits that support weight management, and break old habits that may undermine such efforts. Interventions seeking to break 'bad' weight-related habits have focused on inhibiting unwanted impulses or avoiding cues. This paper draws attention to the possibility that while such approaches may discontinue habitual behaviour, underlying habit associations may remain. We use evidence from existing qualitative studies to demonstrate that, left unchecked, unwanted habit associations can render people prone to lapsing into old patterns of unhealthy behaviours when motivation or willpower is momentarily weakened, or when returning to familiar settings following temporarily discontinued exposure. We highlight six behaviour change techniques especially suited to disrupting habit associations, but show that these techniques have been underused in weight loss maintenance interventions to date. We call for intervention developers and practitioners to adopt techniques conducive to forming new habit associations to directly override old habits, and to use the persistence of unwanted habit associations as a potential indicator of long-term weight loss intervention effectiveness.",

author = "Benjamin Gardner and Rebecca Richards and Phillippa Lally and Amanda Rebar and Tanya Thwaite and Beeken, {Rebecca J}",

note = "Funding Information: The authors thank Dr Lee Ashton for sharing his behaviour change technique coding with us for the purposes of our synthesis of techniques used in previous weight loss interventions. Rebecca J Beeken is supported by the Yorkshire Cancer Research University Academic Fellowship funding. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

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N1 - Funding Information: The authors thank Dr Lee Ashton for sharing his behaviour change technique coding with us for the purposes of our synthesis of techniques used in previous weight loss interventions. Rebecca J Beeken is supported by the Yorkshire Cancer Research University Academic Fellowship funding. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2021 Elsevier Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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N2 - Maintaining weight loss requires long-term behaviour change. Theory and evidence around habitual behaviour - i.e., action triggered by impulses that are automatically activated upon exposure to cues, due to learned cue-action associations - can aid development of interventions to support weight loss maintenance. Specifically, weight loss is more likely to be sustained where people develop new habits that support weight management, and break old habits that may undermine such efforts. Interventions seeking to break 'bad' weight-related habits have focused on inhibiting unwanted impulses or avoiding cues. This paper draws attention to the possibility that while such approaches may discontinue habitual behaviour, underlying habit associations may remain. We use evidence from existing qualitative studies to demonstrate that, left unchecked, unwanted habit associations can render people prone to lapsing into old patterns of unhealthy behaviours when motivation or willpower is momentarily weakened, or when returning to familiar settings following temporarily discontinued exposure. We highlight six behaviour change techniques especially suited to disrupting habit associations, but show that these techniques have been underused in weight loss maintenance interventions to date. We call for intervention developers and practitioners to adopt techniques conducive to forming new habit associations to directly override old habits, and to use the persistence of unwanted habit associations as a potential indicator of long-term weight loss intervention effectiveness.

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Breaking habits or breaking habitual behaviours? Old habits as a neglected factor in weight loss maintenance

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