A qualitative study of psychological, social and behavioral barriers to appropriate food portion size control

Abstract

BackgroundGiven the worldwide prevalence of overweight and obesity, there is a clear need for meaningful practical healthy eating advice - not only in relation to food choice, but also on appropriate food portion sizes. As the majority of portion size research to date has been overwhelmingly quantitative in design, there is a clear need to qualitatively explore consumers’ views in order to fully understand how food portion size decisions are made. Using qualitative methodology this present study aimed to explore consumers’ views about factors influencing their portion size selection and consumption and to identify barriers to appropriate portion size control.MethodsTen focus groups with four to nine participants in each were formed with a total of 66 persons (aged 19–64 years) living on the island of Ireland. The semi-structured discussions elicited participants’ perceptions of suggested serving size guidance and explored the influence of personal, social and environmental factors on their food portion size consumption. Audiotapes of the discussions were professionally transcribed verbatim, loaded into NVivo 9, and analysed using an inductive thematic analysis procedure.ResultsThe rich descriptive data derived from participants highlight that unhealthy portion size behaviors emanate from various psychological, social and behavioral factors. These bypass reflective and deliberative control, and converge to constitute significant barriers to healthy portion size control. Seven significant barriers to healthy portion size control were apparent: (1) lack of clarity and irrelevance of suggested serving size guidance; (2) guiltless eating; (3) lack of self-control over food cues; (4) distracted eating; (5) social pressures; (6) emotional eating rewards; and (7) quantification habits ingrained from childhood.ConclusionsPortion size control strategies should empower consumers to overcome these effects so that the consumption of appropriate food portion sizes becomes automatic and habitual.

Impact of Perceived Healthiness of Food on Food Choices and Intake

“…We have indeed demonstrated that perceptions about the healthiness of food can have a significant impact on food intake (i.e., "if it's healthy, I can eat more") [21]. Such perceptions have also been identified in a qualitative study in which participants talk about "guiltless eating" [22]. They mentioned that beliefs about healthy eating could influence portion control, with "healthy" foods being excluded from food intake monitoring [22].…”

“…Such perceptions have also been identified in a qualitative study in which participants talk about "guiltless eating" [22]. They mentioned that beliefs about healthy eating could influence portion control, with "healthy" foods being excluded from food intake monitoring [22]. Overall, these findings suggest potential negative and unintended consequences of perceived healthiness of food on food choice and intake.…”

“…In their qualitative research, Spence and colleagues reported that emotional eating determines the portion sizes of « comfort » foods [22]. Kroeses and colleagues also demonstrated that strength of temptations could be associated to perceived healthiness of food, so that individuals may eat more from weak food temptations (considered to be less unhealthy) than from strong food temptations (considered to be more unhealthy) [45].…”

Quantifying consumer portion control practices. A cross-sectional study

“…Despite the fact that portion size guidance tools/information are available via industry, healthcare professional and nongovernmental organisations, we found that the measurementstrategy scale carried the lowest score. Previous research has highlighted that the use of practices within this strategy may be hindered by the lack of clarity and irrelevance of portion size advice (Faulkner et al, 2012;Spence et al, 2013), while another study has highlighted the difficulties which consumers encounter when using portion size estimation aids. The second scale, eating-strategy, captures consumer efforts to serve less food and increase, induce or realise satiety (e.g.…”

Overcoming Barriers to Weight Loss Practice Guidelines in Primary Care

“…Some regularly consumed larger portion sizes in order to impress, ingratiate themselves, or be a "good guest." 23,24 Importantly, providers that understand the context in which patient's ideals are set and how sociocultural ideals influence the type of behavioral self-regulation that develops can address these emotional barriers as part of the long-term goals of lifestyle modification for health maintenance. 25 The study by Segaret al 25 suggests that behavioral interventions might better facilitate increased physical activity among midlife women if providers address and acknowledge the internalization of cultural norms and pressures.…”