Abstract:
Background: Overeating is associated with significant public health problems particularly obesity. Recently, there has been a move to conceptualise overeating as an addictive behaviour akin to substance use disorder. This is because of the shared characteristics between overeating and addiction including loss of control, repeated attempts to change, and experiences of carving. A benefit of this approach is that interventions used to reduce addictive behaviours can also be adapted to reduce overeating. While the characteristics of these disorders appear to be similar, there has been limited investigation of the overlapping mechanisms of change. Based on previous studies investigating behaviour change strategies for reducing addictive behaviours, this study aims to develop a classification system detailing how people change their overeating behaviours. The second aim is to develop a set of consumer-informed guidelines that describe the mechanisms for the reduction of overeating. Methods: A pragmatic content analysis was used to develop a classification system of strategies for reducing overeating. To do this, consumer statements on how to reduce overeating were extracted from open access websites. A small sample of these were used to develop the classification system. This involved an inductive approach (data-driven change strategies) and a deductive approach whereby the classification system was informed by the wider literature in behaviour change. To develop the consumer-informed guidelines, a thematic analysis was conducted on the data that was coded into the sub-categories of the classification system. These were reviewed, refined and developed into a set of 16 consumer-informed guidelines. The guidelines were subjected to a peerreview process by 10 experts. Results: A classification system of 21 discrete groups of behaviour change strategies was developed. Consumer statements from online sources (n=451) were then coded into the classification system. This resulted in the coding of 4203 behaviour change strategies. The most frequently coded change strategies were consumption planning (13.6%), followed by dietary approach (11.3%) and consumption control (11.1%). Peer review of the guidelines indicated they were helpful and easy to understand. Conclusion: Behaviour change strategies used for overeating reduction were similar to those used for other addictive behaviours. These involved identifying triggers, improving self-control, managing cravings, self-care and developing coping skills. The guidelines provide a comprehensive approach that may inform self-help interventions for overeating reduction. Conceptualising overeating from an addiction framework can be helpful to improve treatments for overeating and related problems.