Appetite
journal homepage: www.elsevier.com/locate/appet
Research report
a r t i c l e
i n f o
Article history:
Received 16 July 2013
Received in revised form 5 November 2013
Accepted 8 November 2013
Available online 23 November 2013
Keywords:
Guilt
Ambivalence
Healthy eating
Weight-loss
Chocolate
a b s t r a c t
Food and eating are often associated with ambivalent feelings: pleasure and enjoyment, but also worry
and guilt. Guilt has the potential to motivate behaviour change, but may also lead to feelings of helplessness and loss of control. This study rstly examined whether a default association of either guilt or celebration with a prototypical forbidden food item (chocolate cake) was related to differences in attitudes,
perceived behavioural control, and intentions in relation to healthy eating, and secondly whether the
default association was related to weight change over an 18 month period (and short term weight-loss
in a subsample of participants with a weight-loss goal). This study did not nd any evidence for adaptive
or motivational properties of guilt. Participants associating chocolate cake with guilt did not report more
positive attitudes or stronger intentions to eat healthy than did those associating chocolate cake with
celebration. Instead, they reported lower levels of perceived behavioural control over eating and were
less successful at maintaining their weight over an 18 month period. Participants with a weight-loss goal
who associated chocolate cake with guilt were less successful at losing weight over a 3 month period
compared to those associating chocolate cake with celebration.
2014 Published by Elsevier Ltd.
Introduction
In modern society, food and eating are associated with ambivalent feelings: pleasure and enjoyment, but also worry and concern
(e.g., about weight gain, appearance and health effects) (Rozin,
Bauer, & Catanese, 2003; Rozin, Fischler, Imada, Sarubin, &
Wrzesniewski, 1999; Rozin, Kurzer, & Cohen, 2002). Rozin et al.
(2003) suggest that these worries and concerns may reduce peoples quality of life and be unproductive in terms of health and
weight control. It is striking that, for example, the prevalence of
obesity is much higher in the United States than in France (OECD
Health Data, 2011), while the Americans tend to associate food
more with health, tend to worry more about food, and focus less
on the enjoyment and experience of food than do the French (Rozin
et al., 1999; see also Rozin et al., 2002). The prototypical example
of a food item that elicits ambivalent feelings in many people is
chocolate. The present study examines whether a default association of chocolate cake with either guilt or celebration is associated with healthy or unhealthy eating behaviours, attitudes,
perceived behavioural control and intentions towards healthy eating, and weight change over an 18 month period. In addition, the
study examines whether either default association is productive
or unproductive when trying to lose weight.
Corresponding author.
E-mail address: roeline.kuijer@canterbury.ac.nz (R.G. Kuijer).
0195-6663/$ - see front matter 2014 Published by Elsevier Ltd.
http://dx.doi.org/10.1016/j.appet.2013.11.013
49
50
Methods
Participants and procedure
Total sample
Originally, participants were recruited to participate in a crosssectional study on health and well-being. Recruitment took place
over a period of 6 months through random delivery of letters about
the study to 3500 homes in Canterbury, New Zealand. All participants gave their informed consent, and the study was approved
by the university human ethics committee. In order to avoid statistical dependency in the data, data from only one person per household was used in the present study (N = 314). Data from 20
participants could not be used because they had a missing value
on the question asking whether they associated chocolate cake
with guilt or celebration. Most of these participants wrote they
never ate chocolate cake or disliked chocolate cake. The nal sample at baseline therefore consisted of 294 participants.
Eighteen months after the rst participants had entered the
study, participants who at baseline expressed willingness to take
part in future research (N = 252) were re-contacted and received
a follow-up questionnaire with 202 participants returning this
questionnaire. Twelve participants did not report their follow-up
weight, bringing the follow-up sample size down to 190. As participants were initially recruited over a period of 6 months, the
follow-up questionnaire was completed 1218 months post baseline (M = 17.11 months, SD = 2.37, range = 1222 months). However, as the mean time since baseline was so close to 18 months
we refer to this follow-up as the 18 month follow-up throughout
this paper.
At baseline, participants were aged between 18 and 86 years
(M = 48.1, SD = 17.9). The sample was predominantly female
(72%) and of European descent (91%). Compared to New Zealand
census gures for this region, people with higher education levels
were somewhat overrepresented (11% no formal school qualication, 31% secondary school qualication, 22% tertiary school qualication, 35% university degree). Mean Body Mass Index (BMI)
(based on self-reported height and weight) was 25.0 (SD = 4.4;
range: 16.847.2), with men (M = 26.0) having a slightly higher
BMI compared to women (M = 24.6, p < .05). Mean BMI in the present sample was slightly below the national average for both men
and women (27.3 and 27.1, respectively, Ministry of Health,
2008). Participants who did not want to participate in future
research (N = 42) or did not return the follow-up questionnaire
(N = 50) (N = 92 in total; 31% of the original sample of 294) were
younger (p < .01), reported unhealthier eating behaviours
(p < .05), had less positive attitudes toward healthy eating
(p < .01), and were more likely to associate chocolate cake with
guilt (p < .05) at baseline, compared to those who did complete
the 18-month follow-up questionnaire. No other signicant differences were found.
Weight-loss sample
Participants who reported wanting to lose weight in the baseline questionnaire, received an additional questionnaire 3 months
after study entry. As we did not want the Christmas holidays to
interfere with the follow-up assessment, only participants recruited before mid-August received the 3 month follow-up questionnaire. Of the 247 participants recruited before mid August,
53% (N = 131) had a weight-loss goal. Of those people, 109 indicated willingness to participate in future research and received
the 3 month follow-up questionnaire. Eight-three participants
returned the questionnaire. Two participants did not report their
follow-up weight, bringing the sample size down to 81. Participants with a weight-loss goal who did not want to participate in
future research (N = 22) or did not return the follow-up questionnaire (N = 26) (N = 48 in total; 37% of the original weight-loss sample of 131) were younger compared to those who completed the
3 month follow-up (p < .01). No other demographic differences or
differences on baseline measures were found.
Measures
For all multi-item scales, items were summed and then averaged. Means and standard deviations of the key variables, as well
as correlations between these variables and demographic variables
are presented in Table 1.
Total sample
Default association: Following Rozin and colleagues (Rozin et al.,
1999, 2003) participants were asked to indicate of which word
they think rst (forced-choice format) when they read the words
chocolate cake: guilt or celebration.
Eating behaviours: Participants were asked to recall their eating
behaviour over the past 2 weeks with 5 items (based on Baker, Little, & Brownell, 2003). Sample items are: In the past two weeks,
on how many days did you eat in a balanced way with a lot of fruit
and vegetables and In the past two weeks, on how many days did
you eat junk food (potato chips, desserts, sweets, candy bars, etc.).
Data from a small validation study showed that the retrospective
recall of the ve eating behaviours correlated highly with a 2 week
diary report of those behaviours (see Kuijer & Boyce, 2012). All
items were scored on a ve point scale ranging from 1 every
day to 5 less than once a week. Items were scored in such a
way that a higher score on the summed scale indicates healthier
eating behaviours (Cronbachs alpha = .67).
Eating evaluation: Following the eating behaviour questions,
participants were asked to give an overall evaluation of how
healthy their eating had been over the previous 2 weeks (1 = not
very healthy, 7 = very healthy) (Baker et al., 2003).
Theory of Planned Behaviour (TPB) variables: Attitude, Perceived
behavioural control and Intention were all assessed with standard
items (Ajzen, 1991; Conner, Norman, & Bell, 2002). Attitude toward
healthy eating was measured with ve bipolar items on a 7-point
scale: For me, healthy eating is . . . good-bad, important-unimportant, boring-interesting, pleasant-unpleasant, useful-useless
(Cronbachs alpha = .78). All items apart from boring-interesting
were reverse scored. Three questions were asked to measure Perceived behavioural control (Cronbachs alpha = .61): participants
were asked How difcult or easy would the following things be
for you? followed by the options: eat in a balanced way with a
lot of fruit and vegetables, eating moderate amounts of food
and stopping when I am full and staying away from junk food
(1 = very difcult, 5 = very easy). Intention was measured with two
items (Cronbachs alpha = .92): In the next four weeks, do you
plan to eat a healthy diet (balanced diet, moderate amounts and
avoiding too much junk food)? and In the next four weeks, do
you expect to eat healthily? (1 = certainly not, 7 = certainly yes).
18 Month weight change: At baseline and at follow-up
(18 months after baseline) participants were asked how much they
currently weighed. A difference score was computed to assess
weight change. A positive score means weight gain and a negative
score weight loss.
Weight-loss sample
Weight-loss status: In the baseline questionnaire, participants
were asked which of the following statements applied to them:
I am trying to lose some weight, I am happy with my current
weight and I am trying to gain some weight. If participants endorsed the rst option they were asked to complete a number of
questions on weight-loss (see below). Participants trying to lose
51
Age
Educ.
BMI
Default
.01
.02
.17*
.00
.06
.01
.47***
.42***
.22***
.42***
.35***
.20**
.25***
.20**
.20**
.14*
.22***
.13
.13*
.19**
.16*
.23***
.03
.03
.14*
.21***
.08
.21***
.12*
.17**
.03
.03
.06
.07
.09
.03
.19*
.22*
.13
.29**
.18
.02
.14
.01
.15
.08
.10
.22*
.65***
.01
.39***
.04
.04
.04
.06
.24**
.11
.08
.28*
.13
WS
.23***
.29***
.15*
.33***
.21**
.05
(SD)
4.21
5.45
6.03
3.97
6.13
0.84
(0.67)
(1.29)
(0.86)
(0.80)
(1.04)
(4.50)
7.00
6.94
4.26
5.59
0.11
4.06
(5.07)
(2.09)
(2.61)
(2.50)
(2.80)
(2.35)
Note: Sex: 1 = male, 2 = female. Default = default association: 1 = celebration, 2 = guilt. WS = weight-loss status: 1 = no weight-loss goal, 2 = weight-loss goal.
p < .05.
**
p < .01.
***
p < .001.
*
52
Table 2
Differences between participants associating chocolate cake with guilt and
celebration.
Guilt
Celebration
M
pg2
SE
Total sample
Eating behaviours1,2,3,4
Eating evaluation1,2,3,4
Attitudes1,2,3,4,5
PBC1,2,3,4
Intention1,2,4
18 mo weight D (kg)1 (CC)
18 mo weight D (kg)1 (MI)
SE
4.15
5.20
6.04
3.80
5.97
2.36
2.51
(.076)
(.149)
(.116)
(.092)
(.128)
(.651)
(.651)
4.23
5.54
6.10
4.03
6.16
0.36
0.61
(.037)
(.074)
(.058)
(.046)
(.064)
(.362)
(.464)
0.82
4.34*
0.20
4.86*
1.87
7.19**
6.08*
.003
.015
.001
.017
.006
.037
.035
Weight-loss sample
Total WL goal (kg)1,3
Importance goal1
3 mo WL goal (kg)3
3 mo condence1
3 mo weight D (kg)1 (CC)
3 mo weight D (kg)1 (MI)
3 mo effort 2 (CC)
3 mo effort 2 (MI)
6.95
7.56
4.83
5.76
1.25
1.45
4.43
4.65
(.528)
(.295)
(.354)
(.353)
(.530)
(.764)
(.436)
(.422)
7.04
6.60
3.92
5.49
0.43
0.27
3.88
3.81
(.396)
(.218)
(.268)
(.264)
(.365)
(.393)
(.308)
(.281)
0.02
6.71*
4.14*
0.37
6.81*
4.83*
1.06
2.40
.000
.050
.033
.003
.079
.081
.013
.030
Where appropriate, means were adjusted for covariates (1age, 2education, 3BMI,
Weight-loss status (WS), 5Sex). WS and Sex were included as factors in the analyses: no signicant interaction effects were found between WS and default, or Sex
and default, all Fs < 2.28, ps > .13.
CC = complete-case analysis, MI = multiple imputation.
Total sample: N = 294; 78 guilt/216 celebration, except for CC analysis: N = 190; 45
guilt/145 celebration. Weight-loss sample: N = 131; 47 guilt/84 celebration, except
for CC analysis: N = 81, 26 guilt/55 celebration.
*
p < .05.
**
p < .01.
p < .001.
4
perceived behavioural control and follow-up weight-change remained signicant (r = .15, p < .05) once age, education, and BMI
were controlled for.
Participants who associated chocolate cake with guilt or celebration did not differ in the total amount of weight they wanted
to lose. However, participants who responded with guilt had a
more ambitious 3 month goal compared to participants who
responded with celebration (see Table 2). Participants who associated chocolate cake with guilt also rated their weight-loss goal as
more important compared to participants who responded with celebration (Table 2). The groups did not differ in condence.
At follow-up 3 months later, participants weighed on average
the same as they did at baseline (M = 0.11 kg weight gain;
SD = 2.80; range: 7 kg weight-loss10 kg weight-gain). However,
participants who associated chocolate cake with celebration were
on average more successful in losing weight (M = 0.43 weight-loss)
than were participants who associated chocolate cake with guilt
(M = 1.25 weight-gain) (complete case-analysis, see Table 2). The
main effect for default association was signicant regardless of
whether complete-case analysis or multiple imputation was used.
On average participants in the weight-loss sample reported that
they had not tried very hard to reach their goal (M = 4.06 on a scale
from 1 to 10). Although participants who associated chocolate cake
with celebration lost more weight than did participants who associated chocolate cake with guilt, no differences were found
between the two groups with respect to effort (Table 2) and
amount of effort was unrelated to weight change (r = .12, ns). Neither eating behaviours, TPB variables, nor any of the other weightloss variables assessed at baseline were signicantly correlated
with 3 month weight-loss (all rs < .14, ns).
Discussion
With the current increase in obesity and associated health risks,
many countries (including New Zealand) have launched (media)
campaigns and programmes to increase healthy dietary habits
and prevent overweight. An unintended side effect of these campaigns and programmes may be that they fuel feelings of guilt
and worry about food (cf. Rozin et al., 1999, 2003). For example,
a study by Harting, van Assema, and de Vries (2006) showed that
after health counselling by a health advisor about high fat consumption, smoking and physical inactivity, one third of the participants reported an increased guilty conscience. But is guilt good or
bad?
In our study, a little over one quarter of the sample associated
chocolate cake more with guilt than with celebration. This percentage was comparable to that found by Rozin et al. (2003) in a
student sample. As expected, we found that participants with a
weight-loss goal were more likely to associate chocolate cake with
guilt than were participants without a weight-loss goal (e.g., Cartwright & Stritzke, 2008). However, even in a subsample of participants who wanted to lose weight, the majority (63%) associated
chocolate cake with celebration rather than guilt.
The current study did not nd any evidence for adaptive or
motivational properties of guilt. Those who associated chocolate
cake with guilt did not report more positive attitudes toward
healthy eating or stronger intentions to eat healthy in the future
than did those who associated chocolate cake with celebration. Instead, they reported lower levels of perceived behavioural control
over eating (i.e., lower levels of self-efcacy) and were less successful at maintaining their weight over an 18 month period (whilst
taking into account important covariates such as BMI, age and education). Moreover, those with an active weight-loss goal who associated chocolate cake with guilt were less successful at losing
weight over a 3 month period (they actually gained weight) compared to those who associated chocolate cake with celebration.
To our knowledge this is the rst study that has examined the link
between a guilty food-attitude and actual weight change over time
in a healthy sample. Our ndings are in line with Rozins suggestions (Rozin et al., 1999, 2003) that worry, concern and guilt about
food are counterproductive.
Although our ndings support Rozins theory (Rozin et al., 1999,
2003), they do not shed any light on possible underlying mechanisms. Several researchers have suggested that guilt leads to feelings of helplessness and loss of control, and it is those feelings
that result in maladaptive outcomes (cf. Tangney et al., 2007). Guilt
may also signal a conict between approach and avoidance motivations, whereas celebration does not. Just as trying to suppress
an unwanted thought (do not think of a white bear) often results
in this thought actually becoming more prevalent and intrusive
(Wegner, 1994), trying to avoid forbidden foods makes them more
desirable and tends to result in cravings (Rodgers et al., 2011; Rogers & Smit, 2000) and hence less control. In the current study, those
who associated chocolate cake with guilt indeed reported lower
levels of perceived behavioural control over healthy eating, and
both lower levels of perceived behavioural control and associating
chocolate cake with guilt were related to less successful weight
maintenance. Future research should examine a formal mediation
model where each variable in the model is assessed at a different
time point.
There were no other variables assessed at baseline that could
explain the link between associating chocolate cake with celebration and more successful weight maintenance. Participants associating chocolate cake with celebration did not have healthier eating
intentions or attitudes, nor did they try harder to lose weight. And
although they did evaluate their eating as healthier at baseline, this
53
did not affect their weight over time. In line with research showing
a link between chocolate-related guilt and higher body dissatisfaction and drive for thinness (Rodgers et al., 2011), we found that
those with a weight-loss goal associating chocolate cake with guilt
(vs. celebration) had a more ambitious 3 month weight-loss goal
and rated their goal as more important. Perhaps having a more
ambitious goal set these participants up for failure and disappointment (Foster, Wadden, Vogt, & Brewer, 1997). However, neither
the amount of weight participants wanted to lose nor importance
of their weight goal (or condence) was related to 3 month weightchange.
The nding that associating chocolate cake with celebration
was related to more successful weight maintenance ts nicely with
a recent focus in the broader psychological literature on the benecial effects of positive affective states on peoples outcomes in life
(see Lyubomirsky, King, & Diener, 2005). According to Fredericksons (2001) broaden-and-build theory, positive mood works as
a resource, making challenges such as self-control dilemmas easier
to deal with. There is also some evidence from laboratory studies
that positive mood may enhance self-control and decrease unhealthy food intake (Fedorikhin & Patrick, 2010; Turner, Luszczynska, Warner, & Schwarzer, 2010; Winterich & Haws, 2011),
although not all research shows such positive effects (e.g., Evers,
Adriaanse, de Ridder, & de Witt Huberts, 2013). Conversely, Lindeman and Stark (2000) found that especially dieters who rated
ideological issues as important and pleasure as unimportant when
choosing food, showed more signs of eating disorders and lower
psychological well-being compared to other dieters.
The way in which chocolate-related guilt was measured in the
present study deserves some attention. An advantage of measuring
it as a default association is that it taps into the most salient way a
person thinks about a certain issue (see Rozin et al., 1999, 2003).
Like free associations, such forced-choice items demand less
deliberate considerations and may capture more spontaneous
and automatic representations that are not accessible with explicit
questionnaires. A disadvantage of our current measure is that we
have no information about the temporal aspect of those feelings
of guilt (or celebration), that is, we do not know whether those
people who responded with guilt did so because they usually feel
guilty before or after eating chocolate cake, or a mixture of both.
Anticipated guilt has more potential to be motivating (as there
are opportunities to change ones behaviour) than guilt that is
experienced after a transgression or violation (Giner-Sorolla,
2001). A related issue is that we only used one item to assess the
default association in relation to chocolate which is a limitation.
In addition, although chocolate is the prototypical example of a forbidden food (and indeed the majority of studies in the eating domain that have examined eating related guilt have looked at
chocolate), it would be important to consider default associations
toward other food items in future research.
The current study has some limitations that should be addressed. First, the study relied on self-report measures for weight,
and height. Although self-reported and measured BMI are highly
correlated, people tend to slightly overestimate their height and
underestimate their weight (e.g., Spencer, Appleby, Davey & Key,
2002). However, if some people indeed underestimated their
weight then it is likely they will have done so at each measurement
time, hence probably not inuencing the weight change measure.
We also used a self-report measure to assess eating behaviours
over the past 2 weeks. To improve our understanding of exactly
how guilt affects eating behaviour, it is essential that future research uses more objective behavioural measures such as observation of eating behaviour, or diary methods. Second, we controlled
for sex in our analyses where appropriate, but future research
should systematically examine sex as a moderator variable. Our
54
sample did not have enough male participants for such analyses. In
line with other research we found that women were more likely to
report chocolate related guilt than were men (Cramer & Hartleib,
2001; Mller et al., 2008). However, it is also possible that women
and men are differently affected by guilt and future research
should examine this possibility. Third, as participants were not
originally recruited for a multi-measurement study, there was
considerable drop-out between baseline and follow-ups. Younger
participants, those associating chocolate cake with guilt and those
with less healthy eating behaviours and attitudes were less likely
to complete the follow-up measures. To address the issue of
non-response bias, multiple imputation was used in addition to
complete-case analysis. Both methods yielded the same results
suggesting that the differences between completers and drop-outs
did not bias the results.
To conclude, the current study did not nd evidence for adaptive properties of guilt. Increasing peoples guilty conscience about
food and eating through media campaigns and programmes about
healthy nutrition with the view to initiate or motivate behaviour
change seems ill advised. Enjoyment of food and eating is essential
to peoples well-being and the current study shows that people
who associate a forbidden food with celebration and view it as a
treat that can be enjoyed do better in terms of weight management. In education messages about dietary recommendations
enjoyment of food and eating should receive more attention than
it has in the past.
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