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Updated: May 25, 2026

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Published on: January 10, 2025
Usual energy intake mediates the relationship between food reinforcement and BMI
Leonard H Epstein1, Katelyn A Carr, Henry Lin
1Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA. LHENET@acsu.buffalo.edu
Abstract:
The relative reinforcing value of food (RRV(food)) is positively associated with energy consumed and overweight status. One hypothesis relating these variables is that food reinforcement is related to BMI through usual energy intake. Using a sample of two hundred fifty-two adults of varying weight and BMI levels, results showed that usual energy intake mediated the relationship between RRV(food) and BMI (estimated indirect effect = 0.0027, bootstrapped 95% confidence intervals (CIs) 0.0002-0.0068, effect ratio = 0.34), controlling for age, sex, minority status, education, and reinforcing value of reading (RRV(reading)). Laboratory and usual energy intake were correlated (r = 0.24, P < 0.001), indicating that laboratory energy intake could provide an index of eating behavior in the natural environment. The mediational relationship observed suggests that increasing or decreasing food reinforcement could influence body weight by altering food consumption. Research is needed to develop methods of modifying RRV(food) to determine experimentally whether manipulating food reinforcement would result in changes in body weight.
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