Published June 7, 2013
Leonard H. Epstein, PhD, delivered the 2013 Stockton Kimball Lecture “Reinforcement Pathology and Obesity” June 5.
He won the school’s 2012 Stockton Kimball Award in recognition of his outstanding research contributions and significant service to the university. The Stockton Kimball lecture traditionally accompanies the award.
In his lecture, Epstein described two types of choices that influence body weight and are integral to behavioral approaches to obesity.
Some choices are made among concurrently available alternatives: ‘Will I have a doughnut or steel-cut oats for breakfast?’ ‘Will I go for a run or watch a television show?’ These choices are a function of the reinforcing value of food or physical activity.
Other, intertemporal choices involve immediate gratification versus longer-term goals: ‘Will I forgo the ice cream so I can be thinner later?’ ‘Will I fit in a training run even though I’m tired so I can perform better in a race two months from now?’ These choices are related to delay discounting, or the devaluing of future outcomes.
Epstein discussed how obesity, weight gain and weight loss are related to both the reinforcing value of food and delay discounting, and how these factors interact to create reinforcement pathology and influence obesity.
“People who find food very reinforcing and are unable to delay the gratification of eating very palatable food face the greatest risk of weight gain and have the most trouble losing weight,” he says.
“Developments in ways to modify delay of gratification or impulsivity provide new ideas on treatment approaches to obesity,” he explains.
These approaches do not just focus on changing eating and exercise behaviors, but also involve modifying an individual's executive function.
The award and lecture memorialize Stockton Kimball, MD ’29, dean of the UB medical school from 1946 to 1958, and his contributions to physician training for more than 25 years.