Reinforcer Pathology as a Mechanism for the Increase in Obesity Throughout Childhood: A Conceptual Blueprint for Research

The prevalence of childhood obesity increases throughout development. Obesity results from a positive energy balance, which suggests different trajectories of energy intake and energy expenditure as children age. Rapid development of reward processes that motivate eating and sedentary over physically active behaviors coupled with slower development of executive functions that allow youth to focus on long-term goals rather than immediate gratification may influence the imbalance in energy intake and expenditure. Children are motivated to engage in activities that have strong reinforcing value in early childhood, including eating palatable foods, and engaging with sedentary activities. Valuing activities that offer long-term rewards, including healthy food consumption and physical activity, increases as children develop more mature executive functions. We present a conceptual overview of how reinforcer pathology theory, or a combination of the high value of immediate reinforcers such as food and high rates of delay discounting, can be used to understand the balance between the motivation to eat and be active or sedentary within a developing executive function system that prioritizes immediate gratification over delayed rewards are related to changes in obesity prevalence through development. We suggest areas for future study and the potential for reinforcer pathology theory for developing prevention and treatment programs.