Use of Psychology and Behavioral Economics to Promote Healthy Eating

Published:October 17, 2014DOI:
      Understanding the psychology of how people make decisions can shed light on important factors contributing to the cause and maintenance of public health problems like obesity. This knowledge can and should inform the design of government and private-sector public health interventions. Several insights from psychology and behavioral economics that help explain why people are particularly vulnerable to the current food environment are discussed. These insights fall into the following categories: the influence of starting points (status quo bias and anchoring effects); communicating health information (simplicity and framing); and unintended consequences of policy interventions (compensation, substitution, and the peanuts effect). The paper discusses opportunities for improving the design of food policies and interventions by altering default options, providing the public with simple and meaningful nutrition information, carefully constructing the framing of public health messages, and designing food policies to minimize unintended consequences, such as compensation and substitution.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Thaler R.H.
        • Sunstein C.R.
        Nudge: improving decisions about health, wealth, and happiness.
        Penguin Group, New York NY2008
        • Thorgeirsson T.
        • Kawachi I.
        Behavioral economics: merging psychology and economics for lifestyle interventions.
        Am J Prev Med. 2013; 44: 185-189
      1. WHO. Obesity and overweight: fact sheet no. 311. Reviewed: May 2014.

        • Roberto C.A.
        • Brownell K.D.
        The imperative of changing public policy to address obesity. In: The Oxford handbook of the social science of obesity.
        Oxford University Press, Oxford UK2011
        • Gearhardt A.N.
        • Bragg M.A.
        • Pearl R.L.
        • Schvey N.A.
        • Roberto C.A.
        • Brownell K.D.
        Obesity and public policy.
        Annu Rev Clin Psychol. 2012; 8: 405-430
      2. Glickman D. Parker L. Sim L.J. Del Valle Cook H. Miller E.A. Accelerating progress in obesity prevention: solving the weight of the nation. The National Academies Press, Washington DC2012
        • Muraven M.
        • Baumeister R.F.
        Self-regulation and depletion of limited resources: does self-control resemble a muscle?.
        Psychol Bull. 2000; 126: 247-259
        • Simon H.
        Bounded rationality in social science: today and tomorrow.
        Mind Society. 2000; 1: 25-39
        • Ainslie G.
        Specious reward: a behavioral theory of impulsiveness and impulse control.
        Psychol Bull. 1975; 82: 463-496
        • Frederick S.L.
        • Loewenstein G.
        • O’Donoghue T.
        Time discounting and time preference: a critical review.
        J Econ Lit. 2002; 40: 351-401
        • O’Donoghue T.
        • Rabin M.
        The economics of immediate gratification.
        J Behav Decis Mak. 2000; 13: 233-250
        • Buehler R.G.
        • Griffin D.
        • Ross M.
        Exploring the “planning fallacy:” why people underestimate their task completion times.
        J Pers Soc Psychol. 1994; 67: 366-381
        • Wansink B.
        Mindless eating: why we eat more than we think.
        Bantam Dell, New York NY2010
        • Samuelson W.
        • Zeckhauser R.
        Status quo bias in decision making.
        J Risk Uncertain. 1998; 1: 7-59
        • Tversky A.
        • Kahneman D.
        Judgment under uncertainty: heuristics and biases.
        Science. 1974; 185: 1124-1131
        • Wansink B.
        Can package size accelerate usage volume?.
        J Mark. 1996; 60: 1-14
        • Kahneman D.
        Thinking fast and slow.
        Farrar, Straus and Giroux, New York NY2011
        • Dehaene S.
        The number sense: how the mind creates mathematics.
        Oxford University Press, New York NY1997
        • Paulos J.A.
        Innumeracy: mathematical illiteracy and its consequences.
        Hill and Wang, New York NY1988
        • Peters E.
        • Vastfjall D.
        • Slovic P.
        • Mertz C.K.
        • Mazzocco K.
        • Dickert S.
        Numeracy and decision making.
        Psychol Sci. 2006; 17: 407-413
        • Peters E.
        • Dieckmann N.
        • Dixon A.
        • Hibbard J.H.
        • Mertz C.K.
        Less is more in presenting quality information to consumers.
        Med Care Res Rev. 2007; 64: 169-190
        • Fagerlin A.
        • Wang C.
        • Ubel P.A.
        Reducing the influence of anecdotal reasoning on people’s health care decisions: is a picture worth a thousand statistics?.
        Med Decis Making. 2005; 25: 398-405
        • Zikmund-Fisher B.J.
        • Fagerlin A.
        • Keeton K.
        • Ubel P.A.
        Does labeling prenatal screening test results as negative or positive affect a woman’s responses?.
        Am J Obstet Gynecol. 2007; 197 (e1−e6): 528
      3. Food Marketing Institute. Facts Up Front GMA-FMI voluntary front-of-pack nutrition labeling system. 2012.

        • Liu P.J.
        • Wisdom J.
        • Roberto C.A.
        • Liu L.J.
        • Ubel P.A.
        Using behavioral economics to design more effective food policies to address obesity.
        Appl Econ Perspect Pol. 2013; 36: 6-24
        • Malam S.
        • Clegg S.
        • Kirwan S.
        • McGinigal S.
        Comprehension and use of UK nutrition signpost labelling schemes.
        Food Standards Agency. 2009;
        • Sendhil M.
        • Shafir E.
        Decision making and policy in contexts of poverty.
        in: Shafir E. The behavioral foundations of public policy. Princeton University Press, Princeton NJ2013
        • Thorndike A.N.
        • Sonnenberg L.
        • Riis J.
        • Barraclough S.
        • Levy D.E.
        A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices.
        Am J Public Health. 2012; 102: 527-533
        • Entman R.M.
        Framing: towards clarification of a fractured paradigm.
        J Commun. 1993; 43: 51-58
        • Dar-Nimrod I.
        • Heine S.J.
        Genetic essentialism: on the deceptive determinism of DNA.
        Psychol Bull. 2011; 137: 800-818
        • McFerran B.
        • Mukhopadhyay A.
        Lay theories of obesity predict actual body mass.
        Psychol Sci. 2013; 24: 1428-1436
        • Chandon P.
        • Wansink B.
        The biasing health halos of fast-food restaurant health claims: lower calorie estimates and higher side-dish consumption intentions.
        J Consum Res. 2007; 34: 301-314
        • Roberto C.A.
        • Shivaram M.
        • Martinez O.
        • Boles C.
        • Harris J.L.
        • Brownell K.D.
        The Smart Choices front-of-package nutrition label. Influence on perceptions and intake of cereal.
        Appetite. 2012; 58: 651-657
        • Horgen K.B.
        • Brownell K.D.
        Comparison of price change and health message interventions in promoting healthy food choices.
        Health Psychol. 2002; 21: 505-512
        • Scherer G.
        Smoking behaviour and compensation: a review of the literature.
        Psychopharmacology. 1999; 145: 1-20
        • Rosenkilde M.
        • Auerbach P.
        • Reichkendler M.H.
        • Ploug T.
        • Stallknecht B.M.
        • Sjödin A.
        Body fat loss and compensatory mechanisms in response to different doses of aerobic exercise—a randomized controlled trial in overweight sedentary males.
        Am J Physiol Regul Integr Comp Physiol. 2012; 303: R571-R579
        • Wansink B.
        • Chandon P.
        Can “low-fat” nutrition labels lead to obesity?.
        J Mark Res. 2006; 57: 605-617
        • Church T.S.
        • Martin C.K.
        • Thompson A.M.
        • Earnest C.P.
        • Mikus C.R.
        • Blair S.N.
        Changes in weight, waist circumference and compensatory responses with different doses of exercise among sedentary, overweight postmenopausal women.
        PLoS One. 2009; 4: e4515
        • Rolls B.J.
        • Roe L.S.
        • Kral T.V.E.
        • Meengs J.S.
        • Wall D.E.
        Increasing the portion size of a packaged snack increases energy intake in men and women.
        Appetite. 2004; 42: 63-69
        • Connolly G.N.
        • Alpert H.R.
        Trends in the use of cigarettes and other tobacco products, 2000−2007.
        JAMA. 2008; 299: 2629-2630
        • Marantz P.R.
        Rethinking dietary guidelines.
        Crit Rev Food Sci Nutr. 2010; 50: 17-18
        • Downs J.S.
        • Loewenstein G.
        Behavioral economics and obesity.
        in: Cawley J. The Oxford handbook of the social science of obesity. Oxford University Press, Oxford UK2011
        • Scott M.L.
        • Nowlis S.M.
        • Mandel N.
        • Morales A.C.
        The effects of reduced food size and package size on the consumption behaviors of restrained and unrestrained eaters.
        J Consum Res. 2008; 35: 391-405
        • Cochran W.
        The “what the hell” effect. Some effects of goal proximity and goal framing on performance.
        in: Martin L.L. Tesser A. Striving and feeling: interactions among goals, affect, and self-regulation. Lawrence Erlbaum Associates, Inc, Mahwah NJ1996
        • Sunstein C.
        Simpler: the future of government.
        Simon & Schuster, New York NY2013
        • Riis J.
        • Ratner R.
        Simplified nutrition guidelines to fight obesity.
        in: Batra R. Keller P.A. Strecher V.J. Leveraging consumer psychology for effective health communications: the obesity challenge. ME Sharpe, Armonk NY2011
        • Roberto C.A.
        • Agnew H.
        • Brownell K.D.
        An observational study of consumers’ accessing of nutrition information in chain restaurants.
        Am J Public Health. 2009; 99: 820-821
        • Block J.P.
        • Condon S.K.
        • Kleinman K.
        • et al.
        Consumers’ estimation of calorie content at fast food restaurants: cross sectional observational study.
        BMJ. 2013; 346: f2907
        • Auchincloss A.H.
        • Mallya G.G.
        • Leonberg B.L.
        • Ricchezza A.
        • Glanz K.
        • Schwarz D.F.
        Customer responses to mandatory menu labeling at full-service restaurants.
        Am J Prev Med. 2013; 45: 710-719
        • Dumanovsky T.
        • Huang C.Y.
        • Nonas C.A.
        • Matte T.D.
        • Bassett M.T.
        • Silver L.D.
        Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys.
        BMJ. 2011; 343: d4464
        • Bollinger B.
        • Leslie P.
        • Sorensen A.T.
        Calorie posting in chain restaurants. Am Econ J.
        Econ Policy. 2011; 3: 91-128
        • Chu Y.H.
        • Frongillo E.A.
        • Jones S.J.
        • Kaye G.L.
        Improving patrons’ meal selections through the use of point-of-selection nutrition labels.
        Am J Public Health. 2009; 99: 2001-2005
        • Krieger J.W.
        • Chan N.L.
        • Saelens B.E.
        • Ta M.L.
        • Solet D.
        • Fleming D.W.
        Menu labeling regulations and calories purchased at chain restaurants.
        Am J Prev Med. 2013; 44: 595-604
        • Roberto C.A.
        • Larsen P.D.
        • Agnew H.
        • Baik J.
        • Brownell K.D.
        Evaluating the impact of menu labeling on food choices and intake.
        Am J Public Health. 2010; 100: 312-318
        • Finkelstein E.A.
        • Strombotne K.L.
        • Chan N.L.
        • Krieger J.
        Mandatory menu labeling in one fast-food chain in King County, Washington.
        Am J Prev Med. 2011; 40: 122-127
        • Wisdom J.
        • Downs J.S.
        • Loewenstein G.
        Promoting healthy choices: information versus convenience.
        Am Econ J Appl Econ. 2010; 2: 164-178
        • Elbel B.
        • Kersh R.
        • Brescoll V.L.
        • Dixon L.B.
        Calorie labeling and food choices: a first look at the effects on low-income people in New York City.
        Health Aff (Millwood). 2009; 28: w1110-w1121
        • Harnack L.J.
        • French S.A.
        • Oakes J.M.
        • Story M.T.
        • Jeffery R.W.
        • Rydell S.A.
        Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial.
        Int J Behav Nutr Phys Act. 2008; 5: 63
        • Tandon P.S.
        • Zhou C.
        • Chan N.L.
        • et al.
        The impact of menu labeling on fast-food purchases for children and parents.
        Am J Prev Med. 2011; 41: 434-438
        • Liu P.J.
        • Roberto C.A.
        • Liu L.J.
        • Brownell K.D.
        A test of different menu labeling presentations.
        Appetite. 2012; 59: 770-777
        • Bleich S.N.
        • Herring B.J.
        • Flagg D.D.
        • Gary-Webb T.L.
        Reduction in purchases of sugar-sweetened beverages among low-income black adolescents after exposure to caloric information.
        Am J Public Health. 2012; 102: 329-335
        • Diliberti N.
        • Bordi P.L.
        • Conklin M.T.
        • Roe L.S.
        • Rolls B.J.
        Increased portion size leads to increased energy intake in a restaurant meal.
        Obes Res. 2004; 12: 562-568
        • Ello-Martin J.A.
        • Ledikwe J.H.
        • Rolls B.J.
        The influence of food portion size and energy density on energy intake: implications for weight management.
        Am J Clin Nutr. 2005; 82: 236S-241S
        • Schwartz J.
        • Riis J.
        • Elbel B.
        • Ariely D.
        Inviting consumers to downsize fast-food portions significantly reduces calorie consumption.
        Health Aff (Millwood). 2012; 31: 399-407
      4. New York City Department of Health and Mental Hygiene. From supersized to human-sized: reintroducing reasonable portions of sugary drinks in New York City.

        • Malik V.S.
        • Schulze M.B.
        • Hu F.B.
        Intake of sugar-sweetened beverages and weight gain: a systematic review.
        Am J Clin Nutr. 2006; 84: 274-288
        • Pan A.
        • Malik V.S.
        • Hao T.
        • Willett W.C.
        • Mozaffarian D.
        • Hu F.B.
        Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies.
        Int J Obes (Lond). 2013; 37: 1378-1385
        • Ebbeling C.B.
        • Feldman H.A.
        • Chomitz V.R.
        • et al.
        A randomized trial of sugar-sweetened beverages and adolescent body weight.
        N Engl J Med. 2012; 367: 1407-1416
        • Ebbeling C.B.
        • Feldman H.A.
        • Osganian S.K.
        • Chomitz V.R.
        • Ellenbogen S.J.
        • Ludwig D.S.
        Effects of decreasing sugar-sweetened beverage consumption on body weight in adolescents: a randomized, controlled pilot study.
        Pediatrics. 2006; 117: 673-680
        • Camerer C.
        • Issacharoff S.
        • Loewenstein G.
        • O’Donoghue T.
        • Rabin M.
        Regulation for conservatives: behavioral economics and the case for “asymmetric paternalism.”.
        Univ PA Law Rev. 2003; 151: 1211-1254