Obesity and Food Decision-Making from Prospect Theory
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Abstract
Objective: To examine how adults with different weight trajectories structure their food related and health decisions based on the principles of prospect theory. Methods: A qualitative study was conducted with 80 participants aged 20 to 55 years, evenly distributed into four groups: normal weight, overweight, obesity class I, and obesity class II. The study employed 60-minute semistructured interviews, seven-day structured food choice diaries, and two ad hoc experimental risk-choice tasks. Transcripts were analyzed through open, axial, and comparative coding procedures, using ATLAS.ti to develop categories aligned with the constructs of prospect theory. Validity was strengthened through methodological triangulation, double coding, and participant checking. Results: Distinct decision-making patterns emerged across groups. Individuals with normal weight showed a stable reference point and a consistent orientation toward maintaining their current state. The overweight group displayed a daily compensation dynamic and continuous recalibration of their weight reference. In obesity class I, decisions centered on identity-related eating rituals and resistance to altering gratifying practices. In obesity class II, choices were strongly shaped by experiences of stigma and the need to preserve social bonds, with responses oscillating between extreme avoidance and attempts at drastic change. Conclusion: Food-related and health decisions arise from the interplay of prospect-theory biases, identity frameworks, and sociocultural pressures.
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