Healthy Eating Behavior Change with Psychological Features and Insulin Resistance: Buffet and Food Diary App Analysis

Food intake, proportion, and diversity are the major cornerstones of eating behavior. This study examined changes in eating behavior phenotypes using a randomized controlled study (RCT) of digital cognitive behavioral therapy for healthy behavior augmentation (dCBT), with 45 individuals in the dCBT group and 25 individuals in the control group. The dCBT group received a daily intervention for lifestyle modification, while the control group performed self-care for eight weeks. The food intake, proportion, and diversity of both groups were assessed using two different methods: a food diary via a mobile app and buffet test meals consisting of 24 food items classified as healthy or unhealthy. Results revealed that dCBT was successful in promoting healthy eating behaviors that led to physiological and psychological adjustment for the metabolic mechanisms and consequences of healthy eating behavior. Restrained eating behavior at baseline significantly predicted changes in food intake and diversity of healthy diets after the intervention. Lastly, changes in satisfaction with body shape and insulin resistance were significantly correlated with changes in food intake and diversity in healthy diets. These findings suggest that investigating eating behaviors using objective and self-report methods and psychological and physiological indices can facilitate individualized treatment in obesity clinics.