Grazing (human eating pattern)

Grazing is a human eating pattern characterized as "the repetitive eating of small or modest amounts of food in an unplanned manner throughout a period of time, and not in response to hunger or satiety cues".[1]

Two subtypes of grazing have been suggested: compulsive and non-compulsive. Compulsive grazing is accompanied by the feeling that the person is not able to resist going back to repetitively snack on the desired food. Non‐compulsive grazing is repetitively eating in a distracted and mindless way, without paying much attention to what is eaten.[1][2]

## Background

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The term "grazing" has been widely used by the general population in reference to a repetitive eating pattern. The scientific literature began to investigate this concept because of its extensive use and apparent association with weight gain.[3][4] Several terms such as picking, nibbling, and snacking have been used indiscriminately in the literature to characterize grazing-type patterns of repetitive eating in humans.[1][2][5] In 2014, Eva Conceição and colleagues proposed a consensual definition for grazing based on the opinion of various experts in the field.[1]

Grazing seems to be related to loss of control over eating and can be conceptualized on the spectrum of disordered eating behaviors.[2] It is considered as a risk behavior for adults undergoing weight loss treatment[1][2][5][6][7] due to its associations with Body Mass Index and a great variability on weight-loss trajectories after bariatric surgery.[8] It is thought to be present in up to 26.4% of bariatric patients pre‐operatively[9] and in 46.6% after bariatric surgery.[10] Specifically, compulsive grazing appears to be linked to eating disorder psychopathology.

## Repetitive eating questionnaire

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The repetitive eating questionnaire (Rep(eat)-Q) is a 12-item self-report measure developed by Conceição, E. and colleagues to assess grazing eating patterns in adolescents and adults.[1][6][11]

The Rep(eat)-Q is based on the consensual definition proposed by the authors and generates two subscales: 1) repetitive eating, and 2) compulsive grazing.[6] Respondents rate the frequency of grazing eating behaviors in the previous month using a Likert scale ranging from 0 (never) to 6 (every day). Scores are calculated as the mean of the scale items and the total Rep(eat)-Q score can range from 0 to 6. The Rep(eat)-Q is worded in English,[1] Portuguese (European and Brazilian),[6] and Norwegian.[12]

## References

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1. ^ a b c d e f g Conceição, E., Mitchell, J., Engel, S., Machado, P., Lancaster, K., & Wonderlich, S. (2014). What is “grazing”? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition. Surgery for Obesity and Related Diseases, 10 (5), pp. 973-982.doi: 10.1016/j.soard.2014.05.025
2. ^ a b c d Conceição, E., Utzinger, L., & Pisetsky, E. (2015). Eating Disorders and Problematic Eating Behaviours Before and After Bariatric Surgery: Characterization, Assessment and Association with Treatment Outcomes. European Eating Disorders Review, 23 (6), 417-425. doi. 10.1002/erv.2397
3. ^ Saunders, R., Johnson, L., & Teschner, J. (1998). Prevalence of eating disorders among bariatric surgery patients. Eating Disorders, 6, 309–317.https://doi.org/10.1080/10640269808249267
4. ^ Saunders, R. (2004). “Grazing”: A high-risk behavior. Obesity Surgery, 14, 98–102. doi: 10.1381/096089204772787374
5. ^ a b Conceição, E., Crosby, R., Mitchell, J., Engel, S., Wonderlich, S., Simonich, H., et al (2013). Picking or nibbling: Frequency and associated clinical features in bulimia nervosa, anorexia nervosa, and binge eating disorder International Journal of Eating Disorders, 46 (8), pp. 815-818.
6. ^ a b c d Conceição, E., Mitchell, J., Machado, P.P., Vaz, A., Pinto-Bastos, A., Ramalho, S., Brandão, I., Simões, J, Lourdes, M., & Freitas, A. (2017). Repetitive eating questionnaire [Rep(eat)- Q]: Enlightening the concept of grazing and psychometric properties in a Portuguese sample. Appetite, 117, 351-358.doi:10.1016/j.appet.2017.07.012
7. ^ Conceição, E., Mitchell, J., Vaz, R. A., Bastos, P. A., Ramalho, S., Silva, C., Cao, L., Brandão, I., Machado, P. (2014). The presence of maladaptive eating behaviors after bariatric surgery in a cross-sectional study: importance of picking or nibbling on weight regain. Eating Behaviors, 15, 558-562.
8. ^ Conceição, E., Mitchell, J., Pinto-Bastos, A., Arrojado, F., Brandão, I., & Machado, P. (2017). Stability of problem eating behaviors and weight loss trajectories following bariatric surgery: A longitudinal observational study. Surgery for Obesity and Related Diseases, 13 (6), pp. 1063-1070.
9. ^ Colles, S. L., Dixon, J. B., & O'Brien, P. E. (2008). Grazing and loss of control related to eating: two high‐risk factors following bariatric surgery. Obesity, 16, 615– 622.
10. ^ Kofman, M. D., Lent, M. R., & Swencionis, C. (2010). Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity, 18, 1938– 1943. doi.10.1038/oby.2010.27.
11. ^ Ramalho, S., Saint-Maurice, P., Silva, D., Mansilha, H., Silva, C., Gonçalves, S., Machado, P., & Conceição, E. (2018). APOLO-Teens, a web-based intervention for treatment-seeking adolescents with overweight or obesity: study protocol and baseline characterization of a Portuguese sample. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. Epub ahead of print. https://doi.org/10.1007/s40519-018-0623-x.
12. ^ Reas, D., Lindvall Dahlgren, C., Wonderlich, J., Syversen, G., & Lundin Kvalem, I. (2019). Confirmatory factor analysis and psychometric properties of the Norwegian version of the Repetitive Eating Questionnaire: Further evidence for two distinct subtypes of grazing behaviour. Eur Eat Disord Rev, 27(2):205-211.doi: 10.1002/erv.2631.