Food craving, dietary restraint and mood

A common assumption is that dieting causes food cravings, probably as a result of food energy deprivation. This issue was investigated in a two-phase study. In phase one, 206 women completed the Dutch Eating Behaviour Questionnaire, the Three-Factor Eating Questionnaire and a food craving scale. A correlational analysis showed food craving to be only weakly related to dietary restraint, but highly and significantly correlated with external eating, emotional eating and susceptibility to hunger. In phase two, ten women who regularly experienced food cravings and ten who rarely craved food kept prospective records of their food intake, daily mood and food craving episodes. There were few differences in eating behaviour, although the cravers tended to consume slightly more daily energy than the non-cravers. The cravers had higher ratings of boredom and anxiety during the day, and dysphoric mood was prominent prior to the cravings themselves. Food deprivation does not appear to be a necessary condition for food cravings to occur. Rather, food cravings are closely associated with mood, in particular as an antecedent to craving and also as a consequence of craving.     

Dieting and food craving. A descriptive, quasi-prospective study

Evidence linking food restriction and food craving is equivocal. This study investigated whether dieting was associated with a greater frequency of food craving. Dieting to lose weight was distinguished from watching so as not to gain weight. Participants were 129 women (mean age=41 yrs): 52 were currently dieting to lose weight, 40 were watching their weight, and 37 were non-dieters. They completed a food craving record after every food craving, a food diary, and a daily mood assessment over 7-days. Of the 393 craving incidents recorded, dieters experienced significantly more food cravings than non-dieters, with watchers intermediate. Chocolate was the most craved food (37% of cravings) but neither the types of food, the proportion of cravings leading to eating (～70%), the situations in which cravings occurred, nor the time since the last eating episode differed between groups. Compared with non-dieters, dieters experienced stronger cravings that were more difficult to resist, and for foods they were restricting eating. Watchers showed similarities in experience both to dieters (low hunger) and non-dieters (lower craving intensity). These results support an association between dieting and food craving, the usefulness of distinguishing dieting to lose weight and watching, and suggest a need for further experimental investigation of actual food restriction on food craving experiences.     

The food craving questionnaire-trait in a bariatric surgery seeking population and ability to predict post-surgery weight loss at six months

Food cravings have been understudied in bariatric surgery patients and the Food Craving Questionnaire-Trait has not been validated in this population. Reliability and validity of the FCQ-T were examined and a regression analysis was run to determine whether or not preoperative scores on individual subscales of the instrument could predict weight loss at 6 months. The FCQ-T demonstrated excellent internal consistency in bariatric surgery-seeking patients, and individual subscales measuring emotion and mood were correlated with other measures of depression and anxiety. Endorsement of binge eating or emotional eating behaviors during a clinical interview was correlated with similar subscales on the FCQ-T. Higher scores on the subscale ‘cues that may trigger food cravings’ were associated with greater weight loss at 6 months post-surgery and higher scores on the subscale ‘guilt from cravings and/or giving into them’ was associated with less weight loss. Management of external cues may predict successful outcomes while emotional impact of cravings may indicate the need for further intervention to help manage specific food craving traits.     

Women’s Experience and Understanding of Food Cravings in Pregnancy: A Qualitative Study in Women Receiving Prenatal Care at the University of North Carolina–Chapel Hill

BackgroundAlthough the occurrence of food cravings during pregnancy is well established, there is a paucity of qualitative data on pregnant women’s perceptions of and responses to food cravings. This study sought to assess and describe pregnant women’s experiences and behaviors pertaining to food cravings.MethodsEight focus groups were conducted with 68 pregnant women in their second trimester from March 2015 to October 2016. Using a semistructured approach, the facilitator asked women open-ended questions regarding their experience of eating behaviors and food cravings. The content from the focus groups was analyzed using a bottom-up approach based on grounded theory and constant comparison analysis.ResultsParticipants described cravings as urgent, food-specific, and cognitively demanding occurrences that were differentiated from hunger. They described beliefs surrounding the physiological causes of cravings and rationales for satisfying their cravings. Strategies used to manage cravings included environmental modifications to limit proximity and availability of craved foods, cognitive and behavioral strategies like distraction, and acceptance through satisfying the craving. Participants described food cravings as a psychologically salient aspect of their pregnancy, reporting a variety of emotional precursors and reactions surrounding their cravings.ConclusionsA better understanding of food cravings may assist with the development of interventions to improve eating behaviors and reduce eating-related distress during pregnancy. Acceptance regarding food cravings was indicated as a way to diffuse pregnancy-related stress. These findings contribute to our understanding of psychological influences on eating behaviors in pregnant women.     

Chocolate craving and the menstrual cycle

Spanish and American female chocolate cravers reported the usual times when they craved chocolate by answering an open-ended question. They also were asked directly if they craved chocolate perimenstrually. American women (40% open-ended, 60% direct) were more likely than were Spanish women (4% open-ended, 24% direct) to report that their chocolate cravings occurred perimenstrually when responding to both questions. The most frequently reported times (other than perimenstrually) that chocolate was craved were the same for Spanish men and women (after eating, studying) and for American men and women (evening), differing cross-culturally but not across gender. The results suggest a cultural origin rather than a physiological basis for chocolate craving.     

The influence of restrained and external eating patterns on overeating

Eating in response to an increasingly obesogenic environment has been strongly implicated as a salient aspect of eating behaviour, arguably influenced by learning and experience. Interindividual differences in susceptibility to weight gain may be due, in part, to variability in response to environmental triggers. The phenomenon of food craving may also be an important factor influencing appetite control. The present study tested a model, in which food craving was hypothesised to be an intervening causal variable, on a causal pathway between responsivity to environmental cues and the development of obesity. One hundred and twenty four participants (aged 21-71 years, 83 females and 41 males) completed the study. Participants completed the Dutch eating behaviour questionnaire (DEBQ), measuring external eating (externality), emotional eating (emotionality) and restrained eating behaviour (restraint), and an adapted form of the food craving inventory (FCI), assessing cravings for carbohydrate, fats, sweets and fast food fats, in addition to total food cravings. Initial analysis showed positive correlations between FCI-tot and body mass index (BMI), FCI-fats and BMI and FCI-fast food fats and BMI in both men and women, and between FCI-carbohydrates and BMI in men only. Multiple regression analyses showed externality as the principal predictor of food craving, which was greater in males compared to females, but differential for different food groups between genders. Restrained eating and cravings for fats and fast food fats were negatively associated in women only. As predicted, total cravings, and cravings for fats and fast food foods mediated the positive association between external eating and BMI. It is concluded that appetitive response to external cues as an important risk factor in appetite control is mediated through cravings for particular food groups and is gender-dependent.     

Development and validation of the food-craving inventory

OBJECTIVE: The primary aim of this study was to develop and validate the Food-Craving Inventory (FCI), a self-report measure of specific food cravings. RESEARCH METHODS AND PROCEDURES: In a preliminary study, participants (n = 474) completed the initial version of the FCI. The results from this study were used in developing the revised FCI. Participants (n = 379) completed the revised FCI in the primary study designed to develop a self-report measure of specific food cravings. RESULTS: Common factor analysis yielded four conceptual factors (subscales) that were interpreted as high fats, sweets, carbohydrates/starches, and fast-food fats. Confirmatory factor analysis found that the four factors could be modeled as dimensions (or first-order factors) of a higher order construct-food craving. Test-retest and internal consistency analyses indicated good reliability for the total score and each of the subscales. Subscale scores were compared with scores on the Three Factor Eating Questionnaire and a conceptual measure of food craving. We found support for the content, concurrent, construct, and discriminant validity of the FCI. DISCUSSION: The FCI was found to be a reliable and valid measure of general and specific food cravings. The FCI can be used in research related to overeating and binge eating. Also, it may be useful in treatment studies that target obesity and/or food cravings.     

Detailed analysis of binges in obese women with binge eating disorder: Comparisons using multiple methods of data collection

OBJECTIVE: This study compares multiple methods of assessing food intake in obese women with binge eating disorder (BED). METHOD: Twelve women meeting BED criteria completed six random 24-hour dietary recalls, engaged in a laboratory binge eating episode, and completed the EDE interview. RESULTS: There was not a significant difference in total or macronutrient intake when binge eating episodes were assessed via the recall and laboratory methods. However, within-individual correlations were low for the size of different binge eating episodes collected by the two methods. Significantly more calories were consumed during objective than during subjective binges, and significant differences in macronutrient composition were observed. Meal patterning data collected by the EDE and the recalls were comparable. CONCLUSION: The findings suggest only moderate agreement between the methods that were examined. Future investigations with larger sample sizes are needed to examine the relationship among these different methods of assessing food intake.     

Food aversions and cravings during early pregnancy: association with nausea and vomiting

The prospective cohort study examined whether Ecuadorian women with early pregnancy nausea and vomiting (NVP) are more likely to develop food aversions and cravings, and if so, whether the specific foods identified as aversive or craved are the same as those predicted by the popular maternal-embryo protection hypothesis (MEPH). Consistent with MEPH predictions, women with NVP were more likely to report increased odor sensitivity and aversions for some predicted "toxic" foods and more likely to crave fruits. However, other hypothesis predictions were not supported. The relationship of food aversions and cravings with NVP appears more complicated than that explained by the MEPH.     

Chocolate cravings in American and Spanish individuals: biological and cultural influences

This study investigated relationships of culture and physiology with chocolate cravings. Gender differences in chocolate cravings in Spaniards and Americans were examined using parallel Spanish- and English-version questionnaires administered to 259 undergraduate students at one university in Spain and 306 at one university in the US. Responses were examined separately for men and women in American and Spanish samples using multivariate analyses to control for variables like chocolate availability and cultural involvement (which was described by country of birth, years spent in that country, media use, and cultural identification). Chocolate was the most craved food among all Spanish students, but only female American students. A total of 91% of American women and 59% of American men reported chocolate cravings, and this significant difference persisted when controlling for American cultural involvement. In contrast, 90% of Spanish women versus 78% of Spanish men reported chocolate cravings, but the gender difference was no longer significant when controlling for Spanish cultural involvement. These results do not reject a role of physiology in chocolate cravings, but suggest that American culture encourages disproportionately more chocolate cravings among females than males, and that globalization may have led to a similar craving pattern among Spaniards, although gender differences in cravings are less clear-cut than they are in the US.     

Anatomy of a binge: food environment and characteristics of nonpurge binge episodes

This secondary analysis prospectively examined nonpurge binge eating patterns in a naturalistic setting in 48 nonpurge binge eating women. Binge eating episodes were analyzed from 14-day food diaries to describe the binge and to determine how types of foods consumed and setting variables affected nonpurge binge eating women. Findings indicated that binge episodes occurred mostly during the lunch (27.1%) and dinner hours (45.8%) and on weekends (62.5%). Half of the binge episodes occurred in restaurants. The most common items consumed during binges were breads/pasta (64.6%), sweets (56.2%), high fat meat items (45.3%), and salty snacks (39.6%) while the predominant foods consumed during these binges were high fat meat items (29.2%), sweets (21.0%), and salty snacks (18.8%). Those who predominantly binged on sweets had significantly more binge days [t(46)=-2.8, p<.01]. Women who predominantly binged on fried meat had significantly higher body mass index (BMI) [t(46)=-2.8, p<.01]. A higher BMI was also associated with binging during meals rather than binging during snacks [t(46)=2.4, p<.05]. The results suggest that nonpurge binge eating patterns are more problematic during meal times.     

The effect of deprivation on food cravings and eating behavior in restrained and unrestrained eaters

OBJECTIVE: The relation between being deprived of a food and intake and craving for that food was investigated in restrained and unrestrained eaters. METHOD: For 1 week, 103 female undergraduate students were assigned to be chocolate deprived, vanilla deprived, or nondeprived. Only chocolate deprivation was expected to elicit cravings, as chocolate is not easily substituted, whereas vanilla is. RESULTS: The main effect of chocolate deprivation on consumption was qualified by an interaction with restraint. Chocolate-deprived restrained eaters consumed more chocolate food than did any other group. Restrained eaters experienced more food cravings than did unrestrained eaters and were more likely to eat the craved food. Moreover, restrained eaters deprived of chocolate spent the least time doing an anagram task before a "taste-rating task" in which they expected that chocolate foods might be available. CONCLUSION: Converging measures of craving indicate that deprivation causes craving and overeating, but primarily in restrained eaters.     

Energy and macronutrient intake in bulimia nervosa

Energy deprivation and malnutrition are often thought to be key factors in the maintenance of bulimia nervosa (BN). Our review shows that it is unclear how much energy is actually available to BN patients' metabolism because the contribution of food consumed during binge eating is generally neglected. Also, there is little evidence for another key hypothesis that binge-eating episodes are triggered by carbohydrate craving. This study examined energy consumption and macronutrient composition of meals and binge-eating episodes in food diaries. Forty female BN patients, 40 female panic disorder (PD) patients, and 40 healthy women recorded their food intake while in their natural environment during two consecutive days. We did not find the expected evidence for chronic energy deprivation and malnutrition in BN patients. Also, there was no evidence that carbohydrate craving drives binge eating. The implications for models of BN and for treatments targeting eating behavior are discussed.     

Disordered eating and food cravings among urban obese African American women

OBJECTIVE: The prevalence of night eating syndrome (NES), binge eating disorder (BED), and bulimia nervosa (BN) and the general experience of food cravings were examined in 88 obese urban African American women. METHOD: Participants were administered The Questionnaire on Eating and Weight Patterns-R, the Night Eating Syndrome Questionnaire, and the State and Trait Food Cravings Questionnaire, Trait version (FCQ-T). RESULTS: Twenty-eight percent reported symptoms of eating disorders (18.9% NES, 6.4% recurrent binge eating, 2.2% both NES and recurrent binge eating). Those reporting disordered eating had significantly higher total FCQ-T scores than those not reporting disordered eating. Persons endorsing recurrent binge eating had the highest mean score, followed by those reporting NES. Those who identified themselves as binge eaters and night eaters were not significantly different from each other, but both groups were significantly different than the no eating disorder symptoms group on various subscales of the FCQ-T. DISCUSSION: Obese African American women report significant levels of NES and binge eating which may contribute to the development and/ or maintenance of obesity.     

Food cravings, ethnicity and other factors related to eating out

OBJECTIVE: Our objective was to study factors related to eating patterns, specifically whether certain food cravings were associated with frequency of meals eaten away from home. METHODS: Data were collected from 277 patients from a family medicine residency office in Arizona. The survey questionnaire included information about the respondents' demographics, socioeconomic status, food cravings, as well as, number of meals eaten away from home. The food craving inventory included foods in four categories identified by factor analysis: fast foods, carbohydrates, sweets and snacks. Data on food cravings were factor analyzed and scale scores were derived. RESULTS: Being a Hispanic adult, working outside the home, and cravings for individual food items were related to eating more meals away from home. If the mother was working outside the home, the youngest child ate an average of two additional meals away from home each week. In general respondent's cravings for some specific food items were also related to higher numbers of meals their child ate away from home. Cravings for both fast food and snacks were positively correlated with adult eating out. None of the respondents' scale scores were related to child's eating away from home. Adults with Arizona Health Care Cost Containment System insurance (AHCCCS--a form of Medicaid) and older adults were less likely to eat away from home compared to patients with other types of insurance. CONCLUSIONS: Socioeconomic status, ethnicity, and food cravings are related to adult and child patterns of eating meals away from home.     

Food cravings and food cue responding across the menstrual cycle in a non-eating disordered sample

The study aim was to examine changes in food cue-elicited cravings and the macronutrient content of craved foods across menstrual cycle phases in a non-eating disordered sample. Thirty-five college females attended laboratory sessions in the late follicular and late luteal phases. In each session they completed a measure of state food craving before and after exposure to preferred, high fat/high sugar chocolate candy. Candy consumption following cue exposure was measured during an ad libitum "taste test." Additionally, participants rated their desire to eat foods differing systematically and significantly in macronutrient content. Ovulation was confirmed with luteinizing hormone detection kits. Results show that whereas the food cue increased cravings, this effect did not differ between cycle phases examined. The macronutrient content of foods desired also did not differ significantly between cycle phases, however, a non-significant trend suggested that high fat/high complex carbohydrate and low fat/high protein foods were more strongly desired in the late luteal phase. Amount of chocolate candy eaten did not differ between cycle phases. These results suggest that cravings for high fat/high sugar foods do not differ between menstrual cycle phases examined, whereas cravings for other foods may fluctuate across cycle phases in non-eating disordered women.     

Cue-elicited craving for food: a fresh approach to the study of binge eating

Recent research has indicated that craving for food can be elicited by exposure to food cues, suggesting that exposure to food cues may represent a useful experimental paradigm to investigate mechanisms related to binge eating. The first objective of the present research was to replicate previous reports that exposure to food cues elicits craving for food. In addition, this investigation was designed to extend the extant literature by testing the effects of 'priming' portions of food, by examining the association between reactivity to food cues and indicators of binge eating, and to examine the role of a putative genetic factor previously found to be associated with cue-elicited craving for alcohol and tobacco. In Study 1, 48 individuals completed measures of craving and mood after exposure to control cues, after exposure to food cues, and after consuming each of three small portions of food. In Study 2, 31 individuals with subclinical symptoms of binge eating completed the same procedures. The results suggested that food cues reliably elicited craving, increased attention to the cues, and decreased positive affect in both samples, although reactivity was greater among the sample with greater eating pathology. Correlational analyses suggested that reactivity to food cues was correlated with binge eating and body mass index among women but not men. Results also suggest that the DRD4 VNTR polymorphism influences cue-elicited craving for food, although the influence of the DRD4 may depend on the population under study.     

Binge eating antecedents in normal-weight nonpurging females: Is there consistency?

We examined the situational antecedents of binge eating episodes and tested for consistency in the antecedents. We evaluated the antecedents of two successive binges via structured interviews with 50 normal-weight nonpurging females who regularly binge. Cluster analysis yielded two categories of binge-promoting situations: solitary negative affect situations and social eating situations. When this empirically derived classification of binge situations was used, the two successively occurring binges did not systematically fall into the same cluster. Consistency on other measures was also modest. Implications of these findings for conceptual models of binge eating and treatment, including the prospect of individually tailored interventions, are discussed. © 1994 by John Wiley & Sons, Inc.