Accepting or suppressing the desire to eat: Investigating the short-term effects of acceptance-based craving regulation

Previous studies addressing the long-term impact of acceptance of food cravings have revealed positive effects in terms of reduced craving experience. The present study investigated the short-term (direct) consequences of acceptance-based craving regulation. Hungry participants were exposed to desirable food and were either instructed to accept or suppress food cravings during exposure. Control participants did not regulate cravings and were allowed to eat from the food. Participants who accepted food cravings reported a significant increase in food craving during the course of the experiment. Participants who suppressed their cravings during exposure kept their craving levels constant. In contrast, control participants who were allowed to eat from the food, reported a significant drop in cravings. These findings suggest that although acceptance may entail an effective strategy for reducing food cravings in the long run, it may require repeated practice to overcome the immediate counterproductive effects.     

Internal and external antecedents of binge eating episodes in a group of women with bulimia nervosa

OBJECTIVE: This research examined the internal and external factors that predict whether a food craving develops into a binge in bulimia nervosa. METHOD: Fifteen bulimic women kept diary records of food cravings over the course of a week, noting their internal state, environmental triggers, and whether the craving developed into a binge. Eighty cravings were examined, of which approximately one half developed into binges. RESULTS: At the bivariate level, binge eating resulted from cravings more often if the women were alone, in the morning, and following eating the craved food. These factors interacted, so that binges were more likely if the women avoided a craved food in the morning, but not later in the day. CONCLUSIONS: These findings support a model of binge eating for which both internal states (craving, eating the craved food) and external factors (time of day, social circumstances) need to be taken into account. Relevant models of craving are discussed, along with their implications for clinical practice.     

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.     

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.     

State and trait food craving in people with bulimic eating disorders

In two studies, we examined trait and state food craving levels in people with a bulimic disorder (BD) (bulimia nervosa and related disorders) and healthy controls (HC) using multidimensional self-report assessments. In study 1, trait food craving was assessed in 70 people with a BD and 69 HC using the Food Craving Questionnaire — Trait. Participants also completed the Eating Disorder Examination — Questionnaire (EDE-Q). In study 2, 45 people with a BD and 29 HC completed the Food Craving Questionnaire — State and the EDE-Q following exposure to visual and real high-caloric food cues. The results showed that both trait and state food cravings were significantly higher in people with a BD, compared to HC. Trait food craving was associated with eating disorder symptomatology in both the HC and BD groups. State food craving was associated with eating disorder psychopathology, but only in the BD group. This research underscores the importance of food craving in the study and conceptualization of BD.     

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.     

High-calorie food-cues impair working memory performance in high and low food cravers

The experience of food craving can lead to cognitive impairments. Experimentally induced chocolate craving exhausts cognitive resources and, therefore, impacts working memory, particularly in trait chocolate cravers. In the current study, we investigated the effects of exposure to food-cues on working memory task performance in a group with frequent and intense (high cravers, n=28) and less pronounced food cravings (low cravers, n=28). Participants performed an n-back task that contained either pictures of high-calorie sweets, high-calorie savory foods, or neutral objects. Current subjective food craving was assessed before and after the task. All participants showed slower reaction times and made more omission errors in response to food-cues, particularly savory foods. There were no differences in task performance between groups. State cravings did not differ between groups before the task, but increased more in high cravers compared to low cravers during the task. Results support findings about food cravings impairing visuo-spatial working memory performance independent of trait cravings. They further show that this influence is not restricted to chocolate, but also applies to high-calorie savory foods. Limiting working memory capacity may be especially crucial in persons who are more prone to high-calorie food-cues and experience such cravings habitually.     

Cravings and food consumption in binge eating disorder

The purpose of this study was to extend existing work that examines the role of cravings in Binge Eating Disorder (BED). The current study uses a case–control design to establish a relationship between cravings and food exposure, and between cravings and food consumption in individuals diagnosed with BED. Twenty-nine females with BED, 40 obese controls, and 50 normal-weight controls were first presented with a neutral cue and completed a food-craving measure. They were then presented with their favourite snack food and completed the craving measure again, after which they were allowed to consume the food. The BED group had significantly higher scores for pre- and post-craving measures, and consumed more food compared to the controls. There was, however, no significant interaction between group and craving scores. Results also showed a positive correlation between food consumption and cravings scores both before and after food exposure for individuals with BED. The findings suggest that the level of cravings prior to food exposure may be sufficient to predict overeating in BED and that treatment may want to target this as a defining feature that differentiates individuals with BED from those who do not binge eat.     

The psychology of food craving

Cravings are hedonic responses to food, characterised by their intensity and their specificity. Food cravings are extremely common, reported by the majority of young adults. They are closely associated with liking but not synonymous with increased intake. Structured interviews and prospective incident accounts of food cravings have succeeded in revealing a richness of information about their character, their antecedents and their consequences. In addition, laboratory investigations are adding to what is being learned from field and clinical studies. Taking dieting as an example of an assumed influence on food craving, the outcomes of cross-sectional studies are mixed and unconvincing. Prospective and experimental research shows a clearer relationship. Dieting or restrained eating generally increase the likelihood of food craving while fasting makes craving, like hunger, diminish. Attempted restriction or deprivation of a particular food is associated with an increase in craving for the unavailable food. This relationship suggests a variety of underlying cognitive, conditioning and emotional processes, of which ironic cognitive processes, conditioned cue reactivity and dysphoric mood are prominent. Food cravings may also be self-attributions, accounting for why a highly-palatable but self-restricted food is (over-)consumed. Overall, the popularised account of cravings as elicited by specific nutritional need is having to give way to a more subtle and complex appreciation of human eating behaviour.     

Replacing craving imagery with alternative pleasant imagery reduces craving intensity

Laboratory studies have shown that asking people to engage in imagery reduces the intensity of laboratory-induced food cravings. This study examined whether the intensity of naturally occurring cravings can be reduced by replacing the craving-related imagery with alternative, pleasant imagery. Participants were instructed to vividly imagine engaging in their favorite activity. They had to apply this imagery technique over a period of four days whenever they felt a craving arising and were asked to keep applying this technique until the craving passed. Compared to baseline, craving intensity and vividness of craving-related imagery were both significantly reduced. Vividness of craving-related imagery fully mediated the effect of the alternative imagery on craving intensity. No effects were found for control conditions in which participants (1) just formed the goal intention to reduce their cravings, (2) formed implementation intentions to reduce their cravings, and (3) engaged in a cognitive task (reciting the alphabet backwards). The findings suggest that vividly imagining a pleasant element can be an effective technique to curb cravings in everyday life.     

The phenomenology of food cravings: the role of mental imagery

The study aimed to investigate the role of mental imagery in the experience of food cravings. A sample of 130 undergraduate students was first asked to recall and rate a previous food craving experience. Second, they were asked to imagine themselves eating their favourite food and to rate the involvement of different sensory modalities. It was found that mental imagery was a key element in both the retrospective craving experience and the current food induction. In particular, craving intensity was related to the vividness of the food image (r = .46). The specific sensory modalities most involved were visual (39.7%) and gustatory (30.6%), followed by olfactory (15.8%). There was little involvement of auditory or tactile modalities. It was concluded that cognitive experimental techniques aimed at reducing the vividness of visual, gustatory or olfactory imagery, might usefully be deployed to reduce unwanted food cravings.     

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.     

Food cravings in food addiction: the distinct role of positive reinforcement

Craving for a particular substance is an essential characteristic of addictive behavior. Increasing evidence suggests that food cravings and excessive food consumption could similarly be due to addictive processes. Recently, the Yale Food Addiction Scale (YFAS) was introduced for identifying individuals with addictive eating patterns. We conducted an online study (n=616, 75.8% female) in which participants filled out the YFAS and the Food Cravings Questionnaire-Trait (FCQ-T). Participants diagnosed as being addicted to food using the YFAS had higher scores on all food craving subscales except for anticipation of positive reinforcement that may result from eating. In a subsequent regression analysis, all food craving subscales positively predicted food addiction symptoms while positive reinforcement negatively predicted food addiction symptoms. Similar to other addictive behaviors, results indicate that individuals with addictive eating patterns experience more food cravings, but concurrently do not expect a positive reinforcement through eating.     

Non-food odorants reduce chocolate cravings

The present study compared the relative effectiveness of simple, commercially available food and non-food olfactory tasks on chocolate craving reduction. Chocolate cravings were induced by a series of coloured photographs and 67 undergraduate women were asked to smell one of three odours (green apple, jasmine, or water). The non-food odorant (jasmine) significantly reduced chocolate cravings relative to both the food and control odorants. Thus simple non-food odorants offer potential scope as a technique for curbing unwanted food cravings.     

Cravings and aversions of pregnant adolescents.

Adolescents from 31 eastern Tennessee counties were interviewed during the third trimester of pregnancy (n = 97) and at 1-year postpartum (n = 64) to assess cravings and aversions, beliefs about dietary cravings, and how these factors influence dietary intake. Characteristics of cravings and aversions were assessed using a semistructured interview. Beliefs about cravings during pregnancy were measured with a 13-item Likert-type scale (alpha = 0.79). Two 24-hour recalls and 2 days' food records provided dietary data. Most adolescents (86%) reported cravings during pregnancy. They most frequently reported cravings for sweets, especially chocolate; fruits and fruit juices; fast foods; pickles; ice cream; and pizza. Many participants (66%) experienced aversions during pregnancy toward previously liked foods. The most common aversions were to meats, eggs, and pizza. Fewer cravings and aversions were noted during the first year postpartum. No significant relationship existed between craving and aversions and belief scores. Adolescents craving sweets during pregnancy consumed more sugar and energy than those who did not crave sweets. Cravings generally resulted in increased intake, and aversions led to decreased food consumption. On the basis of these results, we suggest that nutritional assessment of pregnant adolescents include questions about cravings and aversions.     

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.     

Dietary cravings and aversions in the postpartum period

Although food cravings and aversions are commonly experienced by pregnant women, the degree to which they persist in the postpartum period is unknown. This study examines this issue in both lactating and nonlactating women. A random sample of 463 subjects was selected from all prenatal patients receiving care at a large health maintenance organization (HMO). Even though almost all of the subjects reported craving some food or beverage during the last trimester of pregnancy and half reported some aversion, those phenomena dropped markedly in the postpartum period. Evaluation of dietary quality as related to food cravings revealed no clear association; that is, the data provided no evidence to support the hypothesis that cravings are caused by dietary deficiencies or that they result in significantly augmented intake of key nutrients found in those foods. Overall, food cravings and aversions do not continue into the postpartum period at a higher rate than one would expect in the adult female population; manifestation of food cravings/aversions is not related to dietary quality.     

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.     

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.