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.     

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.     

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.     

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.     

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.     

Mood and carbohydrate cravings

The relationship between mood and carbohydrate cravings, and the possible role of gender in these associations, was investigated in a sample of 113 males and 138 female college students. Participants completed a Cravings Questionnaire and several mood inventories (profile of mood states, Beck Depression Inventory, and the Vitality Inventory) in groups of 25. Individuals classifying themselves as "carbohydrate cravers" reported foods rich in carbohydrates, and "protein cravers" reported protein-rich foods as being the ones they most strongly craved. Carbohydrate cravers reported feeling distressed prior to their cravings and satisfied, happy/good and relaxed following carbohydrate consumption. Protein cravers reported feeling anxious or hungry prior to their cravings and happy, normal, bored, and energetic following protein-rich food consumption. A non-significant correlation existed between "protein" cravers' ratings of craving intensity and mood, but a significant positive correlation existed between "carbohydrate" cravers' ratings of craving intensity and almost all mood scales assessed for both male and female "carbohydrate" cravers. The correlation between craving intensity and mood existed predominately with individuals who craved sweet carbohydrate-rich foods.     

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.     

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.     

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.     

Satiety and test meal intake among women with binge eating disorder

OBJECTIVE: The purpose of the study was to measure test meal consumption and the changes in hunger and fullness during a test meal in obese individuals with and without binge eating disorder (BED) and normal-weight controls. METHOD: Twelve women with BED, 12 obese control participants, and 12 normal-weight control participants participated in two single-item test meal sessions. In one session participants were instructed to "binge," and the other eat a normal meal. Participants made ratings of hunger and fullness on visual analog scales after every 75-g increment of food. RESULTS: In comparison to obese or normal-weight controls, patients with BED consumed significantly more food to reach a similar level of fullness or hunger. CONCLUSION: Individuals with BED consumed significantly more food and showed blunted changes in hunger and fullness during both the binge and nonbinge meals. These findings suggest that individuals with BED may have disturbances in satiety that in some ways resemble those described among individuals with bulimia nervosa.     

Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder

(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients.     

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.     

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 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.     

Physiological and psychological responses to a glucose challenge in bulimia

Twenty females meeting DSM-III criteria for bulimia, and 12 age- and sex-matched controls underwent a 60-min intravenous glucose tolerance test. Blood samples were taken at −10, 0, 5, 10, 20, 30, 45, and 60 min after the glucose injection. At these times, subjects completed a mood rating scale [Profile of Mood States (POMS)] and a subjective self-report questionnaire addressing both food cravings and thirst, as well as the urge to binge and subjective control over food intake. Blood levels of tryptophan, tyrosine, valine, leucine, phenylalanine, and isoleucine were measured at 0 and 60 min after the injection. Although equivalent at baseline, the blood glucose levels of bulimics at 5 min and insulin/glucagon ratio at 20, 30, and 45 min following injection were reduced in comparison to controls. Blood valine levels were also lower among the bulimic group. There were no differences between the bulimics and normal controls at baseline on subjective self-report measures of urge to binge, control over food intake, carbohydrate (CHO) craving or fatigue. following the glucose injection, however, the observed physiological differences between the two groups were accompanied by increased subjective cravings for sweets and fruits, an enhanced urge to binge, and less subjective control over food intake for bulimics as compared with controls. The bulimics also reported increased fatigue in response to glucose, whereas controls reported feeling less fatigued. The results suggest that abnormal physiological responses to blood glucose are accompanied by alterations in both food cravings and mood, which may promote binging among bulimic patients.     

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.     

Psychometric properties of the Food Craving Inventory among obese patients with binge eating disorder

OBJECTIVE: To examine the psychometric properties of the Food Craving Inventory [FCI; White, M. A., Whisenhunt, B. L., Williamson, D. A., Greenway, F. L., & Netemeyer, R. G. (2002). Development and validation of the food-craving inventory. Obesity Research, 10 (107-114)] in a group of obese patients with binge eating disorder (BED). METHOD: Participants were 122 obese patients seeking treatment for BED who completed the FCI. Data from the original 28-item FCI were examined. The current study sample was then compared to a community sample of obese patients. RESULTS: Confirmatory factor analysis confirmed the 4-factor structure of the FCI. An improved model was found following the deletion of 3 items, yielding a 25-item questionnaire. Secondary analyses indicated differences in patterns of food cravings between BED patients and an obese comparison group. DISCUSSION: The current study confirmed the psychometric properties of the FCI for use with a group of treatment-seeking obese patients with BED. Collectively, the results imply that obese patients with BED may crave sweets to a heightened degree relative to other food classes.     

Sedentary Behavior and Food Cravings in Diverse Overweight Women: A Pilot Study

Obesity rates have risen sharply in the United States, with minority women among those most affected. Although a majority of Americans are considered inactive, little attention has been devoted to studying the correlation of sedentary behavior with dietary cravings in adults. Objective: The current study used objective and self-report methods to measure sedentary behavior and its relationship to food cravings in a sample of overweight African American and Caucasian women. Design: Thirty-nine adult women (54% African American) with an average body mass index of 33.7 wore accelerometers for one week and completed self-report measures of sedentary behavior, physical activity, and food cravings. Results: Self-reported television viewing time was slightly longer (3.0 versus 2.5 hours), although total sedentary time was shorter (6.7 versus 8.0 hours) on weekends versus weekdays. Weekend but not weekday sedentary time and television viewing were associated with stable aspects of food cravings rather than craving for specific foods. Conclusion: In this small sample, only a third of all sedentary time was attributed to viewing television. Assessing whether sedentary behavior occurs by necessity versus choice may be a factor to consider in examining its relationship to food cravings.     

A comparison of the accuracy of self-reported intake with measured intake of a laboratory overeating episode in overweight and obese women with and without binge eating disorder

Purpose

Research has demonstrated significant underreporting of food intake in obese individuals with and without binge eating disorder (BED). An improved understanding of the accuracy of self-reported food intake is central to diagnosis of eating disorders and monitoring response to treatment. The purpose was to: (1) confirm those with BED consume significantly more kilocalories (kcal) than overweight/obese controls when instructed to overeat in the laboratory and (2) compare dietary recall data with measured intake.

Methods

Fifteen women fulfilling BED criteria and 17 controls participated in an overeating episode and completed a 24-h dietary recall.

Results

BED participants consumed significantly more kilocalories according to both methodologies. The BED group self-reported 90% of the measured intake compared to 98% for the control group. Mean differences between the methods indicated that on average both groups underreported intake; however, the mean difference between methods was significantly greater in the BED group.

Conclusions

Findings confirm that those with BED consume significantly more than controls during a laboratory binge and controls tended to be more accurate in recalling their intake 24 h later.     

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.