Changes In Cravings Research Articles

Virtual reality-assisted cognitive behavioral therapy for patients with alcohol use disorder: a randomized feasibility study.

Cognitive behavioral therapy (CBT) is an evidence-based treatment for alcohol use disorder (AUD). Exposure to high-risk situations in virtual reality (VR) has been suggested to have a potential therapeutical benefit, but no previous study has combined VR and CBT for AUD. We aimed to investigate the feasibility of using VR-simulated high-risk environments in CBT-based treatment of AUD. We randomized ten treatment-seeking AUD-diagnosed individuals to three sessions of conventional CBT or VR-assisted CBT performed at two outpatient clinics in Denmark. In each session, patients randomized to VR-CBT were exposed to VR-simulations from a restaurant to induce authentic thoughts, emotions, physiological reactions, and craving for CBT purposes. The primary outcome measure was feasibility: Drop-out rate, psychological reactions, and simulator sickness. Secondary outcomes were assessment of preliminary short-term changes in alcohol consumption and craving from baseline to one-week and one-month follow-up. In addition, the study was conducted for training in operationalization of VR equipment, treatment manuals, and research questionnaires. The majority of patients completed all study visits (90%). VR induced authentic high-risk related thoughts, emotions, and physiological reactions that were considered relevant for CBT by patients and therapists. Four of five patients randomized to VR-CBT experienced cravings during VR simulations, and most of these patients (3/5) experienced mild simulator sickness during VR exposure. The preliminary data showed that patients receiving VR-CBT had more reduction in alcohol consumption than patients receiving conventional CBT at one week- (median 94% vs. 72%) and one-month follow-up (median 98% vs. 55%). Similar results were found regarding changes in cravings. We demonstrated VR-CBT to be a feasible intervention for patients with AUD which supports continued investigations in a larger randomized clinical trial evaluating the efficacy of VR-CBT. https://www.clinicaltrials.gov/study/NCT04990765?cond=addiction%20CRAVR&rank=2, identifier NCT05042180.

Examining the effect of exercise on the relationship between affect and cravings among smokers engaged in cessation treatment

Cigarette smoking is associated with multiple adverse health outcomes. When smokers attempt to quit smoking, one of the leading predictors of relapse are cravings. Recent research shows a relationship between positive and negative affect, exercise, and cravings, but the exact nature of this relationship has yet to be understood. This study explored the relationships between positive and negative affect and cravings in a sample of participants with elevated levels of depressive symptoms (N = 202; 68.8% female; mean age = 46.1 years) who were enrolled in a smoking cessation trial to test the efficacy of a 12-week exercise intervention relative to a health education control on smoking outcomes. Data on affect and craving were gathered before weekly study intervention sessions, and data on cravings were gathered again after each session. The results showed that negative affect had a significant and positive association with cravings before an exercise or health education session. After the session, positive and negative affect were not significant predictors of changes in cravings from pre-session. However, regardless of level of positive or negative affect participants in the exercise condition showed greater reductions in craving pre- to post-class than those in the control condition. These findings suggest that negative affect is associated with cravings, but cravings can be mitigated by exercise.

Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans.

Frequent experiences of discrimination could increase vulnerability to tobacco withdrawal and smoking lapse in populations subject to tobacco-related health disparities. This laboratory study (2013-17) examined whether individual differences in perceived exposure to discrimination in one's daily life predicted tobacco withdrawal symptoms and smoking lapse behavior following acute tobacco deprivation in African American smokers. Mixed design with the between-subjects continuous variable of perceived discrimination crossed with the within-subject variable of tobacco deprivation status (deprived versus non-deprived). Academic medical center in Los Angeles, CA, USA. African American non-treatment seeking daily cigarette smokers (n=607, ≥10 cig/day). At a baseline visit, self-reported frequency of perceived exposure to discrimination in one's daily life was measured [everyday discrimination scale (EDDS)]. At two subsequent counterbalanced experimental visits (16-hour tobacco deprivation versus ad-libitum smoking), self-report assessments of various tobacco withdrawal symptom domains [Brief Questionnaire of Smoking Urges), Wisconsin Smoking Withdrawal Scale (WSWS), Profile of Mood States (POMS), Snaith-Hamilton Pleasure Scale (SHAPS) and Current Impulsivity Scale (CIS)) and a behavioral smoking lapse analogue task were measured. Adjusted models demonstrated that greater frequency of perceived exposure to discrimination was associated with larger deprivation-induced increases in acute urges to smoke to alleviate negative mood, several negative mood states and subjective cognitive functioning-effect sizes were small in magnitude (βs=0.09-0.13; Ps<0.02). Data were inconclusive for associations between perceived exposure to discrimination and deprivation-induced changes in cravings, urges to smoke for pleasure, positive mood reduction, other symptoms or smoking reinstatement behavior. Frequency of perceived exposure to discrimination appears to be modestly associated with increased severity of some deprivation-induced tobacco withdrawal symptoms in African American smokers.

Acute Aerobic Exercise Ameliorates Cravings and Inhibitory Control in Heroin Addicts: Evidence From Event-Related Potentials and Frequency Bands.

ObjectiveAerobic exercise is considered a potential adjunctive treatment for heroin addicts, but little is known about its mechanisms. Less severe cravings and greater inhibitory control have been associated with reduced substance use. The aim of the current study was to determine the effects, as measured by behavioral and neuroelectric measurements, of acute aerobic exercise on heroin cravings and inhibitory control induced by heroin-related conditions among heroin addicts.DesignThe present study used a randomized controlled design.MethodsSixty male heroin addicts who met the DSM-V criteria were recruited from the Isolated Detoxification Center in China and randomly assigned to one of two groups; one group completed a 20-min bout of acute stationary cycle exercise with vigorous intensity (70–80% of maximum heart rate, exercise group), and the other group rested (control group). The self-reported heroin craving levels and inhibitory control outcomes (measured by a heroin-related Go/No-Go task) were assessed pre- and post-exercise.ResultsThe heroin craving levels in the exercise group were significantly attenuated during, immediately following, and 40 min after vigorous exercise compared with before exercise; moreover, during exercise, a smaller craving was observed in the exercise group than in the control group. Acute exercise also facilitated inhibition performance in the No-Go task. After exercise, the participants’ accuracy, the N2d amplitudes, and the theta two band spectral power during the No-Go conditions were higher in the exercise group than in the control group. Interestingly, significant correlations between the changes in these sensitive measurements and the changes in cravings were observed.ConclusionsThis is the first empirical study to demonstrate that aerobic exercise may be efficacious for reducing heroin cravings and promoting inhibitory control among heroin addicts.

The Influence of Exposure to Smoking in Movies on Cigarette Cravings among Adolescents: A Contextual Quasi-Experimental Model

ABSTRACTThis study explored the socio-contextual characteristics of adolescents that led them to have increased cigarette cravings when exposed to smoking scenes in films. We analyzed online survey data collected from a representative sample of 955 Korean adolescents. Our dependent variable was change in cigarette cravings after watching a smoking scene; independent variables included sex, age, school type, allowance, smoking experience, and parental smoking. We used paired t-tests to identify the differences in cigarette cravings modified by individual characteristics, and we performed logistic regression to explore the influences on these changes in cravings. The high school students investigated herein had significantly stronger cigarette cravings after they watched smoking scenes than they did prior to watching these scenes (t = −5.039, p < 0.001). The cravings were significantly higher after watching the clips among non-smokers (t = −4.264, p < 0.001) and participants who had at least one parent who smoked (t = -2.114, p < 0.05); non-smoking adolescents were also more likely to crave cigarettes after they watched smoking scenes than were smokers (odds ratio = 6.90, p < 0.001). Korean adolescents who did not smoke and those who had at least one parent who smoked showed the strongest cigarette cravings after being exposed to smoking in films. Consequently, more effective prevention strategies should be developed that recognize this tendency when regulating smoking scenes in movies or implementing related campaigns among adolescents.

Taste and odor preferences following Roux-en-Y surgery in humans.

It is well established that bariatric surgery, the most effective method to achieve long-term weight loss in obese subjects, reverses enhanced preference and intake of sweet/fatty foods. Although taste and odor preference changes following bariatric surgery have been previously described, their time course and relationship to weight loss remains an issue. The aim of this study was to determine the relationship between taste and odor preference changes and successful weight loss following bariatric surgery. A cross-sectional study was performed on 195 human subjects with body mass index (BMI) above 30 (at least class I obesity), who were scheduled to receive (n = 54) or had previously received (n = 141) Roux-en-Y gastric bypass (RYGB). A Self-Assessment Manikin test was used to measure each participant’s affective reaction (ranging from pleasure to displeasure) to a variety of food-related and odor-related pictures. Results confirmed earlier reports about changes in sweet/fatty foods preference after surgery and revealed a shift in preference toward less calorie-dense foods. Relatedly, endorsements of “favorite” foods were mostly sweet/fatty foods in subjects awaiting surgery but were shifted toward more healthy choices, particularly vegetables, in subjects post-RYGB surgery. However, food preference ratings trended toward pre-surgical levels as the time since surgery increased. Answers to open-ended questions about why their diet changed post-surgery revealed that changes in cravings, rather than changes in taste per se, were the major factor. Surprisingly, patients rating a coffee taste as more pleasing after surgery had a lower post-surgical BMI. No associations of odors with change in BMI were apparent. Results showed that following bariatric surgery taste preferences are significantly altered and that these changes correlate with lowered BMI. However, these changes fade as time since surgery lengthens. These results may suggest diagnostic criteria to identify people at risk for less than optimal changes in BMI following bariatric surgery.

Do scores on the Food Craving Inventory and Three-Factor Eating Questionnaire correlate with expected brain regions of interest in people with obesity?

ObjectiveTo examine whether subscales of Food Craving Inventory (FCI) and Three-factor Eating Questionnaire (TFEQ) correlate with brain functional magnetic resonance imaging food-cue reactivity (fMRI-FCR) in the brain. MethodsThirty-two male and female adults with obesity (19–60years; 30–39.9kg/m2) participated in a 3-week dietary intervention (1120kcal/day from either 1) total meal replacement shakes, 2) portion-controlled typical food. FCI, TFEQ and fMRI-FCR were measured pre- and post-intervention. Correlations between pre-intervention fMRI-FCR and standardized pre-intervention FCI and TFEQ subscales; and also post- versus pre-intervention change in fMRI-FCR (ΔfMRI-FCR) and standardized changes in FCI and TFEQ subscales were examined at the whole brain level using tools in FMRIB Software Library. ResultsTwenty-eight subjects completed the intervention. Pre-intervention high-fat food cravings (P=0.041) and fast-food cravings (P=0.017) were negatively correlated with fMRI-FCR of several brain regions that regulate executive control over ingestion (i.e. bilateral lateral frontal pole, dorsolateral prefrontal cortex and dorsal anterior cingulate cortex). Post- vs. pre-intervention change in sweet (P=0.012) and fast food cravings (P=0.004) were negatively correlated with ΔfMRI-FCR of bilateral lateral frontal pole, dorsolateral prefrontal cortex, inferior frontal gyrus (pars opercularis) and dorsal anterior cingulate cortex (i.e. brain regions that regulate executive control over ingestion). Negative correlations were also observed between the changes in sweet and fast food cravings and ΔfMRI-FCR of brain regions that regulate food reward (i.e. bilateral mid-anterior insula, right nucleus accumbens), motor readiness to ingest (i.e. bilateral precentral gyrus), internally focused attention (i.e. bilateral precuneus and posterior cingulate cortex) and visual object recognition (i.e. occipital pole, lateral occipital cortex and middle and inferior temporal cortices). Changes in cravings for starchy food (P=0.032) and overall food cravings (P=0.027) were also negatively correlated with ΔfMRI-FCR of brain regions involved in regulating internally focused attention and visual object recognition. ConclusionsIn individuals with obesity, decreased food cravings seem to be reflective of increased fMRI-FCR of brain regions that regulate executive control over ingestion. Taken together, constructs measured by FCI seem to be reflective of neurophysiological processes underlying ingestive behavior and the changes in neurophysiological processes occurring during calorie restriction. Clinical trials registry numberNCT02637271; the protocol is available at https://clinicaltrials.gov/ct2/show/NCT02637271

Effectiveness of extended release naltrexone to reduce alcohol cravings and use behaviors during treatment and at follow-up

Changes in cravings to drink alcohol and alcohol use behaviors were examined among 337 patients who were administered extended-release naltrexone (XR-NTX) in conjunction with psychosocial treatment in community-based substance use disorder treatment programs. Cravings and use behaviors were assessed at multiple time points (baseline; weeks 1, 2, and 3 after the first dose; monthly after the first four assessments; and at 30- and 60-days after the last dose). A total of 863 doses (M=2.6, SD=1.8) were administered and the majority of patients (65%) took more than one dose. Alcohol craving scores decreased from 19 to 5.7 after the first dose of XR-NTX. Days of primary alcohol use at admission (M=10.5, SD=10.1) were reduced at discharge (M=to 1.2, SD=4.6). At the first follow-up, 79.8% reported no alcohol use and 77.8% reported no alcohol use at the second follow-up. The expected side effects were reported but the medication was well tolerated and there was no relationship between side effects and subsequent dose. Unexamined or unaccounted for variables (e.g., motivation, external pressures to remain in treatment) are “real world” consequences that may have impacted the outcome of this study. Results indicated that use of the antagonist medication XR-NTX may be related to significant decreases in alcohol craving and use while a patient is in treatment, as well as at 30- and 60-days after the final dose.

Frequency of Consuming Foods Predicts Changes in Cravings for Those Foods During Weight Loss: The POUNDS Lost Study.

ObjectiveFood cravings are thought to be the result of conditioning or pairing hunger with consumption of certain foods.MethodsIn a two-year weight loss trial, subjects were randomized to one of four diets that varied in macronutrient content. The Food Craving Inventory (FCI) was used to measure cravings at baseline, 6, and 24 months. Also, food intake was measured at those time points. To measure free-living consumption of food items measured in the FCI, items on the FCI were matched to the foods consumed from the food intake assessments. Secondarily, we analyzed the amount of food consumed on food intake assessments from foods on the FCI.Results367 subjects who were overweight and obese were included. There was an association between change from baseline FCI item consumption and change in cravings at months 6 (p<0.001) and 24 (p<0.05). There was no association between change from baseline amount of energy consumed per FCI item and change in cravings.ConclusionsAltering frequency of consuming craved foods is positively associated with cravings; however, changing the amount of foods consumed does not appear to alter cravings. These results support the conditioning model of food cravings and provide guidance on how to reduce food cravings.

Frequency of consuming foods predicts changes in cravings for those foods during weight loss: The POUNDS Lost Study

ObjectiveFood cravings are thought to be the result of conditioning or pairing hunger (or other stimuli) with consumption of certain foods. We hypothesize that changes in the frequency of consuming certain foods will be associated with changes in cravings for those foods.MethodsIn a two‐year weight loss trial, participants were randomized to one of four energy restricted diets (energy deficit 750 kcal/d) that varied in macronutrient content. The Food Craving Inventory (FCI) was used to measure cravings at baseline, 6, and 24 months. Also, food intake was measured at those time points. To measure free‐living consumption of food items measured in the FCI, items on the FCI were matched to the foods consumed at each time point from the food intake assessments. Secondarily, we analyzed the amount (kcal) of food consumed on food intake assessments from foods on the FCI.ResultsA total of 429 participants who were overweight and obese were included in the analyses. There was an association between change from baseline FCI item consumption and the change in cravings at months 6 (B 0.032 ± 0.010; Effect Size (ES) 0.060; p &lt; 0.001) and 24 (B 0.027 ± 0.011; ES 0.043; p &lt; 0.05). However there was no difference between changes at month 6 and 24 (p = 0.65). There was no association between change from baseline amount of energy (kcals) consumed per FCI item and the change in cravings at months 6 and 24 and no difference between changes at months 6 and 24.ConclusionsAltering frequency of consuming craved foods is positively associated with cravings for those food items; however, changing the amount (kcal) of foods consumed does not appear to alter cravings. These results support the conditioning model of food cravings and provides guidance on how to reduce food cravings.Support or Funding InformationNational Institutes of Health HL 073286, RR‐02635, F32 HL123242, P30 DK072476, and U54 GM104940.

A Systematic Review Investigating the Impact of Modified Varenicline Regimens on Smoking Cessation

Introduction: The efficacy of varenicline as a smoking cessation aid is affected by commonly-occurring issues, such as intolerable adverse events, cravings and withdrawal symptoms, and poor medication adherence. Improvement in quit rates may be achieved through tailoring doses relative to individual smokers’ behaviours, and previous experiences with smoking cessation medications.Aims: The aim of this review is to evaluate smoking cessation outcomes from published randomised controlled trials that have attempted to improve the efficacy and tolerability of varenicline through modifying its dosage regimen compared to placebo.Methods: A systematic search of the literature up to June 2016 was conducted to identify randomised controlled trials, where varenicline was administered in a regimen not consistent with the current clinical guidelines. Outcome measures evaluated included continuous abstinence rates, changes in cravings, withdrawal symptoms, smoking behaviours, adverse event rates, and premature therapy discontinuations.Results: Ten randomised controlled trials, encompassing four different modifications to standard varenicline therapy, matched the eligibility criteria. Modifications such as the extended duration of therapy and the use of a flexible quit date were effective compared to placebo and have been implemented into some clinical guidelines, whereas other modifications do not appear to produce any benefit for smokers, or require further research to ascertain their suitability for clinical practice.Conclusions: Some varenicline therapy modifications may lead to improvements in efficacy and tolerability. Further research on the effect of modifications such as daily doses higher than 2mg, tapering doses, and the use of extended pre-quit varenicline may advance varenicline therapy outcomes.

A Commercial Program is Effective for Weight Loss and Improving Health-Related Outcomes in Adults

Given the wide variety of commercial weight loss programs, independent evaluations of the effectiveness of these programs are critical to help inform choices by patients and practitioners. PURPOSE: This study evaluated changes in body weight, food cravings, flexibility, physical activity tolerance, and sleep quality (if you have room) in participants enrolled in a Weight Watchers program with the new SmartPointsTM plan. METHODS: Participants (N=150; mean age: 47.3 ± 12.7 years; mean BMI: 33.9 ± 4.3 kg/m2) were enrolled in a 6-month Weight Watchers program with the new SmartPointsTM plan. The intervention was delivered by trained Weight Watchers leaders and evaluated by independent research staff that was not engaged in intervention delivery. The intervention included weekly group sessions, instructions on behavioral methods of weight control and the use of an app to log points for foods and beverages. Body weight, food cravings, flexibility using the YMCA sit and reach test, physical activity tolerance using the 6 minute walk test, and sleep quality using the Pittsburgh Sleep Quality Index were assessed at baseline and 6 months. RESULTS: Of the 150 enrolled participants, 144 (95.3%) completed the 6-month assessment and provided data for weight, food cravings, flexibility, and sleep, with 143 providing data for the 6 minute walk. There was a significant reduction in weight of 2.8 ± 5.0 kg (3.1 ± 5.5%) from 0 at 6 months (p<0.001). There was a significant decrease in cravings for: sweets; carbohydrates and starches; fats; and fats from fast food (all p-values<0.001). There was no change in cravings for fruits and vegetables (p=0.326). Flexibility increased by 15.1±26.3% (p<0.001) and distance during the 6 minute walk increased by 23.8±39.0 meters (p<0.001). There was a significant decrease in the percent of participants classified as a “poor sleeper” at baseline (48.6%) compared to 6 months (43.8%) (p<0.001). CONCLUSIONS: The Weight Watchers SmartPointsTM plan produced significant 6-month improvements in body weight, food craving, flexibility and function, and sleep quality. Thus, this program provides an effective treatment option for adults who are overweight or obese.

Design of a comparative effectiveness evaluation of a culturally tailored versus standard community-based smoking cessation treatment program for LGBT smokers.

BackgroundSmoking prevalence rates among the lesbian, gay, bisexual, and transgender (LGBT) population are significantly higher than the general population. However, there is limited research on smoking cessation treatments in this group, particularly on culturally targeted interventions. Moreover, there are few interventions that address culturally specific psychosocial variables (e.g., minority stress) that may influence outcomes. This paper describes the protocol for a comparative effectiveness trial testing an evidence-based smoking cessation program, Courage to Quit, against a culturally tailored version for LGBT smokers, and examines the role of culturally specific psychosocial variables on cessation outcomes.Methods/DesignTo examine the effectiveness of a culturally targeted versus standard smoking cessation intervention, the study utilizes a 2-arm block, randomized, control trial (RCT) design. Adult LGBT participants (n = 400) are randomized to one of the two programs each consisting of a six-session group program delivered in a community center and an eight week supply of the transdermal nicotine patch. Four individualized telephone counseling sessions occur at weeks 2, 5, 7, and 9, at times of greatest risk for relapse. Study outcome measures are collected at baseline, and 1, 3, 6, and 12 months post quit date. Primary outcomes are expired air carbon monoxide verified 7-day point-prevalence quit rates at each measurement period. Secondary outcomes assess changes in cravings, withdrawal symptoms, smoking cessation self-efficacy, and treatment adherence. Additionally, study staff examines the role of culturally specific psychosocial variables on cessation outcomes using path analysis.DiscussionDetermining the efficacy of culturally specific versus standard evidence based approaches to smoking cessation is a critical issue facing the field today. This study provides a model for the development and implementation of a culturally tailored smoking cessation intervention for LGBT participants and addresses a gap in the field by examining the role of culturally psychosocial variables associated with cessation outcomes.Trial registrationU.S. National Institutes of Health Clinical Trials NCT01633567 Registered 30 May 2012.

Prefrontal cortex transcranial direct current stimulation (tDCS) temporarily reduces food cravings and increases the self-reported ability to resist food in adults with frequent food craving

This study examined whether a 20-min session of prefrontal transcranial direct current stimulation (tDCS) (anode over the right prefrontal cortex and cathode over the left prefrontal cortex) would reduce food cravings and increase the self-reported ability to resist foods in 19 healthy individuals who reported frequent food cravings. Participants viewed computerized images of food and used computerized visual analogue scales to rate food cravings and inability to resist foods before, during, and after receiving either real or sham tDCS. This study employed a randomized within-subject crossover design; participants received both real and sham tDCS and were blind to the condition. Food cravings ratings were reduced in both conditions, however, the percent change in cravings ratings from pre- to post-stimulation was significantly greater for real stimulation than for sham. The percent change in inability to resist food from pre- to post-stimulation also showed a greater decrease in the real condition than for sham. Post hoc analyses suggest that active prefrontal tDCS acutely and significantly decreased food cravings ratings for sweet foods and carbohydrates more so than sham tDCS. No significant differences were seen in the amount of food ingested between real and sham tDCS. These findings in healthy subjects indicate that tDCS is able to temporarily reduce food cravings and improve the self-reported ability to resist foods.

Vagus nerve stimulation and food cravings: A response to Gibson and Mohiyeddini

Recently, we conducted the first study to date on the effects of VNS on food cravings among depressed adults and concluded that VNS activation appears to acutely alter food cravings in depressed adults. Interestingly, we found that VNS device activation was associated with acute increases in cravings in some participants, and decreases in others. We then implemented exploratory regression analysis to determine some potential variables that accounted for this variability in VNS-related changes in food cravings for future studies to consider for further study. Gibson and Mohiyeddini critically examined this paper and despite acknowledging that the concept is interesting, they suggest that our design, analysis and interpretation should be reconsidered. Specifically, they had concerns about the validity of our dependent measure, the way in which we operationalized alteration in cravings, and possible problems with our regression analysis. However, a review of the methods commonly employed in the literature for assessing acute changes in cravings supports the validity of our cravings measure. We believe that our procedures for extracting VNS-related alterations in food cravings, while imperfect, strike a nice balance between the difficult challenges of research design regarding acute VNS-related behavioral changes and meaningful inference. Additionally, logical flaws and unfounded speculation regarding the assumptions of our regression analyses led Gibson and Mohiyeddini to make faulty assertions regarding potential problems with our exploratory model. We contend that the inferences and conclusions we reached in the original paper are sound.

Vagus nerve stimulation confuses appetite: Comment on Bodenlos et al. (2007)

In a recent research report, [Bodenlos et al. 2007. Vagus nerve stimulation (VNS) acutely alters food craving in adults with depression. Appetite, 48, 145–153] concluded that, in depressed patients, acute activation of a device for VNS caused a significant change in cravings specifically for sweet foods. We argue that there is no evidence for any effect on food cravings. Rather, the findings indicate that VNS confuses the patient's appetite for sweet foods: this might result from contextually unexpected internal afferent signals generated by the vagal stimulation. Unfortunately, their multiple regression of potential predictive variables cannot be interpreted reliably. The concept is interesting, but the design, analysis and interpretation should be reconsidered.

Vagus nerve stimulation acutely alters food craving in adults with depression

Vagus nerve stimulation (VNS) is now available as a treatment for epilepsy and treatment-resistant depression. The vagus nerve plays a central role in satiety and short-term regulation of food intake and research suggests a relationship between VNS and weight loss. The underlying mechanisms of this relationship are unknown. The purpose of the current study was to determine whether acute cervical VNS might temporarily alter food cravings. Thirty-three participants were recruited for three groups; depression VNS, depression non-VNS, and healthy controls. Participants viewed 22 computerized images of foods twice in one session and completed ratings for food cravings after each image. The VNS participants' devices were turned on for one viewing of an image and off for the other (randomized order). Participants were blind to VNS condition (on versus off). Acute VNS device activation was associated with a significant change in cravings-ratings for sweet foods. A significant proportion of variability in VNS-related changes in cravings was accounted for by patients' clinical VNS device settings, acute level of depression, and body mass. Further studies are warranted addressing how acute or chronic VNS might modify eating behavior and weight.

Changes in Food Cravings during Low‐Calorie and Very‐Low‐Calorie Diets

This study examined food cravings during a primarily food-based low-calorie diet (LCD) and a supplement-based very-LCD (VLCD). The Food Craving Inventory (FCI) was used to measure general cravings and cravings for specific types of foods (sweets, high fats, carbohydrates/starches, and fast food fats). The FCI was completed by participants in the LCD and VLCD programs at baseline and after 11 weeks of dieting. The VLCD group also completed the FCI at Week 6 and after 5 weeks of a refeeding phase, when their diet consisted primarily of solid food. From baseline to Week 12, craving decreases were greater for the VLCD group than for the LCD group on all measures. All craving measures decreased significantly for the VLCD group. The LCD group experienced a marginally significant decrease in sweet cravings. Within the VLCD group, all craving measures decreased significantly by Week 6 and did not change thereafter, including after resumption of solid food intake, and craving scores during all dieting points were lower than baseline. Changes in cravings were not related to weight loss. Cravings did not increase during either diet; all changes represented decreases. Compared with a primarily food-based diet (LCD), a more restrictive supplement-based diet (VLCD) resulted in significantly larger decreases in food cravings that occurred by the end of the 5th week of supplement use and did not rebound with resumption of solid food intake. The results of this study suggest that food cravings diminish with calorie restriction.

Food cravings during acute hypoglycaemia in adults with Type 1 diabetes

Background: Food craving is defined as an intense desire to eat a specific foodstuff. It may be distinguished from the sensation of hunger, which is relieved by nonspecific foodstuffs. No controlled studies have examined the effects of hypoglycaemia on food cravings. Thus, the aim of this study was to examine change in cravings for eight specified food types during euglycaemia and insulin-induced hypoglycaemia. Methods: Thirteen adults with Type 1 diabetes attended two experimental sessions where acute hypoglycaemia was induced with either insulin aspart or human soluble insulin. Food cravings were assessed, using a questionnaire, at baseline and at the onset of the autonomic reaction to hypoglycaemia (“R”). Results: The mean arterialised blood glucose concentration at baseline was 6.0±0.3 mmol l −1 and at R was 1.9±0.4 mmol l −1 ( P<.01). Fifteen percent of subjects reported having a craving for food during euglycaemia. The prevalence increased to 65% during hypoglycaemia ( P<.01). Cravings for seven of the eight food types increased during hypoglycaemia, but the greatest effect sizes (>1.0 standard deviations) were observed for three food types that had a high carbohydrate content. Conclusions: In people with Type 1 diabetes, acute hypoglycaemia produces a highly reliable generalised increase in cravings for food, particularly foodstuffs with a high content of carbohydrate. The mechanisms behind this response remain to be elicited.

Hormonal, Psychological, and Alcohol Craving Changes after m‐Chlorophenylpiperazine Administration in Alcoholics

To assess the serotonergic function of alcoholics, their neuroendocrine and psychological responsivities to the serotonergic partial agonist meta-chlorophenylpiperazine (m-CPP) was compared with the responsitivity of healthy subjects. The effect of m-CPP on craving for alcohol was also assessed in the alcoholics. Sixteen patients and 14 controls were tested under double-blind, placebo-controlled conditions. m-CPP (0.5 mg/kg of body weight) was given orally. Alcoholics were tested after a period of abstinence of 15 to 39 days. The two groups of subjects did not differ in their cortisol response to m-CPP, but the prolactin response of alcoholics was significantly blunted. Alcoholics reported a significantly more intense "high" feeling after m-CPP than the healthy subjects. m-CPP induced also a decreased craving for alcohol. Our data thus provide further evidence for the existence of a serotonergic dysfunction in alcoholics and a modulation of craving for alcohol by serotonergic systems.