Cue reactivity in bulimia nervosa: A useful self-report approach

Carter, Frances A.; McIntosh, Virginia V.W.; Joyce, Peter R.; Frampton, Christopher; Bulik, Cynthia M.

doi:10.1002/eat.20331

Cited by 13 publications

(9 citation statements)

References 11 publications

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“…132,133 Food craving is commonly defined as an intense desire to eat a specific food. 72 Addiction-like cue reactivity has been described in BN, 155,156 and studies in drug addiction also show anterior cingulate and orbitofrontal activations related to craving. 136Y138 Food cravings are not necessarily a product of nutrient deficit or dietary restraint.…”

Section: Cravingmentioning

confidence: 99%

From Disordered Eating to Addiction

Umberg¹,

Shader²,

Hsu³

et al. 2012

Journal of Clinical Psychopharmacology

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The high prevalence of substance abuse in individuals with bulimia nervosa (BN) and the pervasive symptom substitution in many types of drug addiction suggest that a number of substances--including food--can impair an individual's self-control, even in the presence of negative consequences. Nonetheless, the neurobiological similarities between BN and drug addiction are not clearly established. This review explores how the specific eating patterns seen in BN (binge eating and purging, with intermittent dietary restriction) are particularly addictive and differentiate BN from other eating disorders and obesity. A number of peripheral and central biological aberrations seen in BN may result in altered reward sensitivity in these individuals, particularly through effects on the dopaminergic system. Neurobiological findings support the notion that BN is an addictive disorder, which has treatment implications for therapy and pharmacological manipulations.

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Section: Cravingmentioning

confidence: 99%

From Disordered Eating to Addiction

Umberg¹,

Shader²,

Hsu³

et al. 2012

Journal of Clinical Psychopharmacology

View full text Add to dashboard Cite

show abstract

“…Research into cue reactivity in eating disorders such as bulimia nervosa is relatively extensive (for example, see Carter et al 2006) but tends to overlook food craving in favour of urge to eat or urge to binge, if these subjective data are collected at all. Also, food cravings are not the only triggers to binge episodes.…”

Section: Cognitive Conditioning and Emotional Processesmentioning

confidence: 99%

The psychology of food craving

2007

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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 crosssectional 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 highlypalatable 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. A commonly-held view is that food cravings are expressions of bodily wisdom, elicited by need and serving to stimulate consumption of the required nutrient. This position is becoming increasingly contentious as new research evidence accumulates. However, the demand for a mechanical and unifying explanation of food craving means that non-confirming evidence is often marginalised or overlooked. The purpose of the present paper is to provide an update on these quintessentially psychological phenomena, to look again at the evidence on dieting and food cravings and consider the alternative underlying mechanisms. The phenomenology of food cravingMost surveys find food cravings are extremely common events, and are reported by the great majority of young adult samples. Food craving is closely associated with liking, since the most-commonly-craved foods, such as chocolate, are highly palatable (Pelchat, 2002). However, craving is not synonymous with increased eating. Foods are frequently eaten without being craved for and craved foods are not always eaten. Similarly, hunger is not a precondition for craving. Instead, there are stronger links between mood and craving. Cravings that lead to episodes of binge eating, for example, are more likely to happen against a backdrop of reduced hunger but increased negative affect.So, what is a food craving? How is it defined? Craving is a problematic term for the addictions literature. It is a hypothetical construct, inferred from reports of subjective experience, changes in physiological sta...

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“…6,7 Frameworks related to the phenomenon of cue reactivity are are based on conditioning processes 6,8 because they assume that the negative-reinforcing nature of drug withdrawal or the positive-reinforcing nature of consuming certain substances triggers a specific response to a substance-associated cue. Parallel mechanisms could apply to craving and excessive food consumption (binge eating) in patients with EDs 9,10 : Craving, a nearly irresistible desire for food and the urge to eat, is seen in BN patients and a subgroup of AN patients with binge/purge symptoms, and often leads to binge eating episodes as a behavioral form of cue reactivity. Presumably, the ED patient's response to food cues is not only accompanied by appetitive mechanisms, but also by anxiety and obsessionality, for example, with respect to the fear of weight gain or body shape disturbance.…”

Section: Introductionmentioning

confidence: 99%