San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
Appetite. 2024 Sep 1;200:107575. doi: 10.1016/j.appet.2024.107575. Epub 2024 Jun 20.
Food cue reactivity (FCR) is an appetitive trait associated with overeating and weight gain. We developed a laboratory craving assessment to objectively evaluate cognitive aspects of FCR. This study examined the preliminary construct and criterion validity of this craving assessment and evaluated 4 different interventions, 2 of which incorporated cue-exposure treatment for food, on craving over treatment and follow-up. 271 treatment-seeking adults with overweight/obesity (body mass index = 34.6[5.2]; age = 46.5[11.8]; 81.2% female; 61.6% non-Latinx White) completed the Food Cue Responsivity Scale and the laboratory craving assessment, during which they alternated holding and smelling a highly craved food and provided craving ratings over 5 min. Participants were subsequently randomized to 26 treatment sessions over 12-months of ROC, Behavioral Weight Loss (BWL), a combined arm (ROC+) and an active comparator (AC), and repeated the craving assessment at post-treatment and 12-month follow-up. Linear mixed-effects models assessed associations between trial type (holding vs. smelling), trial number, pre-treatment FCR, treatment arm, assessment time point, and craving. Cravings were greater when smelling vs. holding food (b = 0.31, p < 0.001), and cravings decreased over time (b = -0.02, p < 0.001). Participants with higher pre-treatment FCR reported elevated cravings (b = 0.29, p < 0.001). Longitudinally, we observed a significant 3-way interaction in which treatment arm modified the relationship between pre-treatment FCR and craving over time (F(17,5122) = 6.88, p < 0.001). An attenuated FCR-craving relationship was observed in ROC+ and BWL from baseline to post-treatment but was only sustained in BWL at follow-up. This attenuation was also observed in ROC and AC from post-treatment to follow-up. The preliminary validity of this laboratory craving assessment was supported; however, greater craving reductions over time in ROC/ROC+ compared to BWL and AC were not consistently observed, and thus do not appear to fully account for the moderating effect of FCR on weight losses observed in the trial.
食物线索反应性（FCR）是一种与暴食和体重增加相关的食欲特质。我们开发了一种实验室渴望评估方法，以客观评估 FCR 的认知方面。本研究检验了这种渴望评估的初步构建和效标效度，并评估了 4 种不同的干预措施，其中 2 种措施结合了食物线索暴露治疗，以评估治疗和随访期间的渴望。271 名寻求治疗的超重/肥胖成年人（体重指数=34.6[5.2]；年龄=46.5[11.8]；81.2%为女性；61.6%为非拉丁裔白人）完成了食物线索反应性量表和实验室渴望评估，在此期间，他们交替持有和嗅闻一种非常渴望的食物，并在 5 分钟内提供渴望评分。参与者随后被随机分配到 26 次治疗，为期 12 个月的 ROC、行为体重减轻（BWL）、联合臂（ROC+）和活性对照（AC），并在治疗后和 12 个月随访时重复进行渴望评估。线性混合效应模型评估了试验类型（持有与嗅觉）、试验次数、治疗前 FCR、治疗臂、评估时间点和渴望之间的关联。与持有食物相比，嗅觉食物时渴望更大（b=0.31，p<0.001），随着时间的推移渴望减少（b=-0.02，p<0.001）。治疗前 FCR 较高的参与者报告的渴望较高（b=0.29，p<0.001）。纵向观察到治疗臂在时间上对治疗前 FCR 和渴望之间的关系有显著的 3 向交互作用（F（17，5122）=6.88，p<0.001）。在 ROC+和 BWL 中，从基线到治疗后观察到 FCR-渴望关系减弱，但仅在 BWL 中在随访时持续。在 ROC 和 AC 中也从治疗后到随访时观察到这种衰减。该实验室渴望评估的初步有效性得到了支持；然而，在 ROC/ROC+中，与 BWL 和 AC 相比，渴望随着时间的推移逐渐减少，并没有得到一致的观察，因此似乎并不能完全解释在试验中观察到的 FCR 对体重减轻的调节作用。
