Health & Biosecurity, Commonwealth Scientific Industrial Research Organisation (CSIRO), Adelaide 5000, Australia.
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3800, Australia.
Nutrients. 2024 Sep 25;16(19):3238. doi: 10.3390/nu16193238.
: Food cravings involve a strong drive to consume palatable foods irrespective of nutritional status. Importantly, cravings contribute substantially to the obesity epidemic. Managing hunger alone is insufficient for weight management as this relates only to homeostatic eating and does not address the complex aetiology of hedonic eating and its crucial role in food cravings. Medical weight management clinics and anti-obesity medication trials do not routinely identify and address food cravings. : We conducted a narrative review of the literature consisting of 115 peer-reviewed articles (original articles and reviews). We included articles focused on food craving pathophysiology, assessment, and management strategies providing contrasts against the current medical model of weight management seen in obesity pharmacotherapy trials as well as the current standard of practise. : We outline the neurohormonal and psychological drivers of cravings, which lead to a spectrum of eating behaviours, from comfort food eating to binge eating disorders. We provide an overview of ways of identification and measurement options, including their strengths and weaknesses, and an overview of management strategies and their cravings control efficacy, spanning lifestyle modifications like nutrition and sleep, psychological therapies (i.e., cognitive behavioural therapy [CBT], acceptance-based therapies such as mindfulness) and, last but not least, medications that not only are approved for weight reduction but reduce cravings. Finally, based on these findings, we provide a proposed integrated and iterative model that is able to evolve and adapt to the individual over time in tackling cravings for long-term weight loss maintenance. : The findings emphasise the importance of cravings management and provide a synthesis on how cravings can be identified in a medical weight management setting, which can be practically implemented in an integrated iterative model spanning anti-obesity medications that have craving control data to evidence-based lifestyle and psychological interventions.
食物成瘾是一种强烈的进食美味食物的欲望，而与营养状况无关。重要的是，这种欲望是肥胖流行的主要原因之一。仅管理饥饿感不足以进行体重管理，因为这仅与体内平衡进食有关，而不能解决享乐性进食的复杂病因及其在食物成瘾中的关键作用。医疗体重管理诊所和抗肥胖药物试验通常不会识别和处理食物成瘾。我们对包括 115 篇同行评审文章（原始文章和评论）的文献进行了叙述性综述。我们纳入了关注食物成瘾病理生理学、评估和管理策略的文章，这些文章与肥胖症药物治疗试验中当前的体重管理医学模型以及当前的标准实践形成对比。我们概述了导致一系列进食行为的欲望的神经激素和心理驱动因素，从安慰性进食到暴食障碍。我们提供了识别和测量选择的概述，包括它们的优缺点，并概述了管理策略及其控制欲望的效果，涵盖了营养和睡眠等生活方式的改变、心理治疗（即认知行为疗法 [CBT]、接受为基础的治疗，如正念），最后但并非最不重要的是，不仅批准用于减肥而且可以减少欲望的药物。最后，基于这些发现，我们提供了一个拟议的综合迭代模型，该模型能够随着时间的推移针对个人的需求进行演变和适应，以实现长期的体重维持。研究结果强调了管理欲望的重要性，并提供了关于如何在医疗体重管理环境中识别欲望的综合信息，这可以在一个综合迭代模型中实际实施，该模型涵盖了具有控制欲望数据的抗肥胖药物以及基于证据的生活方式和心理干预措施。
