Allameh Seyed Amirhossein, Mokhtari Zeinab, Hosseini Elham, Askari Gholamreza
Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran.
Int J Behav Med. 2025 Oct 24. doi: 10.1007/s12529-025-10406-6.
Food cravings (FCs) are well-established as a significant factor in obesity. Despite their critical importance, mainstream anti-obesity interventions, including dietary programs and anti-obesity medications, often overlook FCs. While several studies have explored the impact of decentering on FCs, a comprehensive review of this literature has been lacking. Therefore, this study systematically reviewed and analyzed the existing research on the application of decentering to food cravings.
We conducted a systematic review and meta-analysis following PRISMA guidelines and registered it with PROSPERO (CRD420250655903). We systematically searched MEDLINE (via PubMed), Scopus, Embase, CENTRAL, Web of Science, and ProQuest databases. We assessed methodological quality and risk of bias in included studies using the Cochrane RoB2 tool. We evaluated the certainty of the synthesized evidence using GRADEpro. Data synthesis and statistical analyses were performed with CMA v3 software, reporting standardized mean differences as Hedges' g with 95% confidence intervals (CI). To clarify interpretation, outcomes favoring decentering interventions are presented as positive Hedges' g values, while effects favoring control conditions are shown as negative values.
We identified twelve eligible studies, encompassing 1,079 participants. Across these studies, participants had a mean age of 20.4 years, a mean BMI of 22.8, and were predominantly female (82.8%). Using the RoB2 tool, one study was rated as low risk of bias, seven as having some concerns, and four as high risk. The overall effect size for FC intensity was g = 0.38 (95% CI, 0.16 to 0.59; P = 0.001; n = 11). Using the GRADEpro tool, we rated the certainty of this result as moderate. The pooled effect size for FC frequency was g = 0.12 (95% CI, - 0.28 to 0.52; P = 0.56; n = 6).
Decentering effectively reduces the intensity of food cravings but not frequency. Because most included studies involved young, normal-BMI women and had short follow-up, the generalizability of our pooled estimates is limited.
食物渴望（FCs）是肥胖的一个重要因素，这一点已得到充分证实。尽管其至关重要，但包括饮食计划和抗肥胖药物在内的主流抗肥胖干预措施往往忽视了食物渴望。虽然有几项研究探讨了去中心化对食物渴望的影响，但缺乏对该文献的全面综述。因此，本研究系统地回顾和分析了关于将去中心化应用于食物渴望的现有研究。
我们按照PRISMA指南进行了系统综述和荟萃分析，并在PROSPERO（CRD420250655903）上进行了注册。我们系统地检索了MEDLINE（通过PubMed）、Scopus、Embase、CENTRAL、科学网和ProQuest数据库。我们使用Cochrane RoB2工具评估纳入研究的方法学质量和偏倚风险。我们使用GRADEpro评估综合证据的确定性。数据合成和统计分析使用CMA v3软件进行，报告标准化均数差值作为Hedges' g值，并给出95%置信区间（CI）。为了便于解释，有利于去中心化干预的结果以正的Hedges' g值表示，而有利于对照条件的效应则以负值表示。
我们确定了12项符合条件的研究，涉及1079名参与者。在这些研究中，参与者的平均年龄为20.4岁，平均BMI为22.8，且主要为女性（82.8%）。使用RoB2工具，一项研究被评为低偏倚风险，七项有一些担忧，四项为高风险。食物渴望强度的总体效应大小为g = 0.38（95% CI，0.16至0.59；P = 0.001；n = 11）。使用GRADEpro工具，我们将该结果的确定性评为中等。食物渴望频率的合并效应大小为g = 0.12（95% CI，-0.28至0.52；P = 0.56；n = 6）。
去中心化有效地降低了食物渴望的强度，但没有降低频率。由于大多数纳入研究涉及年轻、BMI正常的女性且随访时间较短，我们汇总估计值的可推广性有限。
