How relevant is food craving to obesity and its treatment?

Abstract

Cravings represent strong motivational states that are characterized by intense desires typically relating to the anticipation of consuming pleasure-producing substances or engaging in hedonic behaviors. In considering food craving and the extent of its applicability to food, a brief review of the history of craving within a culture-sensitive framework appears warranted. Many cultures appear to have considered cravings in different contexts over time, although it has been contended, based on analyses of translations and lexicalization across languages, that craving may fail to translate outside of Europe and North America, although there are similarities in the use of craving and addiction across domains of use (1). The word "crave" is derived from the Old English crafian meaning to beg 1. Over time, the term craving became linked to excessive patterns of substance use. For example, in the early nineteenth century, in conceptualizing excessive patterns of alcohol consumption, the term dipsomania (translated from the German term Trunksucht, or drinking addiction) was described to define alcoholism as a condition characterized by a craving for continued intoxication (2). In Buddhism, the term tanhā is commonly translated to mean craving (although its literal translation is "thirst"), with kāmatanhā (sense-craving) describing strong motivations to experience pleasant feelings or sensory pleasures 2. In Buddhism, tanhā is seen as a type of ignorant desire and a cause of suffering and negative affective states, and some current approaches to understanding treatment mechanisms and promoting treatment development in addictions have involved considering craving within a Buddhist context (3, 4). Thus, links between cravings and negative processes including addictions have a longstanding history across multiple cultures.