Food cue reactivity and craving predict eating and weight gain: a meta-analytic review - PubMed (original) (raw)

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Food cue reactivity and craving predict eating and weight gain: a meta-analytic review

Rebecca G Boswell et al. Obes Rev. 2016 Feb.

Abstract

According to learning-based models of behavior, food cue reactivity and craving are conditioned responses that lead to increased eating and subsequent weight gain. However, evidence supporting this relationship has been mixed. We conducted a quantitative meta-analysis to assess the predictive effects of food cue reactivity and craving on eating and weight-related outcomes. Across 69 reported statistics from 45 published reports representing 3,292 participants, we found an overall medium effect of food cue reactivity and craving on outcomes (r = 0.33, p < 0.001; approximately 11% of variance), suggesting that cue exposure and the experience of craving significantly influence and contribute to eating behavior and weight gain. Follow-up tests revealed a medium effect size for the effect of both tonic and cue-induced craving on eating behavior (r = 0.33). We did not find significant differences in effect sizes based on body mass index, age, or dietary restraint. However, we did find that visual food cues (e.g. pictures and videos) were associated with a similar effect size to real food exposure and a stronger effect size than olfactory cues. Overall, the present findings suggest that food cue reactivity, cue-induced craving and tonic craving systematically and prospectively predict food-related outcomes. These results have theoretical, methodological, public health and clinical implications.

Keywords: Craving; cue reactivity; eating behavior; food; weight gain.

© 2015 World Obesity.

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Conflict of interest statement

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1

Figure 1

Study selection and exclusion Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) diagram depicting study selection and exclusion.

Figure 2

Figure 2

Forrest plot of effect sizes. Statistics were converted to a standardized r and are plotted with 95% confidence intervals. The x-axis indicates the strength of the correlation coefficient, and shows that the overall effect favours a positive relationship between variables.

Figure 3

Figure 3

Average effect sizes for Hypotheses 1–3. Average effect sizes and confidence interval: (A) overall, across all study types; (B) separately by outcome type; and (C) separately by study type. All effect sizes are medium or medium-to-large following Cohen’s d convention. ‘Cue condition’ includes all studies that measured responses to cue exposure, including cue-condition, cue reactivity (physiological and neural) and cue-induced craving. ‘Craving’ includes both tonic and cue-induced craving. The effect size in males represents _N_STATISTICS = 1.

Figure 4

Figure 4

Average effect sizes by cue type (Hypothesis 5). Effect sizes for visual and real food cues were not significantly different; both were significantly bigger than for olfactory cues. ‘***’ indicates that p < 0.001.

Figure 5

Figure 5

Funnel plot depicting standard error of effect sizes. Funnel plot shows minimal publication bias in the overall model using the calculated Fisher’s _z-_value for each study in a trim-and-fill analysis. Black circles represent studies included in the analysis, and grey circles represent filled-in studies. The black diamond is the observed effect, and the grey diamond is the adjusted effect after adding the filled-in studies, which is still significant.

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