Validation of a laboratory craving assessment and evaluation of 4 different interventions on cravings among adults with overweight or obesity - PubMed (original) (raw)

Randomized Controlled Trial

Validation of a laboratory craving assessment and evaluation of 4 different interventions on cravings among adults with overweight or obesity

Ellen K Pasquale et al. Appetite. 2024.

Abstract

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.

Keywords: Craving; Cue-exposure treatment; Food cue reactivity; Overeating.

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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Conflict of interest statement

Declaration of competing interest All authors declare that they have no competing interests.

Figures

Figure 1.

Figure 1.. Model-based predicted cravings assessed over the 12 trials and by level of food cue reactivity.

Abbreviations: FCRS, Food Cue Responsivity Scale

Figure 2.

Figure 2.. Treatment arm moderates the relationship between pre-treatment food cue reactivity, assessment time point, and model-based predicted craving.

Abbreviations: FCRS, Food Cue Responsivity Scale; ROC, Regulation of Cues; ROC+, Regulation of Cues + Behavioral Weight Loss combined arm; BWL, Behavioral Weight Loss; AC, active comparator

Figure 3.

Figure 3.. Relationships between pre-treatment food cue reactivity and model-based predicted craving at post-treatment.

Abbreviations: FCRS, Food Cue Responsivity Scale; ROC, Regulation of Cues; ROC+, Regulation of Cues + Behavioral Weight Loss combined arm; BWL, Behavioral Weight Loss; AC, active comparator

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