Dr Raj Persaud Consultant Psychiatrist
Anyone who tries to diet or give up smoking or cut down on alcohol or reduce chocolate consumption will usually experience ‘craving’. This is where you get uncomfortable bodily feelings which only appear to be assuaged by consuming the product you’ve been trying to avoid. The feelings get so overwhelming that breaking your resolve and wolfing down that thing you’ve tried to abstain from for so long, appears the only option available.
Those in the grip of craving tend to emphasise in their own minds how physiological or biological it feels, in other words it seems like your body is telling you that you have to eat now or you’re going to collapse.
A fascinating paper by researchers who specialise in obesity research and based at the University of Plymouth, Queensland University of Technology and the University of Leeds have instead argued that the latest research on craving suggests it’s a more emotional or cognitive process. In other words it’s more about feelings and thoughts than about a physical need, not matter what that grumbling in your tummy tells you.
The team of researchers lead by Jon May and Jackie Andrade from Plymouth University, argue this is good news because it means mental strategies such as distraction are much more likely to succeed. It appears we should invest more in the idea that craving is something we can control rather than it controls us, and if we do this, we are more likely to beat it. Defeating craving appears crucial to all abstinence efforts be they giving up smoking, alcohol or eating too much.
Four mental, visual or emotional triggers typically cause food cravings including “suddenly thinking about it (ie food),” “feeling . . . discomfort,” “imagining the taste/smell of it,” or “picturing yourself having it.” Basically these feeings, thoughts and images are dangerous and the longer they go unchallenged or distracted it seems the more vulnerable we are to succumbing to the craving and breaking our diet. However, the key point is craving is ‘in the mind’ a lot more than its in the body.
In their review of the research, these authors of the latest review on craving, come up with some interesting ideas, some of which, to be honest, they are not absolutely confident are going to work outside the narrow confines of the laboratory. The key principle appears however, to be to fill your mind with anything which distracts you from cravings.
For example, setting chocoholics the exercise of imagining eating a chocolate bar 30 times reduced consumption for chocolate later. So in excess, certain imagery can cause you to go off chocolate rather than craving it. This effect may be due to you getting bored with the chocolate idea by mechanically and mentally going over eating it over and over again a lot more than you would normally. The repeated image seems to lose its emotional power over the course of time. This technique might work in much the same way, the authors argue, as actually eating 30 chocolate sweets would tend to put you off chocolate for a while.
The core point about all the techniques they advise on is that the usual strategy of getting into a panic about a craving coming on and feeling you ‘must do something about it’ could be counterproductive. In particular the idea that you must get rid of the craving in order to survive continuing on the diet. This idea merely contributes to breaking the craving with eating something.
The authors of this paper also point out that too actively trying not to think about something, has been shown to be counterproductive. It leads people to self-monitor their thoughts to check that the nasty idea hasn’t re-entered your mind. The authors point out that those who are instructed to suppress thoughts about chocolate for 5 min subsequently eat more chocolate .
Instead the authors, perhaps somewhat surprisingly advocate an acceptance model of craving. This involves acknowledging food desires are normal, and are not in themselves unhealthy. Thoughts about food indicate that you have choices over what to do next rather than representing an inescapable need. All in all be more accepting about the craving and less panicky when it comes on.
Another key point borrowed from what we know about how anorexics think about craving is that not eating in response to thoughts of food signals a feeling of being in control.
So all in all when craving some on, accept it as inevitable and don’t feel a strong need to get rid of it. Ride out the storm confident that this is possible and that non-panicky distraction is likely to be the answer, combined with a more philosophical approach that this is part of life.
Elaborated Intrusion Theory: A Cognitive-Emotional Theory of Food Craving Jon May& Jackie Andrade & David J. Kavanagh & Marion Hetherington Curr Obes Rep (2012) 1:114–121