Obesity is a major contributor to developing chronic diseases such as hypertension, heart
disease, stroke, and diabetes, and 41.9% of adults were obese in 2020 in the United States.
Although weight loss can reduce or remit these comorbidities , it is challenging for most
individuals with obesity to achieve clinically significant weight loss and sustain healthy
weight through dietary/lifestyle modifications. Achieving sustainable weight loss must be
accompanied by dietary/lifestyle modifications that can be sustained comfortably for a
lifetime. Currently, there is no dietary weight loss program that can reliably induce
sustainable weight loss.
To address this deficiency, our lab has been developing a novel dietary weight loss program
that can achieve a lifetime healthy weight. In our three weight loss trials, we observed that
the reduction of food cravings is associated with successful weight loss and subsequent
weight maintenance. Food cravings have been suggested to predict food intake and weight gain,
lack of success in weight loss, and early drop-out from weight management programs,
supporting our observation. Food cravings are defined as strong or intense desires for a
particular type of food and have been reported to occur in approximately 58% of adults.
Individuals with overweight or obesity report more frequent and intense cravings for
energy-dense food, such as high-fat and sweet foods, relative to normal-weight people.
Specific food craving coping strategies are developed to reduce the frequency and intensity
of cravings to minimize the risk of excessive food intake. These strategies involve
cognitive-behavioral principles, including controlled-based strategies such as avoidance,
resistance, and inclusion. The avoidance strategy uses behavior-oriented techniques to modify
the immediate environment, teaching individuals to encourage healthy eating and avoid
unhealthy eating by controlling the stimuli that trigger their behaviors. The resistance
strategies focus on cognitive regulation and enhancing self-regulatory control, which teaches
individuals how to cognitively restructure urges related to craved food and mentally distract
themselves from cravings. The inclusion strategies focus on self-regulation and planning and
aim to satisfy food cravings by strategically incorporating craved foods into balanced meals.
Despite the existence of coping strategies, very few studies evaluate the efficacy of these
strategies during weight loss trials. Thus, we evaluated the relationship between weight loss
outcomes and the degree of cravings using intra-cohort analysis in our two weight loss
trials. Our preliminary findings suggested that effective management of food cravings appears
to be a key to successful weight loss and weight maintenance. Study 1 found that better
control over food cravings during weight loss and maintenance was associated with long-term
success in weight loss outcomes. Study 2 demonstrated that participants who achieved
clinically significant or greater weight loss (5% weight loss) had significantly lower food
cravings.
Building on the findings from our preliminary studies, a specific aim of this research
proposal is to determine the efficacy of craving coping strategies (and a combination of
strategies) on weight loss outcomes by conducting a randomized controlled trial.
