Reward-Induced Eating: Therapeutic Approaches to Addressing Food Cravings

Abstract

The homeostatic controls over eating are inextricably linked to the reward aspects of eating. The result is an integrated response that coordinates the internal milieu with the prevailing environment. Thus, appetite, which reflects a complex interaction among the external environment, behavioral profile, and subjective states as well as the storage and metabolism of energy, has an important role in the regulation of energy balance. In the prevailing food environment which offers an abundance of food choices it is likely that the motivation to consume from a wide range of delectable foods plays a greater role in contributing to overeating than in the past when the motivation to eat was largely governed by metabolic need. The response to food-related cues can promote strong desires to eat known as cravings by activating the mesocorticolimbic dopamine neurocircuitry. Cravings are associated with subsequent eating and weight-related outcomes. Being able to control food cravings is a determinant of success at adhering to an energy-restricted diet regimen. Increased understanding of the neurocircuitry of appetite regulation, especially reward-related eating behavior, has provided potential targets for therapeutic anti-obesity agents specifically directed at reward mechanisms. The naltrexone–bupropion combination and lorcaserin, which are both approved by the US Food and Drug Administration (FDA) for long-term weight management, have shown promise in addressing craving-related eating behavior. Phentermine and liraglutide are approved as monotherapies for weight management. Preliminary research suggests that liraglutide, as well as phentermine alone or in combination with lorcaserin, may be effective in targeting food cravings. Food components such as thylakoid membranes have also been shown to influence food cravings. This review explores the concepts related to appetite and reward-induced eating behavior, as well as the pharmacological options and food-derived components that may be used to address food cravings.

Epidemiology of Obesity and Pharmacologic Treatment Options

“…Naltrexone is an opioid antagonist, and bupropion is a dopamine and norepinephrine reuptake inhibitor 181 – 183 . Bupropion is approved for depression and smoking cessation.…”

Diabetes care: Inspiration from Sikhism

“…[19] The pleasure from the hedonic value of consuming food leads to nonhomeostatic eating without conscious awareness of it. The SGGS recognizes that unobservant eating causes several inflictions on our body and makes several references to being mindful when eating.…”

Off-label drugs for weight management

“…One facet of such treatment is improvement and abatement of harmful eating behaviors. Regulation of appetite has been a focus of obesity drug effects but there is now also evidence that some obesity drugs induce beneficial changes in eating behavior 2–4. There is also observational evidence that phentermine treatment induces changes in eating behavior,5 and that some phentermine-induced eating behavioral changes persist with long-term therapy 6.…”

“…One focus of such treatment is identification and mitigation of harmful eating behaviors. Recent data suggest that at least some obesity drugs induce reductions in energy intake by generating beneficial changes in cravings and eating behaviors 3,4,19…”