title: Putting the brakes on the "drive to eat": Pilot effects of naltrexone and reward-based eating on food cravings among obese women.
abstract: OBJECTIVE
  Obese individuals vary in their experience of food cravings and tendency to engage in reward-driven eating, both of which can be modulated by the neural reward system rather than physiological hunger. We examined two predictions in a sample of obese women: (1) whether opioidergic blockade reduced food-craving intensity, and (2) whether opioidergic blockade reduced an association between food-craving intensity and reward-driven eating, which is a trait-like index of three factors (lack of control over eating, lack of satiation, preoccupation with food).
  
  
  METHODS
  Forty-four obese, pre-menopausal women completed the Reward-Based Eating Drive (RED) scale at study start and daily food-craving intensity on 5 days on which they ingested either a pill-placebo (2 days), a 25 mg naltrexone dose (1 day), or a standard 50mg naltrexone dose (2 days).
  
  
  RESULTS
  Craving intensity was similar under naltrexone and placebo doses. The association between food-craving intensity and reward-driven eating significantly differed between placebo and 50mg naltrexone doses. Reward-driven eating and craving intensity were significantly positively associated under both placebo doses. As predicted, opioidergic blockade (for both doses 25mg and 50mg naltrexone) reduced the positive association between reward-driven eating and craving intensity to non-significance.
  
  
  CONCLUSIONS
  Opioidergic blockade did not reduce craving intensity; however, blockade reduced an association between trait-like reward-driven eating and daily food-craving intensity, and may help identify an important endophenotype within obesity.
authors.affiliation: University of California, San Francisco, Osher Center for Integrative Medicine, United States. Electronic address: Ashley.Mason@UCSF.edu.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Mason
authors.affiliation: University of California, Berkeley School of Public Health, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Laraia
authors.affiliation: University of California, San Francisco, Osher Center for Integrative Medicine, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Daubenmier
authors.affiliation: University of California, San Francisco, Osher Center for Integrative Medicine, United States.
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Hecht
authors.affiliation: University of California, San Francisco, Department of Pediatrics, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Lustig
authors.affiliation: University of California, San Francisco, Center for Health and Community, United States.
authors.forename: Eli
authors.initials: E
authors.lastname: Puterman
authors.affiliation: University of California, San Francisco, Center for Health and Community, United States.
authors.forename: Nancy
authors.initials: N
authors.lastname: Adler
authors.affiliation: University of California, San Francisco, Center for Health and Community, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Dallman
authors.affiliation: Stanford University, School of Medicine, Stanford Prevention Research Center, United States.
authors.forename: Michaela
authors.initials: M
authors.lastname: Kiernan
authors.affiliation: University of Michigan, Department of Psychology, United States.
authors.forename: Ashley N
authors.initials: AN
authors.lastname: Gearhardt
authors.affiliation: University of California, San Francisco, Osher Center for Integrative Medicine, United States; University of California, San Francisco, Center for Health and Community, United States.
authors.forename: Elissa S
authors.initials: ES
authors.lastname: Epel
mesh_terms: D000328:Adult; D066249:Craving / Q000187:drug effects*; D004435:Eating / Q000187:drug effects* / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009765:Obesity / Q000188:drug therapy* / Q000523:psychology*; D010865:Pilot Projects; D012201:Reward; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: Craving intensity; Naltrexone; Obesity; Opioidergic blockade; Reward-Based Eating Drive