title: Early improvement in food cravings are associated with long-term weight loss success in a large clinical sample.
abstract: Food cravings are associated with dysregulated eating behaviour and obesity, and may impede successful weight loss attempts. Gaining control over food craving is therefore a component in the management of obesity. The current paper examined whether early changes in control over food craving (assessed using the Craving Control subscale on the Control of Eating Questionnaire (CoEQ)) was predictive of weight loss in four phase 3 clinical trials investigating a sustained-release combination of naltrexone/bupropion (NB) in obese adults. The underlying component structure of the CoEQ was also examined.
  
  
  
  In an integrated analysis of four 56-week phase 3 clinical trials, subjects completed the CoEQ and had their body weight measured at baseline and at weeks 8, 16, 28 and 56. All analyses were conducted on subjects who had complete weight and CoEQ measurements at baseline and week 56, and had completed 56 weeks of NB (n=1310) or placebo (n=736). A latent growth curve model was used to examine whether early changes in the CoEQ subscales were associated with decreases in weight loss over time. Confirmatory factor analysis (CFA) was used to determine the psychometric properties of the CoEQ.
  
  
  
  The factor structure of the CoEQ was consistent with previous findings with a four-factor solution being confirmed: Craving Control, Positive Mood, Craving for Sweet and Craving for Savoury with good internal consistency (Cronbach's α=0.72-0.92). Subjects with the greatest improvement in Craving Control at week 8 exhibited a greater weight loss at week 56.
  
  
  
  These findings highlight the importance of the experience of food cravings in the treatment of obesity and support the use of the CoEQ as a psychometric tool for the measurement of food cravings in research and the pharmacological management of obesity.
authors.affiliation: School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
authors.forename: M
authors.initials: M
authors.lastname: Dalton
authors.affiliation: School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
authors.forename: G
authors.initials: G
authors.lastname: Finlayson
authors.affiliation: Orexigen Therapeutics Inc., La Jolla, CA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Walsh
authors.affiliation: Orexigen Therapeutics Inc., La Jolla, CA, USA.
authors.forename: A E
authors.initials: AE
authors.lastname: Halseth
authors.affiliation: Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Duarte
authors.affiliation: School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Blundell
mesh_terms: D000328:Adult; D016642:Bupropion / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D066249:Craving / Q000502:physiology*; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009765:Obesity / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology*; D011594:Psychometrics; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
chemical_list: D018765:Dopamine Uptake Inhibitors; D009292:Narcotic Antagonists; D016642:Bupropion; D009271:Naltrexone