From lab to clinic:Extinction of cued cravings to reduce overeating

Food cue reactivity is a strong motivation to eat, even in the absence of hunger. Therefore, food cue reactivity might sabotage healthy eating, induce weight gain and impede weight loss or weight maintenance. Food cue reactivity can be learned via Pavlovian appetitive conditioning: It is easily acquired but the extinction of appetitive responding seems to be more challenging. Several properties of extinction make it fragile: extinction does not erase the original learning and extinction is context-dependent. These properties threaten full extinction and increase the risk of full relapse. Extinction procedures are discussed to reduce or prevent the occurrence of rapid reacquisition, spontaneous recovery, renewal and reinstatement after extinction. A translation to food cue exposure treatment is made and suggestions are provided, such as conducting the exposure in relevant contexts, using occasional reinforcement and targeting expectancy violation instead of habituation. A new hypothesis proposed here is that the adding of inhibition training to strengthen inhibition skills that reduce instrumental responding, might be beneficial to improve food cue exposure effects

Food cue reactivity, obesity, and impulsivity:are they associated?

Heightened reactivity to food-associated cues and impulsive responding to these cues may be important contributors to the obesity epidemic. This article reviews the evidence for a role of food cue reactivity and impulsivity in food intake, body mass index, and weight-loss success. Inconsistencies in defining and measuring these constructs create difficulties in interpreting findings; however, evidence does support their role in obesity. The relationship between food cue reactivity and impulsivity may depend on the measurement used, but some studies have demonstrated that interactions between these constructs rather than direct effects are important in accounting for food intake pattern. Thus, multimodal assessment of both constructs is recommended. Future research would benefit from standardized definitions, measures, procedures, and reporting to enhance comparisons across studies. Implications for therapy are discussed and suggestions for further research are provided