Craving in eating disorders: Mapping the concept through a systematic review

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Craving is a key feature in addictive disorders and increasingly recognized in eating disorders (ED).
• Current understanding of craving's role in ED pathology is fragmented, lacking consistent conceptualization and measurement.
• This systematic review synthesizes existing knowledge on craving in ED.

Purpose of the Study:

• To systematically review and map existing knowledge on craving in eating disorders.
• To identify inconsistencies in conceptualization, measurement, and theoretical models of craving in ED.
• To highlight gaps in research and intervention strategies for craving in ED.

Main Methods:

• Systematic literature search conducted in Embase, PsycInfo, and Web of Science in July 2025.
• Inclusion criteria: peer-reviewed studies of adults with clinically diagnosed ED.
• Fifty studies and fifteen reviews were included in the analysis.

Main Results:

• Most research focused on bulimia nervosa (BN) and binge-eating disorder (BED), with limited data on anorexia nervosa (AN) or non-food cravings.
• Definitions of craving were inconsistent, often conflating desire with loss of control or behaviors.
• Assessment primarily used visual analogue scales (VAS) and the Food Cravings Questionnaire (FCQ), with limited use of other methods. Interventions showed mixed results.
• Craving consistently correlated with binge eating, with trait craving being a stronger predictor than state craving.

Conclusions:

• Craving is a central but conceptually ambiguous factor in eating disorders.
• Priorities include establishing a consensus definition and developing theory-driven, transdiagnostic assessment tools.
• Future research should broaden focus beyond food and binge-related ED to improve understanding and interventions.