Food cravings are extremely common, particularly among women. Cravings are frequently reported for specific types of foods, including chocolate and foods high in both sugar and fat. Cravings for specific macronutrients, such as carbohydrate, have been postulated to result from a physiological need to alter neurotransmitters in such states as eating disorders, affective disorders or obesity. However, studies of such cravings are often confounded by differing sensory properties of high and low carbohydrate foods. There is some evidence that sweet, high fat foods are preferred by women with binge-eating disorders and that those preferences are mediated by the endogenous opioid system. Aversion to fat is seen primarily in women with anorexia nervosa. However, it is possible that changes in fat preference may be achieved through behavioral or pharmacological approaches. An understanding of food cravings and aversions may lead to improved methods for the prevention and treatment of obesity and eating disorders.