Putting the brakes on the "drive to eat": Pilot effects of naltrexone and reward-based eating on food cravings among obese women

Eat Behav. 2015 Dec:19:53-6. doi: 10.1016/j.eatbeh.2015.06.008. Epub 2015 Jul 2.


Purpose: 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.

Keywords: Craving intensity; Naltrexone; Obesity; Opioidergic blockade; Reward-Based Eating Drive.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Craving / drug effects*
  • Eating / drug effects*
  • Eating / psychology*
  • Female
  • Humans
  • Middle Aged
  • Naltrexone / therapeutic use*
  • Narcotic Antagonists / therapeutic use*
  • Obesity / drug therapy*
  • Obesity / psychology*
  • Pilot Projects
  • Reward
  • Treatment Outcome
  • Young Adult


  • Narcotic Antagonists
  • Naltrexone