BACKGROUND: While weight loss medications commonly target hormones that control hunger and satiety, patients’ interpretations of such concepts and their role in chronic weight management (CWM) are not well documented. Objective. To better understand patients’ perceptions and importance of eating-related concepts in CWM.
METHODS: In-person interviews were conducted with overweight and obese (BMI > 25.0) adults in the United States with and without type 2 diabetes mellitus. Following open-ended concept elicitation, targeted questions were posed to explore hunger, cravings, appetite, and satiety.
RESULTS: Thirty-five individuals with mean BMI of 36.0 (25.7 to 48.7) and 44.9 years of age were interviewed. Participants were mostly white, non-Hispanic, and college educated. Although hunger and cravings were the easiest concepts for participants to define, describe, and differentiate, all four concepts were deemed important in CWM. • Participants commonly described hunger as a physical need to eat and indicated that controlling hunger was key to CWM. Nearly all participants reported they made poorer food choices and/or ate too much if they were too hungry. • Participants defined the feeling of fullness (satiety) after eating as the absence or opposite of hunger. The ability to achieve satiety and stop eating after consuming reasonable portions was frequently reported as key to CWM. • In contrast to hunger, participants defined cravings as a desire (rather than physical need) to eat a specific type of food. While the majority reported that cravings could make it more difficult to lose or maintain a healthy weight, this concept was not as central to CWM as hunger and satiety. • The concept of appetite was generally more difficult for participants to define; however, they commonly noted that having a big appetite implied a significant level of hunger. Nearly all participants reported that appetite, like hunger, influenced food selections and the amount consumed.
CONCLUSIONS: While the relationships among these four concepts are intertwined, each plays a role in CWM. Specifically, the quantity of food consumed appears to be most influenced by hunger, appetite, and satiety, whereas food selection is generally influenced by hunger, appetite, and cravings.
