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Wednesday, February 13, 2013


Whether its sugar, carbs, alcohol, cigarettes, gambling, or even sex, cravings can feel like they will never stop coming and like they will last forever.  You’re on the couch watching your favorite show and all of a sudden you need some ice cream or chocolate.  You’re halfway through the morning at work and you need a cigarette.  Why won’t the cravings stop? Where are they really coming from?  Human evolution, brain biology, and psychological and even social factors drive you to craving, which is why oversimplified solutions to cravings don’t work.

You evolved to crave:

No matter what your sex drive is, you can be sure your ancestors had a strong one, or you wouldn’t be here.  The drive to crave led to selective advantage as those who
craved foods and behaviors that were either necessary for survival or that conferred advantage survived and reproduced, and those who didn’t died.  Likes, wants and needs have evolutionary origins that helped us at one time even though they may be maladaptive now.

Your brain wants to crave:

This should be obvious to anyone who has attempted to control their cravings.   Trying to stop one craving seems to kickstart another.  For example:

  • Addicts in early recovery frequently switch addictions. 
  • People who lose weight often start smoking.
  • Many sober alcoholics gain weight in their first year, and
  • Many people who try to kick one habit end up with two more they don’t want. 

Why is that?  People in recovery will tell you it’s because the latest bright shiny object will never adequately fill the spiritual hole-in-the-soul.  But brain science also supports the idea that cravings are very similar regardless of what’s craved.  A study of functional brain scans published this month  demonstrated that marijuana cravings involve similar brain pathways as cocaine, heroin, alcohol and even nicotine cravings.

If you remove one craved object from your life, your grey matter will help you find another.  Your brain doesn’t really care what it craves, as long as it’s craving.  Your brain wants to crave.

Your friends want you to crave:

You would think your friends would want to support your goals and help you to avoid giving in to that light night Ben and Jerry’s run.  But the truth is that most people find comfort in knowing that they aren’t the only ones struggling.  So when you give in to your cravings, they will often feel more secure. Somerset Maughm once famously said “it’s not enough that I fail, my friends must fail.”  Often this is unconscious; usually people aren’t aware that they are subtly pushing you towards giving in.

Advertisers want you to crave:

Several studies of cigarette advertising  have shown that ads increase in January and February , no doubt because your new year’s resolution means bad business for tobacco sales.  Children may be the most vulnerable group; a study of several hundred ads on children’s television programs found that over 80% were for sweets and fast food, and snack time was depicted more than breakfast, lunch and dinner combined.  Comfort foods are advertised during the hours that you crave carbs the most.  To make matters worse, most people believe they are immune to the effects of advertising, which only serves to increase its influence over what and when you crave.

So what can you do about it?

Because cravings have multiple causes, a simple approach won’t work to stopping them.  Substituting behaviors or foods for the objects of your cravings may work in the short term, but long term recovery requires a more comprehensive approach that deals with the biology, psychology, and social pressures that drive cravings.  Stay tuned for posts that explore strategies that actually work to reduce and eliminate cravings.

Omar Manejwala, M.D. is board certified in Psychiatry and Addiction Medicine. He currently serves as Chief Medical Officer at Catasys, a health services management company. Dr. Manejwala previously served as Medical Director at Hazelden foundation. After receiving his medical degree from University of Maryland School of Medicine, he completed his residency in Psychiatry at Duke where he served as Executive Chief Resident. He obtained his M.B.A. from the University of Virginia’s Darden School of Business.

Dr. Manejwala is one of the nation’s leading experts on addictions, cravings and behavior. He has appeared on several national media outlets including Good Morning America, 20/20, ABC World News Tonight with Diane Sawyer, The CBS Early Show, The CBS Evening News with Katie Couric, and ABC News Primetime. He is the author of Craving: Why We Can’t Seem to Get Enough (Hazelden Publishing 2013) which explains why we crave and prescribes a practical approach to taming cravings of all sorts.

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