Problem Food Cravings: a Cycle Fed by Stigma and Shame, a Classical Grounded Theory Exploration of the Experience of Food Cravings in Obese and Formerly-Obese Women
Cowling, Kelly C.
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Food cravings, commonly defined as intense desires for a specific food, were identified decades ago as problems for people with a variety of health conditions, including eating disorders (Bruch, 1973), mood disorders (Wurtman, 1988a), premenstrual disorder (Morton et al., 1953) pregnancy (Harries & Hughes, 1958), and obesity (Randolph, 1956). Food cravings are known to complicate adherence to medically prescribed diets (Koch et al., 1999; Doyle et al., 2011), use of medications that have food cravings as a side effect (Garland et al., 1988), and smoking cessation efforts (Toll et al., 2008). Although food cravings are known to be problems for people with a variety of health conditions, research describing, conceptualizing, and treating food cravings has focused largely on populations who do not have health conditions associated with food cravings. Researchers have found that food cravings among these populations are experienced as merely a curiosity (Hill & Heaton-Brown, 1994) and are so common as to be considered normative (Weingarten & Elston, 1991). The experience of food cravings among populations who may find food cravings problematic has not been described. The present study employed Classical Grounded Theory (CGT) methodology to explore the experience of food cravings among a population with a health condition associated with food cravings, obesity. CGT as described by Glaser & Strauss (1967) and Glaser (e.g., 1998) is a rigorous, inductive methodology for generating theory and is ideally suited for the study of phenomena about which little is known. Individual interviews were conducted with ten obese or formerly obese women who have experienced problems with food cravings. The food craving cycle emerged as the main concern of the participants. Breaking the cycle emerged as the core category, the means by which the women seek to resolve their main concern. Stigma, difference, toxic internal dialogue, and struggle emerged as conceptual categories related to the main concern and the core category. Integration of concepts that emerged from the data resulted in the grounded theory problem food cravings: a cycle fed by stigma and shame. The theory may provide new insight to clinicians, researchers, and obese persons who experience problem food cravings.