Crave: The Hidden Biology of Addiction and Cancer — A Book Review

By: Zacarya Elbash

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The book Crave: The Hidden Biology of Addiction and Cancer by Raphael Cuomo, Ph.D., provides a framework for understanding how repeated exposure shapes biology. It identifies how addiction in society is commonly framed as a matter of chemical dependency. However, this definition of addiction lacks the essential context in which it occurs and cravings form. Crave redefines addiction and considers how modern life conditions us to seek relief in ways that eventually compromise our health.

The book highlights the relief we seek from economic pressure, social disconnection, and psychological fatigue. Modern life conditions us to look for short-term comforts, often in destructive avenues such as sugar, social media, caffeine, alcohol, and nicotine. Each time we seek relief, the body keeps a molecular record that persists long after the moment of indulgence has passed. Repeated exposure causes the body to adapt, transforming immune function, metabolic regulation, and even gene expression in ways that can ultimately lead to disease, including cancer.

The book is predicated on new research showing that addiction is not simply confined to the brain but is systemic. As Cuomo explains, dopamine and cortisol are key components that drive the mental and emotional aspects of craving, yet the real damage happens when those same signals ripple through the rest of the body. When the body faces repeated cycles of immune suppression, glucose spikes, and temporary antioxidant disruption, it creates what Cuomo calls cellular disorder: a biological terrain that fosters inflammation and potentially cancer.

Cuomo also emphasizes the adaptability of biology. While constant bombardment with sugar, social media, caffeine, alcohol, and nicotine leads to imbalance and chronic illness, the body can rebalance itself through rest and consistency. It functions best when its inputs are predictable, restorative, and balanced. He underscores the importance of maintaining steady sleep and wake cycles, choosing whole foods over ultra-processed ones, and engaging in regular physical activity. These habits may seem modest, but over time they create measurable biological change. By reducing stress hormones, normalizing glucose levels, and strengthening immune function, the body gradually shifts away from a state of inflammation and toward recovery. In Crave, these small, consistent behaviors are not just lifestyle advice; they are biological interventions that help retrain the systems once hijacked by craving.

Importantly, the book does not discuss these changes in isolation. Cuomo addresses one of the most persistent misconceptions about addiction and craving: that people simply lack discipline or willpower. He makes clear this is far from the case. As he writes:

“These changes do not occur because people are weak or lacking discipline. They occur because the environment makes craving easier than regulation. Fast food is cheaper than fresh produce. Notifications are more immediate than conversation. Streaming content is more accessible than silence. In nearly every domain, the quickest path to relief is the one that reinforces the craving loop.”

This observation underscores one of the book’s central messages: recovery requires more than individual effort; it demands environments that make balance more attainable than indulgence. Cuomo also calls for a shift toward preventive medicine, urging providers to look beyond isolated symptoms such as fatigue, weight gain, or pain and instead ask about sleep quality, social support, and daily experience.

Crave: The Hidden Biology of Addiction and Cancer bridges neuroscience, immunology, and behavioral science in an accessible way. Cuomo lays out the biological and environmental contributors to the cravings we all experience and offers a clear message: the same processes that sustain craving can, with time and balance, sustain recovery.

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Resources:

Photo of Raphael Cuomo in a suit and glasses. Yahoo Health, https://health.yahoo.com/conditions/cancer/articles/5-easy-ways-cut-cravings-100000539.html.

Cover image of Crave: The Hidden Biology of Addiction and Cancer by Raphael E. Cuomo, Ph.D. Amazon, https://www.amazon.com/dp/B0CJ2BVZ3T.

Tuffs, Dan. Photograph illustrating an article on addictive personality and cancer risk. Originally published in The Telegraph, https://www.telegraph.co.uk/health-fitness/conditions/cancer/addictive-personality-cancer-risk/.

Reposted by UC San Diego School of Medicine on X (formerly Twitter), 15 Oct. 2024, https://x.com/UCSDMedSchool/status/1940821963838222811.