Abstract
Objectives:Obesity is associated with hyperactivation of the reward system for high-calorie (HC) versus low-calorie (LC) food cues, which encourages unhealthy food selection and overeating. However, the extent to which this hyperactivation can be reversed is uncertain, and to date there has been no demonstration of changes by behavioral intervention.Subjects and methods:We used functional magnetic resonance imaging to measure changes in activation of the striatum for food images at baseline and 6 months in a pilot study of 13 overweight or obese adults randomized to a control group or a novel weight-loss intervention.Results:Compared to controls, intervention participants achieved significant weight loss (−6.3±1.0 kg versus +2.1±1.1 kg, P<0.001) and had increased activation for LC food images with a composition consistent with that recommended in the behavioral intervention at 6 months versus baseline in the right ventral putamen (P=0.04), decreased activation for HC images of typically consumed foods in the left dorsal putamen (P=0.01). There was also a large significant shift in relative activation favoring LC versus HC foods in both regions (P<0.04).Conclusions:This study provides the first demonstration of a positive shift in activation of the reward system toward healthy versus unhealthy food cues in a behavioral intervention, suggesting new avenues to enhance behavioral treatments of obesity.
Highlights
Mechanisms that ensure sufficient food consumption for bodily maintenance and health are integral to the survival of all species including humans
Two regions in the dorsal and ventral striatum were identified where there were significant differences between the groups in changes (6 months to baseline) in functional magnetic resonance imaging (fMRI) blood oxygen-level-dependent activation to the food images corrected for the paired NF images, which did not include areas such as the caudate that have previously been implicated as important in reward system responsiveness to food in humans
We examined the directional changes in blood oxygenlevel-dependent responses to HC and LC food images over time
Summary
Mechanisms that ensure sufficient food consumption for bodily maintenance and health are integral to the survival of all species including humans. As the gathering and preparation of food requires work, neurological pathways that provide reward for the anticipation of eating are essential for incentivizing the necessary effort.[1] Abnormalities in the anticipatory reward system are implicated in the development of obesity and the frequent resistance of obesity to successful treatment.[2,3] In particular, a conditioned hyperactivation of the reward system for high-calorie (HC) versus low-calorie (LC) food cues may be of particular importance because HC foods are readily available and overeaten, known to provide more reward than LC foods,[4,5] and an individual’s relative reward center activation to HC versus LC cues will influence which foods are selected for consumption when a wide array of foods is available. To our knowledge, the only reported assessments of changes in reward system responsiveness to HC versus LC foods during behavioral weight-loss programs have reported no significant changes.[6,7] whether neural plasticity can be achieved to reverse reward system hyperactivation for HC versus LC foods to facilitate obesity treatment is unknown
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