151
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Herwig U, Dhum M, Hittmeyer A, Opialla S, Scherpiet S, Keller C, Brühl AB, Siegrist M. Neural Signaling of Food Healthiness Associated with Emotion Processing. Front Aging Neurosci 2016; 8:16. [PMID: 26903859 PMCID: PMC4748030 DOI: 10.3389/fnagi.2016.00016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 01/21/2016] [Indexed: 12/30/2022] Open
Abstract
The ability to differentiate healthy from unhealthy foods is important in order to promote good health. Food, however, may have an emotional connotation, which could be inversely related to healthiness. The neurobiological background of differentiating healthy and unhealthy food and its relations to emotion processing are not yet well understood. We addressed the neural activations, particularly considering the single subject level, when one evaluates a food item to be of a higher, compared to a lower grade of healthiness with a particular view on emotion processing brain regions. Thirty-seven healthy subjects underwent functional magnetic resonance imaging while evaluating the healthiness of food presented as photographs with a subsequent rating on a visual analog scale. We compared individual evaluations of high and low healthiness of food items and also considered gender differences. We found increased activation when food was evaluated to be healthy in the left dorsolateral prefrontal cortex and precuneus in whole brain analyses. In ROI analyses, perceived and rated higher healthiness was associated with lower amygdala activity and higher ventral striatal and orbitofrontal cortex activity. Females exerted a higher activation in midbrain areas when rating food items as being healthy. Our results underline the close relationship between food and emotion processing, which makes sense considering evolutionary aspects. Actively evaluating and deciding whether food is healthy is accompanied by neural signaling associated with reward and self-relevance, which could promote salutary nutrition behavior. The involved brain regions may be amenable to mechanisms of emotion regulation in the context of psychotherapeutic regulation of food intake.
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Affiliation(s)
- Uwe Herwig
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry in ZürichZürich, Switzerland; Department of Consumer Behaviour, Institute for Environmental Decisions, ETH ZürichZürich, Switzerland
| | - Matthias Dhum
- Department of Consumer Behaviour, Institute for Environmental Decisions, ETH Zürich Zürich, Switzerland
| | - Anna Hittmeyer
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry in Zürich Zürich, Switzerland
| | - Sarah Opialla
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry in Zürich Zürich, Switzerland
| | - Sigrid Scherpiet
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry in Zürich Zürich, Switzerland
| | - Carmen Keller
- Department of Consumer Behaviour, Institute for Environmental Decisions, ETH Zürich Zürich, Switzerland
| | - Annette B Brühl
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry in ZürichZürich, Switzerland; Department of Consumer Behaviour, Institute for Environmental Decisions, ETH ZürichZürich, Switzerland
| | - Michael Siegrist
- Department of Consumer Behaviour, Institute for Environmental Decisions, ETH Zürich Zürich, Switzerland
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152
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Kessler RM, Hutson PH, Herman BK, Potenza MN. The neurobiological basis of binge-eating disorder. Neurosci Biobehav Rev 2016; 63:223-38. [PMID: 26850211 DOI: 10.1016/j.neubiorev.2016.01.013] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/25/2016] [Accepted: 01/31/2016] [Indexed: 02/07/2023]
Abstract
Relatively little is known about the neuropathophysiology of binge-eating disorder (BED). Here, the evidence from neuroimaging, neurocognitive, genetics, and animal studies are reviewed to synthesize our current understanding of the pathophysiology of BED. Binge-eating disorder may be conceptualized as an impulsive/compulsive disorder, with altered reward sensitivity and food-related attentional biases. Neuroimaging studies suggest there are corticostriatal circuitry alterations in BED similar to those observed in substance abuse, including altered function of prefrontal, insular, and orbitofrontal cortices and the striatum. Human genetics and animal studies suggest that there are changes in neurotransmitter networks, including dopaminergic and opioidergic systems, associated with binge-eating behaviors. Overall, the current evidence suggests that BED may be related to maladaptation of the corticostriatal circuitry regulating motivation and impulse control similar to that found in other impulsive/compulsive disorders. Further studies are needed to understand the genetics of BED and how neurotransmitter activity and neurocircuitry function are altered in BED and how pharmacotherapies may influence these systems to reduce BED symptoms.
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Affiliation(s)
- Robert M Kessler
- Department of Radiology, University of Alabama at Birmingham School of Medicine, 619 19th St. South, Birmingham, AL 35249, United States.
| | - Peter H Hutson
- Shire, 300 Shire Way, Lexington, MA 02421, United States.
| | - Barry K Herman
- Shire, 300 Shire Way, Lexington, MA 02421, United States.
| | - Marc N Potenza
- Department of Psychiatry, Department of Neurobiology, Child Study Center, CASAColumbia and Connecticut Mental Health Center, Yale University School of Medicine, 34 Park St., New Haven, CT 06519, United States.
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153
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Boswell RG, Kober H. Food cue reactivity and craving predict eating and weight gain: a meta-analytic review. Obes Rev 2016; 17:159-77. [PMID: 26644270 PMCID: PMC6042864 DOI: 10.1111/obr.12354] [Citation(s) in RCA: 406] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/07/2015] [Accepted: 10/09/2015] [Indexed: 12/12/2022]
Abstract
According to learning-based models of behavior, food cue reactivity and craving are conditioned responses that lead to increased eating and subsequent weight gain. However, evidence supporting this relationship has been mixed. We conducted a quantitative meta-analysis to assess the predictive effects of food cue reactivity and craving on eating and weight-related outcomes. Across 69 reported statistics from 45 published reports representing 3,292 participants, we found an overall medium effect of food cue reactivity and craving on outcomes (r = 0.33, p < 0.001; approximately 11% of variance), suggesting that cue exposure and the experience of craving significantly influence and contribute to eating behavior and weight gain. Follow-up tests revealed a medium effect size for the effect of both tonic and cue-induced craving on eating behavior (r = 0.33). We did not find significant differences in effect sizes based on body mass index, age, or dietary restraint. However, we did find that visual food cues (e.g. pictures and videos) were associated with a similar effect size to real food exposure and a stronger effect size than olfactory cues. Overall, the present findings suggest that food cue reactivity, cue-induced craving and tonic craving systematically and prospectively predict food-related outcomes. These results have theoretical, methodological, public health and clinical implications.
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Affiliation(s)
| | - Hedy Kober
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
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154
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Lerma-Cabrera JM, Carvajal F, Lopez-Legarrea P. Food addiction as a new piece of the obesity framework. Nutr J 2016; 15:5. [PMID: 26758504 PMCID: PMC4711027 DOI: 10.1186/s12937-016-0124-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/09/2016] [Indexed: 02/05/2023] Open
Affiliation(s)
- Jose Manuel Lerma-Cabrera
- Centro de Investigacion Biomedica, Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Santiago, Chile.
| | - Francisca Carvajal
- Centro de Investigacion Biomedica, Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Santiago, Chile. .,Depto de Psicología y Sociología. Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, España.
| | - Patricia Lopez-Legarrea
- Centro de Investigacion Biomedica, Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Santiago, Chile.
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155
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Monteleone AM, Di Marzo V, Monteleone P, Dalle Grave R, Aveta T, Ghoch ME, Piscitelli F, Volpe U, Calugi S, Maj M. Responses of peripheral endocannabinoids and endocannabinoid-related compounds to hedonic eating in obesity. Eur J Nutr 2016; 55:1799-805. [PMID: 26759262 DOI: 10.1007/s00394-016-1153-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 01/03/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Hedonic eating occurs independently from homeostatic needs prompting the ingestion of pleasurable foods that are typically rich in fat, sugar and/or salt content. In normal weight healthy subjects, we found that before hedonic eating, plasma levels of 2-arachidonoylglycerol (2-AG) were higher than before nonhedonic eating, and although they progressively decreased after food ingestion in both eating conditions, they were significantly higher in hedonic eating. Plasma levels of anandamide (AEA), oleoylethanolamide (OEA) and palmitoylethanolamide (PEA), instead, progressively decreased in both eating conditions without significant differences. In this study, we investigated the responses of AEA, 2-AG, OEA and PEA to hedonic eating in obese individuals. METHODS Peripheral levels of AEA, 2-AG, OEA and PEA were measured in 14 obese patients after eating favourite (hedonic eating) and non-favourite (nonhedonic eating) foods in conditions of no homeostatic needs. RESULTS Plasma levels of 2-AG increased after eating the favourite food, whereas they decreased after eating the non-favourite food, with the production of the endocannabinoid being significantly enhanced in hedonic eating. Plasma levels of AEA decreased progressively in nonhedonic eating, whereas they showed a decrease after the exposure to the favourite food followed by a return to baseline values after eating it. No significant differences emerged in plasma OEA and PEA responses to favourite and non-favourite food. CONCLUSION Present findings compared with those obtained in our previously studied normal weight healthy subjects suggest deranged responses of endocannabinoids to food-related reward in obesity.
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Affiliation(s)
- A M Monteleone
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - V Di Marzo
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, 80078, Pozzuoli, NA, Italy.
| | - P Monteleone
- Department of Psychiatry, University of Naples SUN, Naples, Italy.
- Neuroscience Section, Department of Medicine and Surgery, University of Salerno, 84081, Baronissi, Salerno, Italy.
| | - R Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - T Aveta
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, 80078, Pozzuoli, NA, Italy
| | - M El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - F Piscitelli
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, 80078, Pozzuoli, NA, Italy
| | - U Volpe
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - S Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - M Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
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156
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Westwater ML, Fletcher PC, Ziauddeen H. Sugar addiction: the state of the science. Eur J Nutr 2016; 55:55-69. [PMID: 27372453 PMCID: PMC5174153 DOI: 10.1007/s00394-016-1229-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/20/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE As obesity rates continue to climb, the notion that overconsumption reflects an underlying 'food addiction' (FA) has become increasingly influential. An increasingly popular theory is that sugar acts as an addictive agent, eliciting neurobiological changes similar to those seen in drug addiction. In this paper, we review the evidence in support of sugar addiction. METHODS We reviewed the literature on food and sugar addiction and considered the evidence suggesting the addictiveness of highly processed foods, particularly those with high sugar content. We then examined the addictive potential of sugar by contrasting evidence from the animal and human neuroscience literature on drug and sugar addiction. RESULTS We find little evidence to support sugar addiction in humans, and findings from the animal literature suggest that addiction-like behaviours, such as bingeing, occur only in the context of intermittent access to sugar. These behaviours likely arise from intermittent access to sweet tasting or highly palatable foods, not the neurochemical effects of sugar. CONCLUSION Given the lack of evidence supporting it, we argue against a premature incorporation of sugar addiction into the scientific literature and public policy recommendations.
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Affiliation(s)
- Margaret L. Westwater
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, CB2 3EB UK ,Department of Psychiatry, Addenbrooke’s Hospital, University of Cambridge, Herchel Smith Building, Cambridge, CB2 0SZ UK
| | - Paul C. Fletcher
- Department of Psychiatry, Addenbrooke’s Hospital, University of Cambridge, Herchel Smith Building, Cambridge, CB2 0SZ UK ,Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK ,Cambridgeshire and Peterborough Foundation Trust, Cambridge, CB21 5EF UK
| | - Hisham Ziauddeen
- Department of Psychiatry, Addenbrooke’s Hospital, University of Cambridge, Herchel Smith Building, Cambridge, CB2 0SZ UK ,Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK ,Cambridgeshire and Peterborough Foundation Trust, Cambridge, CB21 5EF UK ,Box 189, Herchel Smith Building, West Forvie Site, Robinson Way, Cambridge Biomedical Campus, Cambridge, CB21 5DS UK
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157
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Munn-Chernoff MA, Baker JH. A Primer on the Genetics of Comorbid Eating Disorders and Substance Use Disorders. EUROPEAN EATING DISORDERS REVIEW 2015; 24:91-100. [PMID: 26663753 DOI: 10.1002/erv.2424] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 01/05/2023]
Abstract
Eating disorders (EDs) and substance use disorders (SUDs) frequently co-occur; however, the reasons for this are unclear. We review the current literature on genetic risk for EDs and SUDs, as well as preliminary findings exploring whether these classes of disorders have overlapping genetic risk. Overall, genetic factors contribute to individual differences in liability to multiple EDs and SUDs. Although initial family studies concluded that no shared familial (which includes genetic) risk between EDs and SUDs exists, twin studies suggest a moderate proportion of shared variance is attributable to overlapping genetic factors, particularly for those EDs characterized by binge eating and/or inappropriate compensatory behaviours. No adoption or molecular genetic studies have examined shared genetic risk between these classes of disorders. Research investigating binge eating and inappropriate compensatory behaviours using emerging statistical genetic methods, as well as examining gene-environment interplay, will provide important clues into the aetiology of comorbid EDs and SUDs.
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Affiliation(s)
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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158
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Long CG, Blundell JE, Finlayson G. A Systematic Review of the Application And Correlates of YFAS-Diagnosed 'Food Addiction' in Humans: Are Eating-Related 'Addictions' a Cause for Concern or Empty Concepts? Obes Facts 2015; 8:386-401. [PMID: 26633647 PMCID: PMC5644849 DOI: 10.1159/000442403] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/21/2015] [Indexed: 01/10/2023] Open
Abstract
The proposition of so-called 'food addiction' (FA) in the scientific literature has stimulated a recent surge in research and debate. The concept of FA is controversial, and opinion is divided. Many of the findings depend upon the use of a single instrument called the Yale Food Addiction Scale (YFAS). This review systematically examined FA, as defined by the YFAS, reported in 40 experimental human studies published in or after 2009. The results indicated that much of the literature makes the supposition that food addiction is an accepted neurobiological disease, consistent with substance use disorders; an interpretation based on very limited data. This raises the question as to whether those individuals who meet the YFAS criteria for diagnosis are truly 'addicted' to food or if they experience significant impairment to their psychological wellbeing and quality of life as would be expected in clinically recognised addictive disorders. At the present time, little research has investigated the extent to which a psychometric self-assessment of FA symptomatology can elucidate a harmful relationship with target foods in the diet. A positive YFAS diagnosis is usually positively associated with BMI and strongly linked with the presence of binge eating, but certain exceptions within the literature were revealed. Further clarification is required as to whether so-called FA is sufficiently different to existing conditions and traits to warrant classification as a distinctive disease phenotype rather than an expression of strong habits and preferences.
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Affiliation(s)
| | | | - Graham Finlayson
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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159
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Eating to live or living to eat? Exploring the causal attributions of self-perceived food addiction. Appetite 2015. [DOI: 10.1016/j.appet.2015.07.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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160
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Joyner MA, Gearhardt AN, White MA. Food craving as a mediator between addictive-like eating and problematic eating outcomes. Eat Behav 2015; 19:98-101. [PMID: 26262570 PMCID: PMC4644434 DOI: 10.1016/j.eatbeh.2015.07.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/25/2015] [Accepted: 07/29/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is growing interest and debate about whether an addictive process contributes to problematic eating outcomes, such as obesity. Craving is a core component of addiction, but there has been little research on the relationship between addictive-like eating, craving, and eating-related concerns. In the current study, we examine the effect of both overall food craving and craving for different types of food on the relationship between addictive-like eating symptoms and elevated body mass index (BMI) and binge eating episodes. METHODS In a community sample (n=283), we conducted analyses to examine whether overall craving mediated the association between addictive-like eating and elevated BMI, as well as binge eating frequency. We also ran separate mediational models examining the indirect effect of cravings for sweets, fats, carbohydrates, and fast food fats on these same associations. RESULTS Overall food craving was a significant partial mediator in the relationships between addictive-like eating and both elevated BMI and binge eating episodes. Cravings for sweets and other carbohydrates significantly mediated the relationship between addictive-like eating and binge eating episodes, while cravings for fats significantly mediated the relationship between addictive-like eating and elevated BMI. CONCLUSIONS Craving appears to be an important component in the pathway between addictive-like eating and problematic eating outcomes. The current results highlight the importance of further evaluating the role of an addictive process in problematic eating behaviors and potentially targeting food cravings in intervention approaches.
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Affiliation(s)
- Michelle A Joyner
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, USA.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, USA
| | - Marney A White
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06511, USA
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161
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From covalent bonds to eco-physiological pharmacology of secondary plant metabolites. Biochem Pharmacol 2015; 98:269-77. [DOI: 10.1016/j.bcp.2015.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 07/30/2015] [Indexed: 01/08/2023]
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162
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Pressman P, Clemens RA, Rodriguez HA. Food Addiction: Clinical Reality or Mythology. Am J Med 2015; 128:1165-6. [PMID: 26149675 DOI: 10.1016/j.amjmed.2015.05.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 05/28/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Peter Pressman
- Medicine, Public Health & Nutrition, The Daedalus Foundation, Mount Vernon, Va.
| | - Roger A Clemens
- University of Southern California, International Center for Regulatory Science, Los Angeles, Calif
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163
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Schulte EM, Yokum S, Potenza MN, Gearhardt AN. Neural systems implicated in obesity as an addictive disorder: from biological to behavioral mechanisms. PROGRESS IN BRAIN RESEARCH 2015; 223:329-46. [PMID: 26806784 DOI: 10.1016/bs.pbr.2015.07.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Contributing factors to obesity have been identified, yet prevention and treatment efforts have had limited long-term success. It has recently been suggested that some individuals may experience an addictive-like response to certain foods, such as losing control over consumption and continued consumption despite negative consequences. In support, shared biological and behavioral features seem to exist between "food addiction" and traditional substance-use disorders. "Food addiction" may be another important contributor to obesity. The current chapter reviews existing literature regarding neural systems implicated similarly in obesity and addiction, discusses unique considerations for addictive-like eating, and proposes directions for future research regarding "food addiction" as an emerging construct for addiction medicine.
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Affiliation(s)
- Erica M Schulte
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | | | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neurobiology, Child Study Center, Yale University School of Medicine, New Haven, CT, USA; CASAColumbia, Yale University School of Medicine, New Haven, CT, USA
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164
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Janse Van Vuuren M, Strodl E, White KM, Lockie P. Psychosocial presentation of revisional LAGB patients: a qualitative study. Clin Obes 2015; 5:273-80. [PMID: 26278522 DOI: 10.1111/cob.12113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/18/2015] [Accepted: 07/17/2015] [Indexed: 12/21/2022]
Abstract
This qualitative study offers insight into the experiences, expectations, perceptions and beliefs that may lead to laparoscopic adjustable gastric band patients' failure to achieve expected weight loss and seek revisional bariatric surgery. The 23 participants from two sites were interviewed and data were analysed from a grounded theory methodology in order to build a causal model. Analysis of participants' reports identified 'unrealistic expectations of the LAGB' as the core category. Additionally, the restriction of the band had a negative impact on participants' social interactions, leading to feelings of deprivation and, thus, to a desire for reward from food choices and consequently an increase of consumption of high-calorie-dense foods. These foods were chosen because of their specific texture or ability to provide reward. The resulting increase in weight or failure to achieve excess weight loss, led to feelings of shame and loneliness and emotional eating resulting in increased the consumption of rewarding foods. Thus, identifying unrealistic expectations of laparoscopic adjustable gastric band (LAGB) and emotional eating behaviours are important in those who are present initially for primary bariatric and revisional bariatric surgery, as they may contribute specifically to these patients' weight regain and consequent failure to achieve excess weight loss.
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Affiliation(s)
- M Janse Van Vuuren
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - E Strodl
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - K M White
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - P Lockie
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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165
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166
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Allison DB, Bassaganya-Riera J, Burlingame B, Brown AW, le Coutre J, Dickson SL, van Eden W, Garssen J, Hontecillas R, Khoo CSH, Knorr D, Kussmann M, Magistretti PJ, Mehta T, Meule A, Rychlik M, Vögele C. Goals in Nutrition Science 2015-2020. Front Nutr 2015; 2:26. [PMID: 26442272 PMCID: PMC4563164 DOI: 10.3389/fnut.2015.00026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/14/2015] [Indexed: 12/12/2022] Open
Affiliation(s)
- David B Allison
- Office of Energetics and Nutrition Obesity Research Center, School of Public Health, University of Alabama at Birmingham , Birmingham, AL , USA ; Section on Statistical Genetics, University of Alabama at Birmingham , Birmingham, AL , USA ; Department of Nutrition Sciences, University of Alabama at Birmingham , Birmingham, AL , USA ; Department of Biostatistics, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Josep Bassaganya-Riera
- Nutritional Immunology and Molecular Medicine Laboratory, Virginia Bioinformatics Institute, Virginia Tech , Blacksburg, VA , USA
| | - Barbara Burlingame
- Deakin University , Melbourne, VIC , Australia ; American University of Rome , Rome , Italy
| | - Andrew W Brown
- Office of Energetics and Nutrition Obesity Research Center, School of Public Health, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Johannes le Coutre
- Nestlé Research Center , Lausanne , Switzerland ; Organization for Interdisciplinary Research Projects, The University of Tokyo , Tokyo , Japan ; École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Suzanne L Dickson
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden
| | - Willem van Eden
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University , Utrecht , Netherlands
| | - Johan Garssen
- Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Utrecht , Netherlands
| | - Raquel Hontecillas
- Nutritional Immunology and Molecular Medicine Laboratory, Virginia Bioinformatics Institute, Virginia Tech , Blacksburg, VA , USA
| | - Chor San H Khoo
- North American Branch of International Life Sciences Institute , Washington, DC , USA
| | | | - Martin Kussmann
- École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland ; Nestlé Institute of Health Sciences SA , Lausanne , Switzerland
| | - Pierre J Magistretti
- Division of Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology , Thuwal , Saudi Arabia ; Laboratory of Neuroenergetics and Cellular Dynamics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Tapan Mehta
- Department of Health Services Administration, Nutrition Obesity Research Center, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Adrian Meule
- Department of Psychology, University of Salzburg , Salzburg , Austria
| | - Michael Rychlik
- Analytical Food Chemistry, Technische Universität München , Freising , Germany
| | - Claus Vögele
- Research Unit INSIDE, Institute for Health and Behaviour, University of Luxembourg , Luxembourg , Luxembourg
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167
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Clark L. Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. On the slippery slopes: The case of gambling addiction. J Behav Addict 2015; 4:132-4. [PMID: 26551898 PMCID: PMC4627669 DOI: 10.1556/2006.4.2015.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Billieux et al. (2015) propose that the recent proliferation of behavioral addictions has been driven by deficiencies in the underlying research strategy. This commentary considers how pathological gambling (now termed gambling disorder) traversed these challenges to become the first recognized behavioral addiction in the DSM-5. Ironically, many similar issues continue to exist in research on gambling disorder, including question-marks over the validity of tolerance, heterogeneity in gambling motives, and the under-specification of neuroimaging biomarkers. Nevertheless, I contend that the case for gambling disorder as a behavioral addiction has been bolstered by the existence of clear and consistent functional impairment (primarily in the form of debt), coupled with the development of a public health approach that has given emphasis to product features (i.e. the structural characteristics of gambling forms) as much as individual dispositions (the 'addictive personality').
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Affiliation(s)
- Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, Canada,* Corresponding address: Dr Luke Clark; Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, Canada V6T 1Z4; E-mail:
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168
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Hardman CA, Rogers PJ, Dallas R, Scott J, Ruddock HK, Robinson E. “Food addiction is real”. The effects of exposure to this message on self-diagnosed food addiction and eating behaviour. Appetite 2015; 91:179-84. [DOI: 10.1016/j.appet.2015.04.052] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/18/2015] [Accepted: 04/14/2015] [Indexed: 10/23/2022]
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169
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Malika NM, Hayman LW, Miller AL, Lee HJ, Lumeng JC. Low-income women's conceptualizations of food craving and food addiction. Eat Behav 2015; 18:25-9. [PMID: 25867800 PMCID: PMC4504758 DOI: 10.1016/j.eatbeh.2015.03.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 01/15/2015] [Accepted: 03/19/2015] [Indexed: 01/02/2023]
Abstract
Food craving and food addiction have been proposed as targets for obesity focused interventions. However, individuals' conceptualizations of these constructs are not well understood and no studies have employed a qualitative approach. Therefore, we sought to understand how women conceptualize food craving and food addiction. Low-income women with preschool-aged children (2-5years old) participated in either a semi-structured individual interview or focus group in which they were asked about their conceptualization of eating behaviors among adults and children. All responses were audio-recorded and transcribed. Themes were identified using the constant comparative method of qualitative analysis. Identified themes revealed that the women perceived food craving to be common, less severe and to a degree more humorous than food addiction. It was not felt that food cravings were something to be guarded against or resisted. Food addiction was described in a very "matter of fact" manner and was believed to be identifiable through its behavioral features including a compulsive need to have certain foods all the time. A more detailed understanding of how the general population perceives food craving and food addiction may enable more refined measurement of these constructs with questionnaire measures in the future. In addition, interventions may be designed to use the language most consistent with participants' conceptualizations of these constructs.
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Affiliation(s)
- Nipher M Malika
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
| | - Lenwood W Hayman
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Hannah J Lee
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States; Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI, United States; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.
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170
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171
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Ziauddeen H, Alonso-Alonso M, Hill JO, Kelley M, Khan NA. Obesity and the neurocognitive basis of food reward and the control of intake. Adv Nutr 2015; 6:474-86. [PMID: 26178031 PMCID: PMC4496739 DOI: 10.3945/an.115.008268] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
With the rising prevalence of obesity, hedonic eating has become an important theme in obesity research. Hedonic eating is thought to be that driven by the reward of food consumption and not metabolic need, and this has focused attention on the brain reward system and how its dysregulation may cause overeating and obesity. Here, we begin by examining the brain reward system and the evidence for its dysregulation in human obesity. We then consider the issue of how individuals are able to control their hedonic eating in the present obesogenic environment and compare 2 contrasting perspectives on the control of hedonic eating, specifically, enhanced control of intake via higher cognitive control and loss of control over intake as captured by the food addiction model. We conclude by considering what these perspectives offer in terms of directions for future research and for potential interventions to improve control over food intake at the population and the individual levels.
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Affiliation(s)
- Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Wellcome Trust-MRC, Institute of Metabolic Science, Cambridge, United Kingdom; Cambridgeshire and Peterborough Foundation Trust, Cambridge, United Kingdom;
| | - Miguel Alonso-Alonso
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - James O Hill
- Anschutz Health and Wellness Center, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Michael Kelley
- Scientific and Regulatory Affairs, Wm. Wrigley Jr. Company, Chicago, IL; and
| | - Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL
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172
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Rivera HM, Christiansen KJ, Sullivan EL. The role of maternal obesity in the risk of neuropsychiatric disorders. Front Neurosci 2015; 9:194. [PMID: 26150767 PMCID: PMC4471351 DOI: 10.3389/fnins.2015.00194] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 05/16/2015] [Indexed: 12/22/2022] Open
Abstract
Recent evidence indicates that perinatal exposure to maternal obesity, metabolic disease, including diabetes and hypertension, and unhealthy maternal diet has a long-term impact on offspring behavior and physiology. During the past three decades, the prevalence of both obesity and neuropsychiatric disorders has rapidly increased. Epidemiologic studies provide evidence that maternal obesity and metabolic complications increase the risk of attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, anxiety, depression, schizophrenia, eating disorders (food addiction, anorexia nervosa, and bulimia nervosa), and impairments in cognition in offspring. Animal models of maternal high-fat diet (HFD) induced obesity also document persistent changes in offspring behavior and impairments in critical neural circuitry. Animals exposed to maternal obesity and HFD consumption display hyperactivity, impairments in social behavior, increased anxiety-like and depressive-like behaviors, substance addiction, food addiction, and diminished cognition. During development, these offspring are exposed to elevated levels of nutrients (fatty acids, glucose), hormones (leptin, insulin), and inflammatory factors (C-reactive protein, interleukin, and tumor necrosis factor). Such factors appear to permanently change neuroendocrine regulation and brain development in offspring. In addition, inflammation of the offspring brain during gestation impairs the development of neural pathways critical in the regulation of behavior, such as serotoninergic, dopaminergic, and melanocortinergic systems. Dysregulation of these circuits increases the risk of mental health disorders. Given the high rates of obesity in most developed nations, it is critical that the mechanisms by which maternal obesity programs offspring behavior are thoroughly characterized. Such knowledge will be critical in the development of preventative strategies and therapeutic interventions.
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Affiliation(s)
- Heidi M Rivera
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR, USA
| | | | - Elinor L Sullivan
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR, USA ; Department of Biology, University of Portland Portland, OR, USA
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173
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Abstract
The global rise in the prevalence of obesity and associated co-morbidities such as type 2 diabetes, cardiovascular disease, and cancer represents a major public health concern. The biological response to increased consumption of palatable foods or a reduction in energy expenditure is highly variable between individuals. A more detailed mechanistic understanding of the molecular, physiological, and behavioral pathways involved in the development of obesity in susceptible individuals is critical for identifying effective mechanism-based preventative and therapeutic interventions.
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Affiliation(s)
- Agatha A van der Klaauw
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - I Sadaf Farooqi
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
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174
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Böning J. [Behavioral addictions]. MMW Fortschr Med 2015; 157:64-70. [PMID: 26019100 DOI: 10.1007/s15006-015-2724-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Jobst Böning
- Zentrum für Psychische Gesundheit, Klinik für Psychiatrie, Psychosomatik und Psychotherapie der Universität Würzburg, Füchsleinstraße 15, D-97080, Würzburg, Deutschland,
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175
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Blanco C, García-Anaya M, Wall M, de los Cobos JCP, Swierad E, Wang S, Petry NM. Should pathological gambling and obesity be considered addictive disorders? A factor analytic study in a nationally representative sample. Drug Alcohol Depend 2015; 150:129-34. [PMID: 25769392 PMCID: PMC4387020 DOI: 10.1016/j.drugalcdep.2015.02.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 02/17/2015] [Accepted: 02/18/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Pathological gambling (PG) is now aligned with substance use disorders in the DSM-5 as the first officially recognized behavioral addiction. There is growing interest in examining obesity as an addictive disorder as well. The goal of this study was to investigate whether epidemiological data provide support for the consideration of PG and obesity as addictive disorders. METHOD Factor analysis of data from a large, nationally representative sample of US adults (N=43,093), using nicotine dependence, alcohol dependence, drug dependence, PG and obesity as indicators. It was hypothesized that nicotine dependence, alcohol dependence and drug use dependence would load on a single factor. It was further hypothesized that if PG and obesity were addictive disorders, they would load on the same factor as substance use disorders, whereas failure to load on the addictive factor would not support their conceptualization as addictive disorders. RESULTS A model with one factor including nicotine dependence, alcohol dependence, drug dependence and PG, but not obesity, provided a very good fit to the data, as indicated by CFI=0.99, TLI=0.99 and RMSEA=0.01 and loadings of all indicators >0.4. CONCLUSION Data from this study support the inclusion of PG in a latent factor with substance use disorders but do not lend support to the consideration of obesity, as defined by BMI, as an addictive disorder. Future research should investigate whether certain subtypes of obesity are best conceptualized as addictive disorders and the shared biological and environmental factors that account for the common and specific features of addictive disorders.
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Affiliation(s)
- Carlos Blanco
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
| | - María García-Anaya
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University,Clinical Research Division, National Institute of Psychiatry Ramón de la Fuente, Mexico City
| | - Melanie Wall
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University,Department of Biostatistics, New York State Psychiatric Institute/Columbia University
| | - José Carlos Pérez de los Cobos
- Addictive Behaviors Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, (IIB Sant Pau) Departament de Psiguiatria i Medicina Legal, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ewelina Swierad
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University
| | - Shuai Wang
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University
| | - Nancy M. Petry
- Calhoun Cardiology Center, University of Connecticut Health Center
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176
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Caravaggio F, Borlido C, Hahn M, Feng Z, Fervaha G, Gerretsen P, Nakajima S, Plitman E, Chung JK, Iwata Y, Wilson A, Remington G, Graff-Guerrero A. Reduced insulin sensitivity is related to less endogenous dopamine at D2/3 receptors in the ventral striatum of healthy nonobese humans. Int J Neuropsychopharmacol 2015; 18:pyv014. [PMID: 25716779 PMCID: PMC4540108 DOI: 10.1093/ijnp/pyv014] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 02/04/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Food addiction is a debated topic in neuroscience. Evidence suggests diabetes is related to reduced basal dopamine levels in the nucleus accumbens, similar to persons with drug addiction. It is unknown whether insulin sensitivity is related to endogenous dopamine levels in the ventral striatum of humans. We examined this using the agonist dopamine D2/3 receptor radiotracer [(11)C]-(+)-PHNO and an acute dopamine depletion challenge. In a separate sample of healthy persons, we examined whether dopamine depletion could alter insulin sensitivity. METHODS Insulin sensitivity was estimated for each subject from fasting plasma glucose and insulin using the Homeostasis Model Assessment II. Eleven healthy nonobese and nondiabetic persons (3 female) provided a baseline [(11)C]-(+)-PHNO scan, 9 of which provided a scan under dopamine depletion, allowing estimates of endogenous dopamine at dopamine D2/3 receptor. Dopamine depletion was achieved via alpha-methyl-para-tyrosine (64mg/kg, P.O.). In 25 healthy persons (9 female), fasting plasma and glucose was acquired before and after dopamine depletion. RESULTS Endogenous dopamine at ventral striatum dopamine D2/3 receptor was positively correlated with insulin sensitivity (r(7)=.84, P=.005) and negatively correlated with insulin levels (r(7)=-.85, P=.004). Glucose levels were not correlated with endogenous dopamine at ventral striatum dopamine D2/3 receptor (r(7)=-.49, P=.18). Consistently, acute dopamine depletion in healthy persons significantly decreased insulin sensitivity (t(24)=2.82, P=.01), increased insulin levels (t(24)=-2.62, P=.01), and did not change glucose levels (t(24)=-0.93, P=.36). CONCLUSION In healthy individuals, diminished insulin sensitivity is related to less endogenous dopamine at dopamine D2/3 receptor in the ventral striatum. Moreover, acute dopamine depletion reduces insulin sensitivity. These findings may have important implications for neuropsychiatric populations with metabolic abnormalities.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Ariel Graff-Guerrero
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Mr Caravaggio, Ms Borlido, Ms Feng, Dr Gerretsen, Dr Nakajima, Mr Plitman, Mr Chung, Dr Iwata, Dr Wilson, Dr Remington, and Dr Graff-Guerrero); Institute of Medical Science (Mr Caravaggio, Dr Hahn, Mr Fervaha, Dr Gerretsen, Mr Plitman, Mr Chung, Dr Wilson, Dr Remington, and Dr Graff-Guerrero), and Department of Psychiatry (Drs Hahn, Gerretsen, Nakajima, Iwata, Wilson, Remington, and Graff-Guerrero), University of Toronto, Toronto, Ontario, Canada.
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177
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Val-Laillet D, Aarts E, Weber B, Ferrari M, Quaresima V, Stoeckel L, Alonso-Alonso M, Audette M, Malbert C, Stice E. Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity. Neuroimage Clin 2015; 8:1-31. [PMID: 26110109 PMCID: PMC4473270 DOI: 10.1016/j.nicl.2015.03.016] [Citation(s) in RCA: 279] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 12/11/2022]
Abstract
Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain-behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). Converging evidence points at the value of these non-invasive neuromodulation strategies to study basic mechanisms underlying eating behavior and to treat its disorders. Both of these approaches will be compared in light of recent work in this field, while addressing technical and practical questions. The third part of this review will be dedicated to invasive neuromodulation strategies, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). In combination with neuroimaging approaches, these techniques are promising experimental tools to unravel the intricate relationships between homeostatic and hedonic brain circuits. Their potential as additional therapeutic tools to combat pharmacorefractory morbid obesity or acute eating disorders will be discussed, in terms of technical challenges, applicability and ethics. In a general discussion, we will put the brain at the core of fundamental research, prevention and therapy in the context of obesity and eating disorders. First, we will discuss the possibility to identify new biological markers of brain functions. Second, we will highlight the potential of neuroimaging and neuromodulation in individualized medicine. Third, we will introduce the ethical questions that are concomitant to the emergence of new neuromodulation therapies.
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Key Words
- 5-HT, serotonin
- ADHD, attention deficit hyperactivity disorder
- AN, anorexia nervosa
- ANT, anterior nucleus of the thalamus
- B N, bulimia nervosa
- BAT, brown adipose tissue
- BED, binge eating disorder
- BMI, body mass index
- BOLD, blood oxygenation level dependent
- BS, bariatric surgery
- Brain
- CBF, cerebral blood flow
- CCK, cholecystokinin
- Cg25, subgenual cingulate cortex
- DA, dopamine
- DAT, dopamine transporter
- DBS, deep brain stimulation
- DBT, deep brain therapy
- DTI, diffusion tensor imaging
- ED, eating disorders
- EEG, electroencephalography
- Eating disorders
- GP, globus pallidus
- HD-tDCS, high-definition transcranial direct current stimulation
- HFD, high-fat diet
- HHb, deoxygenated-hemoglobin
- Human
- LHA, lateral hypothalamus
- MER, microelectrode recording
- MRS, magnetic resonance spectroscopy
- Nac, nucleus accumbens
- Neuroimaging
- Neuromodulation
- O2Hb, oxygenated-hemoglobin
- OCD, obsessive–compulsive disorder
- OFC, orbitofrontal cortex
- Obesity
- PD, Parkinson's disease
- PET, positron emission tomography
- PFC, prefrontal cortex
- PYY, peptide tyrosine tyrosine
- SPECT, single photon emission computed tomography
- STN, subthalamic nucleus
- TMS, transcranial magnetic stimulation
- TRD, treatment-resistant depression
- VBM, voxel-based morphometry
- VN, vagus nerve
- VNS, vagus nerve stimulation
- VS, ventral striatum
- VTA, ventral tegmental area
- aCC, anterior cingulate cortex
- dTMS, deep transcranial magnetic stimulation
- daCC, dorsal anterior cingulate cortex
- dlPFC, dorsolateral prefrontal cortex
- fMRI, functional magnetic resonance imaging
- fNIRS, functional near-infrared spectroscopy
- lPFC, lateral prefrontal cortex
- pCC, posterior cingulate cortex
- rCBF, regional cerebral blood flow
- rTMS, repetitive transcranial magnetic stimulation
- rtfMRI, real-time functional magnetic resonance imaging
- tACS, transcranial alternate current stimulation
- tDCS, transcranial direct current stimulation
- tRNS, transcranial random noise stimulation
- vlPFC, ventrolateral prefrontal cortex
- vmH, ventromedial hypothalamus
- vmPFC, ventromedial prefrontal cortex
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Affiliation(s)
| | - E. Aarts
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - B. Weber
- Department of Epileptology, University Hospital Bonn, Germany
| | - M. Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - V. Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - L.E. Stoeckel
- Massachusetts General Hospital, Harvard Medical School, USA
| | - M. Alonso-Alonso
- Beth Israel Deaconess Medical Center, Harvard Medical School, USA
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178
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Meule A, Hermann T, Kübler A. Food addiction in overweight and obese adolescents seeking weight-loss treatment. EUROPEAN EATING DISORDERS REVIEW 2015; 23:193-8. [PMID: 25778000 DOI: 10.1002/erv.2355] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 01/10/2023]
Abstract
Some forms of overeating closely resemble addictive behaviour. The Yale Food Addiction Scale (YFAS) was developed to measure such addiction-like eating in humans and has been employed in numerous studies for examining food addiction in adults. Yet, little is known about food addiction in children and adolescents. Fifty adolescents were recruited at the beginning of treatment in a weight-loss hospital and completed the YFAS among other questionnaires. Nineteen participants (38%) received a YFAS diagnosis, who did not differ in age, body mass and gender distribution from those not receiving a diagnosis. However, those with food addiction reported more binge days, more frequent food cravings, higher eating, weight and shape concerns, more symptoms of depression and higher attentional and motor impulsivity. Eating restraint and nonplanning impulsivity did not differ between groups. Results replicate findings from studies in obese adults such that food addiction is not related to age, gender, body mass or eating restraint, but to higher eating pathology, more symptoms of depression and higher impulsivity. Furthermore, results highlight that particularly attentional impulsivity is related to 'food addiction'. Addiction-like eating appears to be a valid phenotype in a substantial subset of treatment-seeking, obese adolescents.
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Affiliation(s)
- Adrian Meule
- Institute of Psychology, Department of Psychology I, University of Würzburg, Würzburg, Germany; Hospital for Child and Adolescent Psychiatry, LWL University Hospital of the Ruhr University Bochum, Hamm, Germany
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179
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Manning S, Pucci A, Batterham RL. Roux-en-Y gastric bypass: effects on feeding behavior and underlying mechanisms. J Clin Invest 2015; 125:939-48. [PMID: 25729850 DOI: 10.1172/jci76305] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Bariatric surgery is the most effective treatment for severe obesity, producing marked sustained weight loss with associated reduced morbidity and mortality. Roux-en-Y gastric bypass surgery (RYGBP), the most commonly performed procedure, was initially viewed as a hybrid restrictive-malabsorptive procedure. However, over the last decade, it has become apparent that alternative physiologic mechanisms underlie its beneficial effects. RYGBP-induced altered feeding behavior, including reduced appetite and changes in taste/food preferences, is now recognized as a key driver of the sustained postoperative weight loss. The brain ultimately determines feeding behavior, and here we review the mechanisms by which RYGBP may affect central appetite-regulating pathways.
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180
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Mole TB, Irvine MA, Worbe Y, Collins P, Mitchell SP, Bolton S, Harrison NA, Robbins TW, Voon V. Impulsivity in disorders of food and drug misuse. Psychol Med 2015; 45:771-82. [PMID: 25118940 PMCID: PMC4998952 DOI: 10.1017/s0033291714001834] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Evidence suggests some overlap between the pathological use of food and drugs, yet how impulsivity compares across these different clinical disorders remains unclear. Substance use disorders are commonly characterized by elevated impulsivity, and impulsivity subtypes may show commonalities and differences in various conditions. We hypothesized that obese subjects with binge-eating disorder (BED) and abstinent alcohol-dependent cohorts would have relatively more impulsive profiles compared to obese subjects without BED. We also predicted decision impulsivity impairment in obesity with and without BED. METHOD Thirty obese subjects with BED, 30 without BED and 30 abstinent alcohol-dependent subjects and age- and gender-matched controls were tested on delay discounting (preference for a smaller immediate reward over a larger delayed reward), reflection impulsivity (rapid decision making prior to evidence accumulation) and motor response inhibition (action cancellation of a prepotent response). RESULTS All three groups had greater delay discounting relative to healthy volunteers. Both obese subjects without BED and alcohol-dependent subjects had impaired motor response inhibition. Only obese subjects without BED had impaired integration of available information to optimize outcomes over later trials with a cost condition. CONCLUSIONS Delay discounting appears to be a common core impairment across disorders of food and drug intake. Unexpectedly, obese subjects without BED showed greater impulsivity than obese subjects with BED. We highlight the dissociability and heterogeneity of impulsivity subtypes and add to the understanding of neurocognitive profiles across disorders involving food and drugs. Our results have therapeutic implications suggesting that disorder-specific patterns of impulsivity could be targeted.
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Affiliation(s)
- T B Mole
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - M A Irvine
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - Y Worbe
- Behavioural and Clinical Neuroscience Institute,University of Cambridge,Cambridge,UK
| | - P Collins
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - S P Mitchell
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - S Bolton
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - N A Harrison
- Brighton and Sussex Medical School,University of Sussex,Brighton,UK
| | - T W Robbins
- Behavioural and Clinical Neuroscience Institute,University of Cambridge,Cambridge,UK
| | - V Voon
- Department of Psychiatry,University of Cambridge,Cambridge,UK
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181
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Food and addiction among the ageing population. Ageing Res Rev 2015; 20:79-85. [PMID: 25449527 DOI: 10.1016/j.arr.2014.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 08/25/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022]
Abstract
Obesity among the elderly is a growing public health concern. Among the various factors that may contribute to the current rates of obesity is the rewarding aspect of highly palatable foods and beverages, which may lead to overconsumption and excess caloric intake. The present review describes recent research supporting the hypothesis that, for some individuals, the consumption these highly palatable foods and beverages may lead to the development of addictive-like behaviors. In particular, the authors consider the relevance of this hypothesis to the ageing population.
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182
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Voon V, Morris LS, Irvine MA, Ruck C, Worbe Y, Derbyshire K, Rankov V, Schreiber LRN, Odlaug BL, Harrison NA, Wood J, Robbins TW, Bullmore ET, Grant JE. Risk-taking in disorders of natural and drug rewards: neural correlates and effects of probability, valence, and magnitude. Neuropsychopharmacology 2015; 40:804-12. [PMID: 25270821 PMCID: PMC4305336 DOI: 10.1038/npp.2014.242] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 08/27/2014] [Accepted: 08/27/2014] [Indexed: 11/24/2022]
Abstract
Pathological behaviors toward drugs and food rewards have underlying commonalities. Risk-taking has a fourfold pattern varying as a function of probability and valence leading to the nonlinearity of probability weighting with overweighting of small probabilities and underweighting of large probabilities. Here we assess these influences on risk-taking in patients with pathological behaviors toward drug and food rewards and examine structural neural correlates of nonlinearity of probability weighting in healthy volunteers. In the anticipation of rewards, subjects with binge eating disorder show greater risk-taking, similar to substance-use disorders. Methamphetamine-dependent subjects had greater nonlinearity of probability weighting along with impaired subjective discrimination of probability and reward magnitude. Ex-smokers also had lower risk-taking to rewards compared with non-smokers. In the anticipation of losses, obesity without binge eating had a similar pattern to other substance-use disorders. Obese subjects with binge eating also have impaired discrimination of subjective value similar to that of the methamphetamine-dependent subjects. Nonlinearity of probability weighting was associated with lower gray matter volume in dorsolateral and ventromedial prefrontal cortex and orbitofrontal cortex in healthy volunteers. Our findings support a distinct subtype of binge eating disorder in obesity with similarities in risk-taking in the reward domain to substance use disorders. The results dovetail with the current approach of defining mechanistically based dimensional approaches rather than categorical approaches to psychiatric disorders. The relationship to risk probability and valence may underlie the propensity toward pathological behaviors toward different types of rewards.
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Affiliation(s)
- Valerie Voon
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK,Department of Psychiatry, Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK,Cambridgeshire and Peterborough Foundation Trust, Cambridge, UK,Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Hills Road, Cambridge CB2 0QQ, UK, Tel: +44 122 367 1327, Fax: +44 122 333 6581, E-mail:
| | - Laurel S Morris
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK,Department of Psychiatry, Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK
| | - Michael A Irvine
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK,Department of Psychiatry, Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK
| | - Christian Ruck
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Yulia Worbe
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Katherine Derbyshire
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Vladan Rankov
- Department of Psychiatry, Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK
| | | | - Brian L Odlaug
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Neil A Harrison
- Department of Psychiatry, Brighton and Sussex Medical School, Brighton, UK
| | - Jonathan Wood
- Cambridgeshire and Peterborough Foundation Trust, Cambridge, UK
| | - Trevor W Robbins
- Department of Psychiatry, Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK
| | - Edward T Bullmore
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK,Department of Psychiatry, Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK,Cambridgeshire and Peterborough Foundation Trust, Cambridge, UK
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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183
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Disorders of compulsivity: a common bias towards learning habits. Mol Psychiatry 2015; 20:345-52. [PMID: 24840709 PMCID: PMC4351889 DOI: 10.1038/mp.2014.44] [Citation(s) in RCA: 373] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 02/24/2014] [Accepted: 03/17/2014] [Indexed: 02/02/2023]
Abstract
Why do we repeat choices that we know are bad for us? Decision making is characterized by the parallel engagement of two distinct systems, goal-directed and habitual, thought to arise from two computational learning mechanisms, model-based and model-free. The habitual system is a candidate source of pathological fixedness. Using a decision task that measures the contribution to learning of either mechanism, we show a bias towards model-free (habit) acquisition in disorders involving both natural (binge eating) and artificial (methamphetamine) rewards, and obsessive-compulsive disorder. This favoring of model-free learning may underlie the repetitive behaviors that ultimately dominate in these disorders. Further, we show that the habit formation bias is associated with lower gray matter volumes in caudate and medial orbitofrontal cortex. Our findings suggest that the dysfunction in a common neurocomputational mechanism may underlie diverse disorders involving compulsion.
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184
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Tuulari JJ, Karlsson HK, Hirvonen J, Salminen P, Nuutila P, Nummenmaa L. Neural circuits for cognitive appetite control in healthy and obese individuals: an fMRI study. PLoS One 2015; 10:e0116640. [PMID: 25658479 PMCID: PMC4320085 DOI: 10.1371/journal.pone.0116640] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 12/11/2014] [Indexed: 11/23/2022] Open
Abstract
The mere sight of foods may activate the brain’s reward circuitry, and humans often experience difficulties in inhibiting urges to eat upon encountering visual food signals. Imbalance between the reward circuit and those supporting inhibitory control may underlie obesity, yet brain circuits supporting volitional control of appetite and their possible dysfunction that can lead to obesity remain poorly specified. Here we delineated the brain basis of volitional appetite control in healthy and obese individuals with functional magnetic resonance imaging (fMRI). Twenty-seven morbidly obese women (mean BMI = 41.4) and fourteen age-matched normal-weight women (mean BMI = 22.6) were scanned with 1.5 Tesla fMRI while viewing food pictures. They were instructed to inhibit their urge to eat the foods, view the stimuli passively or imagine eating the foods. Across all subjects, a frontal cortical control circuit was activated during appetite inhibition versus passive viewing of the foods. Inhibition minus imagined eating (appetite control) activated bilateral precunei and parietal cortices and frontal regions spanning anterior cingulate and superior medial frontal cortices. During appetite control, obese subjects had lower responses in the medial frontal, middle cingulate and dorsal caudate nuclei. Functional connectivity of the control circuit was increased in morbidly obese versus control subjects during appetite control, which might reflect impaired integrative and executive function in obesity.
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Affiliation(s)
| | | | - Jussi Hirvonen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Paulina Salminen
- Department of Surgery, Turku University Hospital, Turku, Finland
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Biomedical Engineering and Computational Science, School of Science, Aalto University, Aalto, Finland
- Brain Research Unit, O.V. Lounasmaa Laboratory, School of Science, Aalto University, Aalto, Finland
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185
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Stanfill AG, Conley Y, Cashion A, Thompson C, Homayouni R, Cowan P, Hathaway D. Neurogenetic and Neuroimaging Evidence for a Conceptual Model of Dopaminergic Contributions to Obesity. Biol Res Nurs 2015; 17:413-21. [PMID: 25576324 DOI: 10.1177/1099800414565170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
As the incidence of obesity continues to rise, clinicians and researchers alike are seeking explanations for why some people become obese while others do not. While caloric intake and physical activity most certainly play a role, some individuals continue to gain weight despite careful attention to these factors. Increasing evidence suggests that genetics may play a role, with one potential explanation being genetic variability in genes within the neurotransmitter dopamine pathway. This variability can lead to a disordered experience with the rewarding properties of food. This review of literature examines the extant knowledge about the relationship between obesity and the dopaminergic reward pathways in the brain, with particularly strong evidence provided from neuroimaging and neurogenetic data. Pubmed, Google Scholar, and Cumulative Index to Nursing and Allied Health Literature searches were conducted with the search terms dopamine, obesity, weight gain, food addiction, brain regions relevant to the mesocortical and mesolimbic (reward) pathways, and relevant dopaminergic genes and receptors. These terms returned over 200 articles. Other than a few sentinel articles, articles were published between 1993 and 2013. These data suggest a conceptual model for obesity that emphasizes dopaminergic genetic contributions as well as more traditional risk factors for obesity, such as demographics (age, race, and gender), physical activity, diet, and medications. A greater understanding of variables contributing to weight gain and obesity is imperative for effective clinical treatment.
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Affiliation(s)
- Ansley Grimes Stanfill
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Ann Cashion
- National Institutes of Health, Bethesda, MD, USA
| | | | | | - Patricia Cowan
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Donna Hathaway
- University of Tennessee Health Science Center, Memphis, TN, USA
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186
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Smith DG, Jones PS, Williams GB, Bullmore ET, Robbins TW, Ersche KD. Overlapping decline in orbitofrontal gray matter volume related to cocaine use and body mass index. Addict Biol 2015; 20:194-6. [PMID: 23927455 DOI: 10.1111/adb.12081] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Loss of control over hedonically motivated actions is a defining component of impulse control disorders, such as drug dependence and the proposed 'food addiction' model of obesity. Devolution from goal-directed to compulsively maintained behaviors is partially attributed to abnormalities in the orbitofrontal cortex, an area critical in reward valuation. In the current study, overlapping reductions in orbitofrontal gray matter volume relating to body mass index were seen in healthy control and cocaine-dependent individuals, as well as in relation to duration of cocaine abuse, providing support for a shared neuropathology between the two conditions potentially related to dysfunctional reward-seeking behavior.
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Affiliation(s)
- Dana G. Smith
- Behavioural and Clinical Neuroscience Institute; Department of Psychology and Department of Psychiatry; University of Cambridge; UK
| | - P. Simon Jones
- Behavioural and Clinical Neuroscience Institute; Department of Psychology and Department of Psychiatry; University of Cambridge; UK
| | - Guy B. Williams
- Wolfson Brain Imaging Centre; Department of Clinical Neurosciences; University of Cambridge; UK
| | - Edward T. Bullmore
- Behavioural and Clinical Neuroscience Institute; Department of Psychology and Department of Psychiatry; University of Cambridge; UK
- GlaxoSmithKline; Clinical Unit Cambridge; UK
- Cambridgeshire and Peterborough NHS Foundation Trust; UK
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute; Department of Psychology and Department of Psychiatry; University of Cambridge; UK
| | - Karen D. Ersche
- Behavioural and Clinical Neuroscience Institute; Department of Psychology and Department of Psychiatry; University of Cambridge; UK
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187
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Pedram P, Sun G. Hormonal and dietary characteristics in obese human subjects with and without food addiction. Nutrients 2014; 7:223-38. [PMID: 25558907 PMCID: PMC4303835 DOI: 10.3390/nu7010223] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/19/2014] [Indexed: 01/08/2023] Open
Abstract
The concept of food addiction (FA) is a potentially important contributing factor to the development of obesity in the general population; however, little is known about the hormonal and dietary differences between obesity with and without FA. Therefore, the aim of our study was to explore potential biomarkers, including various hormones and neuropeptides, which regulate appetite and metabolism, and dietary components that could potentially differentiate obesity with and without FA. Of the 737 adults recruited from the general Newfoundland population, 58 food-addicted and non-food-addicted overweight/obese individuals (FAO, NFO) matched for age, sex, BMI and physical activity were selected. A total of 34 neuropeptides, gut hormones, pituitary polypeptide hormones and adipokines were measured in fasting serum. We found that the FAO group had lower levels of TSH, TNF-α and amylin, but higher levels of prolactin, as compared to NFO group. The total calorie intake (per kg body weight), the dietary intake of fat (per g/kg body weight, per BMI and per percentage of trunk fat) and the percent calorie intake from fat and carbohydrates (g/kg) was higher in the FAO group compared to the NFO group. The FAO subjects consumed more sugar, minerals (including sodium, potassium, calcium and selenium), fat and its components (such as saturated, monounsaturated and trans fat), omega 3 and 6, vitamin D and gamma-tocopherol compared to the NFO group. To our knowledge, this is the first study indicating possible differences in hormonal levels and micro-nutrient intakes between obese individuals classified with and without food addiction. The findings provide insights into the mechanisms by which FA could contribute to obesity.
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Affiliation(s)
- Pardis Pedram
- Faculty of medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL A1B3V6, Canada.
| | - Guang Sun
- Faculty of medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL A1B3V6, Canada.
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188
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Simon JJ, Skunde M, Wu M, Schnell K, Herpertz SC, Bendszus M, Herzog W, Friederich HC. Neural dissociation of food- and money-related reward processing using an abstract incentive delay task. Soc Cogn Affect Neurosci 2014; 10:1113-20. [PMID: 25552570 DOI: 10.1093/scan/nsu162] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 12/24/2014] [Indexed: 11/13/2022] Open
Abstract
Food is an innate reward stimulus related to energy homeostasis and survival, whereas money is considered a more general reward stimulus that gains a rewarding value through learning experiences. Although the underlying neural processing for both modalities of reward has been investigated independently from one another, a more detailed investigation of neural similarities and/or differences between food and monetary reward is still missing. Here, we investigated the neural processing of food compared with monetary-related rewards in 27 healthy, normal-weight women using functional magnetic resonance imaging. We developed a task distinguishing between the anticipation and the receipt of either abstract food or monetary reward. Both tasks activated the ventral striatum during the expectation of a reward. Compared with money, greater food-related activations were observed in prefrontal, parietal and central midline structures during the anticipation and lateral orbitofrontal cortex (lOFC) during the receipt of food reward. Furthermore, during the receipt of food reward, brain activation in the secondary taste cortex was positively related to the body mass index. These results indicate that food-dependent activations encompass to a greater extent brain regions involved in self-control and self-reflection during the anticipation and phylogenetically older parts of the lOFC during the receipt of reward.
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Affiliation(s)
- Joe J Simon
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, Heidelberg, Germany,
| | - Mandy Skunde
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, Heidelberg, Germany
| | - Mudan Wu
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, Heidelberg, Germany
| | - Knut Schnell
- Department of General Adult Psychiatry, Centre for Psychosocial Medicine, Heidelberg, Germany
| | - Sabine C Herpertz
- Department of General Adult Psychiatry, Centre for Psychosocial Medicine, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany, and
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, Heidelberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, LVR-Klinikum Essen, Essen, Germany
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189
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Food addiction: an evolving nonlinear science. Nutrients 2014; 6:5370-91. [PMID: 25421535 PMCID: PMC4245594 DOI: 10.3390/nu6115370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/12/2014] [Accepted: 10/13/2014] [Indexed: 12/12/2022] Open
Abstract
The purpose of this review is to familiarize readers with the role that addiction plays in the formation and treatment of obesity, type 2 diabetes and disorders of eating. We will outline several useful models that integrate metabolism, addiction, and human relationship adaptations to eating. A special effort will be made to demonstrate how the use of simple and straightforward nonlinear models can and are being used to improve our knowledge and treatment of patients suffering from nutritional pathology. Moving forward, the reader should be able to incorporate some of the findings in this review into their own practice, research, teaching efforts or other interests in the fields of nutrition, diabetes, and/or bariatric (weight) management.
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190
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Potenza MN, Grilo CM. How Relevant is Food Craving to Obesity and Its Treatment? Front Psychiatry 2014; 5:164. [PMID: 25477827 PMCID: PMC4237037 DOI: 10.3389/fpsyt.2014.00164] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 11/06/2014] [Indexed: 01/26/2023] Open
Affiliation(s)
- Marc N. Potenza
- Departments of Psychiatry, Neurobiology and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Carlos M. Grilo
- Department of Psychiatry and Psychology, Yale University, New Haven, CT, USA
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191
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García-García I, Horstmann A, Jurado MA, Garolera M, Chaudhry SJ, Margulies DS, Villringer A, Neumann J. Reward processing in obesity, substance addiction and non-substance addiction. Obes Rev 2014; 15:853-69. [PMID: 25263466 DOI: 10.1111/obr.12221] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/03/2014] [Accepted: 07/21/2014] [Indexed: 12/16/2022]
Abstract
Similarities and differences between obesity and addiction are a prominent topic of ongoing research. We conducted an activation likelihood estimation meta-analysis on 87 studies in order to map the functional magnetic resonance imaging (fMRI) response to reward in participants with obesity, substance addiction and non-substance (or behavioural) addiction, and to identify commonalities and differences between them. Our study confirms the existence of alterations during reward processing in obesity, non-substance addiction and substance addiction. Specifically, participants with obesity or with addictions differed from controls in several brain regions including prefrontal areas, subcortical structures and sensory areas. Additionally, participants with obesity and substance addictions exhibited similar blood-oxygen-level-dependent fMRI hyperactivity in the amygdala and striatum when processing either general rewarding stimuli or the problematic stimuli (food and drug-related stimuli, respectively). We propose that these similarities may be associated with an enhanced focus on reward--especially with regard to food or drug-related stimuli--in obesity and substance addiction. Ultimately, this enhancement of reward processes may facilitate the presence of compulsive-like behaviour in some individuals or under some specific circumstances. We hope that increasing knowledge about the neurobehavioural correlates of obesity and addictions will lead to practical strategies that target the high prevalence of these central public health challenges.
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Affiliation(s)
- I García-García
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain; Institute for Brain, Cognition and Behaviour (IR3C), Barcelona, Spain; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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192
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D’Addario C, Micioni Di Bonaventura M, Pucci M, Romano A, Gaetani S, Ciccocioppo R, Cifani C, Maccarrone M. Endocannabinoid signaling and food addiction. Neurosci Biobehav Rev 2014; 47:203-24. [DOI: 10.1016/j.neubiorev.2014.08.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 07/28/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022]
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193
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Meule A, Gearhardt AN. Food addiction in the light of DSM-5. Nutrients 2014; 6:3653-71. [PMID: 25230209 PMCID: PMC4179181 DOI: 10.3390/nu6093653] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 08/21/2014] [Accepted: 08/25/2014] [Indexed: 12/18/2022] Open
Abstract
The idea that specific kind of foods may have an addiction potential and that some forms of overeating may represent an addicted behavior has been discussed for decades. In recent years, the interest in food addiction is growing and research on this topic lead to more precise definitions and assessment methods. For example, the Yale Food Addiction Scale has been developed for the measurement of addiction-like eating behavior based on the diagnostic criteria for substance dependence of the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). In 2013, diagnostic criteria for substance abuse and-dependence were merged, thereby increasing the number of symptoms for substance use disorders (SUDs) in the DSM-5. Moreover, gambling disorder is now included along SUDs as a behavioral addiction. Although a plethora of review articles exist that discuss the applicability of the DSM-IV substance dependence criteria to eating behavior, the transferability of the newly added criteria to eating is unknown. Thus, the current article discusses if and how these new criteria may be translated to overeating. Furthermore, it is examined if the new SUD criteria will impact future research on food addiction, for example, if "diagnosing" food addiction should also be adapted by considering all of the new symptoms. Given the critical response to the revisions in DSM-5, we also discuss if the recent approach of Research Domain Criteria can be helpful in evaluating the concept of food addiction.
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Affiliation(s)
- Adrian Meule
- Institute of Psychology, University of Würzburg, Marcusstr. 9-11, Würzburg 97070, Germany.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, USA.
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194
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Murray S, Tulloch A, Gold MS, Avena NM. Hormonal and neural mechanisms of food reward, eating behaviour and obesity. Nat Rev Endocrinol 2014; 10:540-52. [PMID: 24958311 DOI: 10.1038/nrendo.2014.91] [Citation(s) in RCA: 147] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
With rising rates of obesity, research continues to explore the contributions of homeostatic and hedonic mechanisms related to eating behaviour. In this Review, we synthesize the existing information on select biological mechanisms associated with reward-related food intake, dealing primarily with consumption of highly palatable foods. In addition to their established functions in normal feeding, three primary peripheral hormones (leptin, ghrelin and insulin) play important parts in food reward. Studies in laboratory animals and humans also show relationships between hyperphagia or obesity and neural pathways involved in reward. These findings have prompted questions regarding the possibility of addictive-like aspects in food consumption. Further exploration of this topic may help to explain aberrant eating patterns, such as binge eating, and provide insight into the current rates of overweight and obesity.
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Affiliation(s)
- Susan Murray
- New York Obesity Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, P&S Box 30 DOM/NYORC, 630 West 168th Street, New York, NY 10032-3702, USA
| | - Alastair Tulloch
- New York Obesity Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, P&S Box 30 DOM/NYORC, 630 West 168th Street, New York, NY 10032-3702, USA
| | - Mark S Gold
- Department of Psychiatry, College of Medicine, University of Florida, McKnight Brain Institute, 1149 SW Newell Drive, L4-100, Gainesville, FL 32610, USA
| | - Nicole M Avena
- New York Obesity Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, P&S Box 30 DOM/NYORC, 630 West 168th Street, New York, NY 10032-3702, USA
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195
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Abstract
Food is a potent natural reward and food intake is a complex process. Reward and gratification associated with food consumption leads to dopamine (DA) production, which in turn activates reward and pleasure centers in the brain. An individual will repeatedly eat a particular food to experience this positive feeling of gratification. This type of repetitive behavior of food intake leads to the activation of brain reward pathways that eventually overrides other signals of satiety and hunger. Thus, a gratification habit through a favorable food leads to overeating and morbid obesity. Overeating and obesity stems from many biological factors engaging both central and peripheral systems in a bi-directional manner involving mood and emotions. Emotional eating and altered mood can also lead to altered food choice and intake leading to overeating and obesity. Research findings from human and animal studies support a two-way link between three concepts, mood, food, and obesity. The focus of this article is to provide an overview of complex nature of food intake where various biological factors link mood, food intake, and brain signaling that engages both peripheral and central nervous system signaling pathways in a bi-directional manner in obesity.
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Affiliation(s)
- Minati Singh
- Department of Pediatrics, University of Iowa Iowa City, IA, USA ; Department of Pediatrics, HHMI, University of Iowa Iowa City, IA, USA
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196
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Abstract
As the lifestyle medicine movement continues to gain traction and strength, it is critically important that lifestyle medicine practitioners base their recommendations on the best available evidence. This review outlines ways of accomplishing that goal. The core concepts behind lifestyle medicine reside in many different bodies of information. These include nutrition, exercise physiology, behavioral medicine, psychology, and many more. Lifestyle medicine practitioners will need to be knowledgeable in all of these areas. A good place to start is with the evidence-based recommendations put out by major national bodies. The Dietary Guidelines for Americans and Physical Activity Guidelines for Americans also provide comprehensive, evidence-based information regarding these 2 critically important modalities. This review also discusses ways that scientific information is often distorted and how conjecture may sometimes be confused with proof. The review concludes with some recommendations for how lifestyle medicine practitioners can ground their recommendations on sound scientific evidence.
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197
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Velázquez-Sánchez C, Ferragud A, Moore CF, Everitt BJ, Sabino V, Cottone P. High trait impulsivity predicts food addiction-like behavior in the rat. Neuropsychopharmacology 2014; 39:2463-72. [PMID: 24776685 PMCID: PMC4138758 DOI: 10.1038/npp.2014.98] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/24/2014] [Accepted: 04/24/2014] [Indexed: 12/19/2022]
Abstract
Impulsivity is a behavioral trait frequently seen not only in drug-addicted individuals but also in individuals who pathologically overeat. However, whether impulsivity predates the development of uncontrollable feeding is unknown. In this study, we hypothesized that a high impulsivity trait precedes and confers vulnerability for food addiction-like behavior. For this purpose, we trained ad libitum-fed male Wistar rats in a differential reinforcement of low rates of responding (DRL) task to select Low- and High-impulsive rats. Then, we allowed Low- and High-impulsive rats to self-administer a highly palatable diet (Palatable group) or a regular chow diet (Chow group) in 1-h daily sessions, under fixed ratio (FR) 1, FR3, FR5, and under a progressive ratio (PR) schedules of reinforcement. In addition, we tested the compulsiveness for food in Low- and High-impulsive rats by measuring the food eaten in the aversive, open compartment of a light/dark conflict test. Finally, we measured the expression of the transcription factor ΔFosB in the shell and the core of the nucleus accumbens, which is a marker for neuroadaptive changes following addictive drug exposure. The data we obtained demonstrate that impulsivity is a trait that predicts the development of food addiction-like behaviors, including: (i) excessive intake, (ii) heightened motivation for food, and (iii) compulsive-like eating, when rats are given access to highly palatable food. In addition, we show that the food addiction phenotype in high impulsive subjects is characterized by an increased expression of the transcription factor ΔFosB in the nucleus accumbens shell. These results reveal that impulsivity confers an increased propensity to develop uncontrollable overeating of palatable food.
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Affiliation(s)
- Clara Velázquez-Sánchez
- Laboratory of Addictive Disorders, Departments of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Antonio Ferragud
- Laboratory of Addictive Disorders, Departments of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Catherine F Moore
- Laboratory of Addictive Disorders, Departments of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Barry J Everitt
- Behavioral and Clinical Neuroscience Institute and Department of Experimental Psychology, University of Cambridge, Cambridge, UK
| | - Valentina Sabino
- Laboratory of Addictive Disorders, Departments of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Pietro Cottone
- Laboratory of Addictive Disorders, Departments of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, Boston, MA, USA,Laboratory of Addictive Disorders, Departments of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E Concord Street, R-618, Boston, MA 02118, USA, Tel: +1 617 638 5662, E-mail:
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198
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van de Giessen E, Celik F, Schweitzer DH, van den Brink W, Booij J. Dopamine D2/3 receptor availability and amphetamine-induced dopamine release in obesity. J Psychopharmacol 2014; 28:866-73. [PMID: 24785761 DOI: 10.1177/0269881114531664] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The neurotransmitter dopamine is important in the regulation of food intake. It is hypothesised that obese people experience less reward from food due to lower striatal dopamine release, which consequently leads to overeating. This study is the first to assess whether obese subjects have blunted striatal dopamine release. METHOD We measured striatal dopamine D2/3 receptor (DRD2/3) availability and amphetamine-induced striatal dopamine release in 15 obese and 15 age-matched, normal-weight women using [(123)I]iodobenzamide single photon emission computed tomography (SPECT) imaging. In addition, correlations with food craving were examined. RESULTS Baseline striatal DRD2/3 availability was lower in obese subjects (0.91 ± 0.16) compared to controls (1.09 ± 0.16; p = 0.006). Amphetamine-induced dopamine release was significant in controls (7.5% ± 9.2; p = 0.007) and not in obese subjects (1.2% ± 17.7; p = 0.802), although the difference in release between groups (d=0.45) was not significant. Dopamine release positively correlated with the trait food craving in obese subjects. CONCLUSION This study replicates previous findings of lower striatal DRD2/3 availability in obesity and provides preliminary data that obesity is associated with blunted dopamine release. The positive correlation between dopamine release and food craving in obesity may seem contradictory with the latter finding but is presumably related to heterogeneity within the obese subjects.
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Affiliation(s)
- Elsmarieke van de Giessen
- Department of Nuclear Medicine, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - Funda Celik
- Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
| | - Dave H Schweitzer
- Department of Internal Medicine, Reinier de Graaf Group of Hospitals, Delft, The Netherlands
| | - Wim van den Brink
- Amsterdam Institute for Addiction Research, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Booij
- Department of Nuclear Medicine, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
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199
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Verdejo-García A, Verdejo-Román J, Rio-Valle JS, Lacomba JA, Lagos FM, Soriano-Mas C. Dysfunctional involvement of emotion and reward brain regions on social decision making in excess weight adolescents. Hum Brain Mapp 2014; 36:226-37. [PMID: 25168709 DOI: 10.1002/hbm.22625] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 07/27/2014] [Accepted: 08/21/2014] [Indexed: 02/02/2023] Open
Abstract
Obese adolescents suffer negative social experiences, but no studies have examined whether obesity is associated with dysfunction of the social brain or whether social brain abnormalities relate to disadvantageous traits and social decisions. We aimed at mapping functional activation differences in the brain circuitry of social decision making in adolescents with excess versus normal weight, and at examining whether these separate patterns correlate with reward/punishment sensitivity, disordered eating features, and behavioral decisions. In this fMRI study, 80 adolescents aged 12 to 18 years old were classified in two groups based on age adjusted body mass index (BMI) percentiles: normal weight (n = 44, BMI percentiles 5th-84th) and excess weight (n = 36, BMI percentile ≥ 85th). Participants were scanned while performing a social decision-making task (ultimatum game) in which they chose to "accept" or "reject" offers to split monetary stakes made by another peer. Offers varied in fairness (Fair vs. Unfair) but in all cases "accepting" meant both players win the money, whereas "rejecting" meant both lose it. We showed that adolescents with excess weight compared to controls display significantly decreased activation of anterior insula, anterior cingulate, and midbrain during decisions about Unfair versus Fair offers. Moreover, excess weight subjects show lower sensitivity to reward and more maturity fears, which correlate with insula activation. Indeed, blunted insula activation accounted for the relationship between maturity fears and acceptance of unfair offers. Excess weight adolescents have diminished activation of brain regions essential for affective tracking of social decision making, which accounts for the association between maturity fears and social decisions.
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Affiliation(s)
- Antonio Verdejo-García
- School of Psychological Sciences, Monash University, 3800 Wellington Rd, Melbourne (Australia); Department of Clinical Psychology & Institute of Neuroscience F. Oloriz, Universidad de Granada, Universidad de Granada. Campus de Cartuja S/N, 18071 Granada, Spain
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200
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Södersten P, Bergh C, Zandian M, Ioakimidis I. Homeostasis in anorexia nervosa. Front Neurosci 2014; 8:234. [PMID: 25147496 PMCID: PMC4123620 DOI: 10.3389/fnins.2014.00234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/15/2014] [Indexed: 12/20/2022] Open
Abstract
Brainstem and hypothalamic “orexigenic/anorexigenic” networks are thought to maintain body weight homeostasis in response to hormonal and metabolic feedback from peripheral sites. This approach has not been successful in managing over- and underweight patients. It is suggested that concept of homeostasis has been misinterpreted; rather than exerting control, the brain permits eating in proportion to the amount of physical activity necessary to obtain food. In support, animal experiments have shown that while a hypothalamic “orexigen” excites eating when food is abundant, it inhibits eating and stimulates foraging when food is in short supply. As the physical price of food approaches zero, eating and body weight increase without constraints. Conversely, in anorexia nervosa body weight is homeostatically regulated, the high level of physical activity in anorexia is displaced hoarding for food that keeps body weight constantly low. A treatment based on this point of view, providing patients with computerized mealtime support to re-establish normal eating behavior, has brought 75% of patients with eating disorders into remission, reduced the rate of relapse to 10%, and eliminated mortality.
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Affiliation(s)
- Per Södersten
- Section of Applied Neuroendocrinology, Karolinska Institutet Huddinge, Sweden
| | - Cecilia Bergh
- Section of Applied Neuroendocrinology, Karolinska Institutet Huddinge, Sweden
| | - Modjtaba Zandian
- Section of Applied Neuroendocrinology, Karolinska Institutet Huddinge, Sweden
| | - Ioannis Ioakimidis
- Section of Applied Neuroendocrinology, Karolinska Institutet Huddinge, Sweden
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