Elevated brain reward region response to food cues, & a genetic propensity for greater dopamine signaling, predict weight gain; youth who show greater food reward-cue learning show greater gains

Neural vulnerability factors for obesity. Eric Stice, Kyle Burger. Clinical Psychology Review, https://doi.org/10.1016/j.cpr.2018.12.002

Highlights
•    Youth at risk for weight gain show greater reward region response to food tastes.
•    Elevated brain reward region response to food cues predicts future weight gain.
•    A genetic propensity for greater dopamine signaling predicts weight gain.
•    Youth who show greater food reward-cue learning show greater weight gain.
•    Overeating reduces reward region response to high-calorie foods.
•    Data provide strong support for the incentive sensitization theory of obesity.

Abstract: Multiple theories identify neural vulnerability factors that may increase risk for overeating and weight gain. Early cross-sectional neuroimaging studies were unable to determine whether aberrant neural responsivity was a risk factor for or a consequence of overeating. More recent obesity risk, prospective, repeated-measures, and experimental neuroimaging studies with humans have advanced knowledge of etiologic processes and neural plasticity resulting from overeating. Herein, we review evidence from these more rigorous human neuroimaging studies, in conjunction with behavioral measures reflecting neural function, as well as experiments with animals that investigated neural vulnerability theories for overeating. Findings provide support for the reward surfeit theory that posits that individuals at risk for obesity initially show hyper-responsivity of reward circuitry to high-calorie food tastes, which theoretically drives elevated intake of such foods. However, findings provide little support for the reward deficit theory that postulates that individuals at risk for obesity show an initial hypo-responsivity of reward circuitry that motives overeating. Further, results provide support for the incentive sensitization and dynamic vulnerability theories that propose that overconsumption of high-calorie foods results in increased reward and attention region responsivity to cues that are associated with hedonic reward from intake of these high-calorie foods via conditioning, as well as a simultaneous decrease in reward region responsivity to high-calorie food tastes. However, there is little evidence that this induced reduction in reward region response to high-calorie food tastes drives an escalation in overeating. Finally, results provide support for the theory that an initial deficit in inhibitory control and a bias for immediate reward contribute to overconsumption of high-calorie foods. Findings imply that interventions that reduce reward and attention region responsivity to food cues and increase inhibitory control should reduce overeating and excessive weight gain, an intervention theory that is receiving support in randomized trials.