Food for Thought: Reward Mechanisms and Hedonic Overeating in Obesity
Purpose of Review
This review examines the food addiction model and the role of food hedonic pathways in the pathogenesis and treatment of obesity.
The hedonic pathway interacts with the obesogenic environment to override homeostatic mechanisms to cause increase in body weight. Weight gain sustained over time leads to “upward setting” of defended level of body-fat mass. There are neurobiological and phenotypic similarities and differences between hedonic pathways triggered by food compared with other addictive substances, and the entity of food addiction remains controversial. Treatment for obesity including pharmacotherapy and bariatric surgery impacts on neural pathways governing appetite and hedonic control of food intake. The food addiction model may also have significant impact on public health policy, regulation of certain foods, and weight stigma and bias.
Recent rapid progress in delineation of food hedonic pathways advances our understanding of obesity and facilitates development of effective treatment measures against the disease.
KeywordsObesity Hedonic overeating Food reward pathway Energy homeostasis Neural control of appetite
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 10.Speakman JR, Levitsky DA, Allison DB, Bray MS, de Castro JM, Clegg DJ, et al. Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity. Dis Model Mech. 2011;4(6):733–45.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Cameron JD, Chaput JP, Sjodin AM, Goldfield GS. Brain on fire: incentive salience, hedonic hot spots, dopamine, obesity, and other hunger games. Annu Rev Nutr. 2017.Google Scholar
- 18.Finlayson G. Food addiction and obesity: unnecessary medicalization of hedonic overeating. Nat Rev Endocrinol. 2017.Google Scholar
- 23.McCaffery JM, Haley AP, Sweet LH, Phelan S, Raynor HA, Del Parigi A, et al. Differential functional magnetic resonance imaging response to food pictures in successful weight-loss maintainers relative to normal-weight and obese controls. Am J Clin Nutr. 2009;90(4):928–34.CrossRefPubMedPubMedCentralGoogle Scholar
- 32.• Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52(2):430–6. This study proposes a novel questionnaire to diagnose food addiction based on substance addiction criteria and has spurred research into the area of food addiction. CrossRefPubMedGoogle Scholar
- 43.• Cornelis MC, Flint A, Field AE, Kraft P, Han J, Rimm EB, et al. A genome-wide investigation of food addiction. Obesity (Silver Spring). 2016;24(6):1336–41. This study involved genome-wide investigation of YFAS-diagnosed food addiction cohort and found limited similarities between food addiction and drug addiction. CrossRefGoogle Scholar
- 45.Mason AE, Epel ES, Aschbacher K, Lustig RH, Acree M, Kristeller J, et al. Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: data from the SHINE randomized controlled trial. Appetite. 2016;100:86–93.CrossRefPubMedPubMedCentralGoogle Scholar
- 46.Mason AE, Epel ES, Kristeller J, Moran PJ, Dallman M, Lustig RH, et al. Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. J Behav Med. 2016;39(2):201–13.CrossRefPubMedGoogle Scholar
- 52.Contrave Product Information Website. [Available from: https://contrave.com/.]
- 54.Farr OM, Sofopoulos M, Tsoukas MA, Dincer F, Thakkar B, Sahin-Efe A, et al. GLP-1 receptors exist in the parietal cortex, hypothalamus and medulla of human brains and the GLP-1 analogue liraglutide alters brain activity related to highly desirable food cues in individuals with diabetes: a crossover, randomised, placebo-controlled trial. Diabetologia. 2016;59(5):954–65.CrossRefPubMedPubMedCentralGoogle Scholar
- 66.• Scholtz S, Miras AD, Chhina N, Prechtl CG, Sleeth ML, Daud NM, et al. Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding. Gut. 2014;63(6):891–902. This study compares the brain hedonic responses to different bariatric procedures using fMRI. CrossRefPubMedGoogle Scholar
- 69.Sanmiguel CP, Jacobs J, Gupta A, Ju T, Stains J, Coveleskie K, et al. Surgically induced changes in gut microbiome and hedonic eating as related to weight loss: preliminary findings in obese women undergoing bariatric surgery. Psychosom Med. 2017.Google Scholar
- 70.• King WC, Chen JY, Mitchell JE, Kalarchian MA, Steffen KJ, Engel SG, et al. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA. 2012;307(23):2516–2525. This study examined the prevalence and factors associated with alcohol use disorders in the prospective Longitudinal Assessment of Bariatric Surgery-2 cohort. Google Scholar