Purpose of Review
In the modern obesogenic environment, food cues play a crucial role in the development of obesity by disrupting hormone and energy balance mechanisms. Thus, it is critical to understand the neurobiology of feeding behaviors and obesity in the context of ubiquitous food cues. The current paper reviews the physiology of feeding, hormonal regulation of energy balance, and food cue responses and discusses their contributions to obesity.
Food cues have strong impact on human physiology. Obese individuals have altered food cue-elicited responses in the brain and periphery, overpowering hormone and energy balance regulation. Disrupted homeostasis during food cue exposure leads to continued food intake, unsuccessful weight management, and poor treatment outcomes, which further contributes to obesity epidemic.
Findings from the review emphasize the crucial role of food cues in obesity epidemic, which necessitates multidimensional approaches to the prevention and treatment of obesity, including psychosocial interventions to reduce food cue reactivity, along with conventional treatment.
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C D Fryar, M D Carroll and C L Ogden. Prevalence of overweight, obesity, and extreme obesity among adults: United States, trends 1960–1962 through 2009–2010. NCHS Health E-Stat. 2014.
Mitchell NS, Catenacci VA, Wyatt HR, Hill JO. Obesity: overview of an epidemic. Psychiatr Clin North Am. 2011;34(4):717–32.
Swinburn B, Sacks G, Ravussin E. Increased food energy supply is more than sufficient to explain the US epidemic of obesity. Am J Clin Nutr. 2009;90(6):1453–6.
Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–14.
Yang W, Kelly T, He J. Genetic epidemiology of obesity. Epidemiol Rev. 2007;29:49–61.
Locke AE, Kahali B, Berndt SI, Justice AE, Pers TH, Day FR, et al. Genetic studies of body mass index yield new insights for obesity biology. Nature. 2015;518(7538):197–206.
Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology. 2007;132(6):2087–102.
Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science. 1998;280(5368):1371–4.
King DM, Jacobson SH. What is driving obesity? A review on the connections between obesity and motorized transportation. Curr Obes Rep. 2017;6(1):3–9.
Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. Arch Pediatr Adolesc Med. 1996;150(4):356–62.
Westerterp-Plantenga MS, Wijckmans-Duijsens NE, Verboeket-van de Venne WP, de Graaf K, van het Hof KH, Weststrate JA. Energy intake and body weight effects of six months reduced or full fat diets, as a function of dietary restraint. Int J Obes Relat Metab Disord. 1998;22(1):14–22.
Yao M, Roberts SB. Dietary energy density and weight regulation. Nutr Rev. 2001;59(8 Pt 1):247–58.
• Gittelsohn J, Trude A. Diabetes and obesity prevention: changing the food environment in low-income settings. Nutr Rev. 2017;75(suppl 1):62–9. A review of 10 community trials evaluating the impact of changes in the food environment in low-income minority settings.
Koplan JP, Dietz WH. Caloric imbalance and public health policy. JAMA. 1999;282(16):1579–81.
Cutler D, Glaeser E, Shapiro J. Why have Americans become more obese. J Econ Perspect. 2003;17(3):93–118.
• Louzada ML, Baraldi LG, Steele EM, Martins AP, Canella DS, Moubarac JC, et al. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med. 2015;81:9–15. A dietary survey from 30,243 individuals in Brazil demonstrated that ultra-processed food is associated with obesity and weight gain.
Putnam J, Allshouse J, Kantor LS. U.S. per capita food supply trends: more calories, refined carbohydrates, and fats. Food Rev: Mag Food Econ. 2002;25(3):2–15.
Ludwig DS. Technology, diet, and the burden of chronic disease. JAMA. 2011;305(13):1352–3.
Holt SH, Miller JC, Petocz P, Farmakalidis E. A satiety index of common foods. Eur J Clin Nutr. 1995;49(9):675–90.
• Fardet A. Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods. Food Funct. 2016;7(5):2338–46. Evaluation of the glycemic glucose equivalent (GGE) of ultraprocessed food on satiety and blood glucose levels. Ultraprocessed food was associated with higher glycemic response and decreased satiety.
Volkow ND, Wise RA. How can drug addiction help us understand obesity? Nat Neurosci. 2005;8:555–60.
Cohen DA. Obesity and the built environment: changes in environmental cues cause energy imbalances. Int J Obes. 2008;32(Suppl 7):S137–42.
Volkow ND, Wang GJ, Fowler JS, Tomasi D, Baler R. Food and drug reward: overlapping circuits in human obesity and addiction. In: Carter CS, Dalley JW, editors. Brain imaging in behavioral neuroscience. Berlin, Heidelberg: Springer Berlin Heidelberg; 2012. p. 1–24.
Carnell S, Gibson C, Benson L, Ochner CN, Geliebter A. Neuroimaging and obesity: current knowledge and future directions. Obes Rev. 2012;13(1):43–56.
Berthoud HR. Homeostatic and non-homeostatic pathways involved in the control of food intake and energy balance. Obesity (Silver Spring). 2006;14(Suppl 5):197S–200S.
Christensen CM, Navazesh M. Anticipatory salivary flow to the sight of different foods. Appetite. 1984;5(4):307–15.
Pangborn RM, Berggren B. Human parotid secretion in response to pleasant and unpleasant odorants. Psychophysiology. 1973;10(3):231–7.
Lindemann B. Receptors and transduction in taste. Nature. 2001;413(6852):219–25.
Morton GJ, Meek TH, Schwartz MW. Neurobiology of food intake in health and disease. Nat Rev Neurosci. 2014;15(6):367–78.
Kairupan TS, Amitani H, Cheng KC, Runtuwene J, Asakawa A, Inui A. Role of gastrointestinal hormones in feeding behavior and obesity treatment. J Gastroenterol. 2016;51(2):93–103.
Gao Q, Horvath TL. Neurobiology of feeding and energy expenditure. Annu Rev Neurosci. 2007;30:367–98.
Strader AD, Woods SC. Gastrointestinal hormones and food intake. Gastroenterology. 2005;128(1):175–91.
Begg DP, Woods SC. The endocrinology of food intake. Nat Rev Endocrinol. 2013;9(10):584–97.
•• Timper K, Bruning JC. Hypothalamic circuits regulating appetite and energy homeostasis: pathways to obesity. Dis Model Mech. 2017;10(6):679–89. A review with the latest information about the role of the hypothalamus on feeding and the pathogenesis of obesity.
Berthoud HR, Bereiter DA, Trimble ER, Siegel EG, Jeanrenaud B. Cephalic phase, reflex insulin secretion neuroanatomical and physiological characterization. Diabetologia. 1981;20(Suppl 1):393–401.
Drazen DL, Vahl TP, D’Alessio DA, Seeley RJ, Woods SC. Effects of a fixed meal pattern on ghrelin secretion: evidence for a learned response independent of nutrient status. Endocrinology. 2006;147(1):23–30.
Simon C, Schlienger JL, Sapin R, Imler M. Cephalic phase insulin secretion in relation to food presentation in normal and overweight subjects. Physiol Behav. 1986;36(3):465–9.
Schussler P, Kluge M, Yassouridis A, Dresler M, Uhr M, Steiger A. Ghrelin levels increase after pictures showing food. Obesity (Silver Spring). 2012;20(6):1212–7.
Vahl TP, Drazen DL, Seeley RJ, D’Alessio DA, Woods SC. Meal-anticipatory glucagon-like peptide-1 secretion in rats. Endocrinology. 2010;151(2):569–75.
Chen M, Porte D Jr. The effect of rate and dose of glucose infusion on the acute insulin response in man. J Clin Endocrinol Metab. 1976;42(6):1168–75.
Polonsky KS, Given BD, Van Cauter E. Twenty-four-hour profiles and pulsatile patterns of insulin secretion in normal and obese subjects. J Clin Invest. 1988;81(2):442–8.
Woods SC, Lotter EC, McKay LD, Porte D. Chronic intracerebroventricular infusion of insulin reduces food intake and body weight of baboons. Nature. 1979;282:503–5.
Baura GD, Foster DM, Porte D Jr, Kahn SE, Bergman RN, Cobelli C, et al. Saturable transport of insulin from plasma into the central nervous system of dogs in vivo. A mechanism for regulated insulin delivery to the brain. J Clin Invest. 1993;92(4):1824–30.
Banks WA, Jaspan JB, Kastin AJ. Selective, physiological transport of insulin across the blood-brain barrier: novel demonstration by species-specific radioimmunoassays. Peptides. 1997;18(8):1257–62.
Unger J, McNeill TH, Moxley RT 3rd, White M, Moss A, Livingston JN. Distribution of insulin receptor-like immunoreactivity in the rat forebrain. Neuroscience. 1989;31(1):143–57.
Florant GL, Singer L, Scheurink AJ, Park CR, Richardson RD, Woods SC. Intraventricular insulin reduces food intake and body weight of marmots during the summer feeding period. Physiol Behav. 1991;49(2):335–8.
Honda K, Kamisoyama H, Saneyasu T, Sugahara K, Hasegawa S. Central administration of insulin suppresses food intake in chicks. Neurosci Lett. 2007;423(2):153–7.
Brown LM, Clegg DJ, Benoit SC, Woods SC. Intraventricular insulin and leptin reduce food intake and body weight in C57BL/6J mice. Physiol Behav. 2006;89(5):687–91.
Konner AC, Janoschek R, Plum L, Jordan SD, Rother E, Ma X, et al. Insulin action in AgRP-expressing neurons is required for suppression of hepatic glucose production. Cell Metab. 2007;5(6):438–49.
Williams KW, Margatho LO, Lee CE, Choi M, Lee S, Scott MM, et al. Segregation of acute leptin and insulin effects in distinct populations of arcuate proopiomelanocortin neurons. J Neurosci. 2010;30(7):2472–9.
Hallschmid M, Benedict C, Schultes B, Fehm HL, Born J, Kern W. Intranasal insulin reduces body fat in men but not in women. Diabetes. 2004;53(11):3024–9.
Bagdade JD, Bierman EL, Porte D Jr. The significance of basal insulin levels in the evaluation of the insulin response to glucose in diabetic and nondiabetic subjects. J Clin Invest. 1967;46(10):1549–57.
Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996;334(5):292–5.
Campfield LA, Smith FJ, Guisez Y, Devos R, Burn P. Recombinant mouse OB protein: evidence for a peripheral signal linking adiposity and central neural networks. Science. 1995;269(5223):546–9.
Montague CT, Farooqi IS, Whitehead JP, Soos MA, Rau H, Wareham NJ, et al. Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature. 1997;387(6636):903–8.
Brubaker PL, Anini Y. Direct and indirect mechanisms regulating secretion of glucagon-like peptide-1 and glucagon-like peptide-2. Can J Physiol Pharmacol. 2003;81(11):1005–12.
Willms B, Werner J, Holst JJ, Orskov C, Creutzfeldt W, Nauck MA. Gastric emptying, glucose responses, and insulin secretion after a liquid test meal: effects of exogenous glucagon-like peptide-1 (GLP-1)-(7-36) amide in type 2 (noninsulin-dependent) diabetic patients. J Clin Endocrinol Metab. 1996;81(1):327–32.
Campos RV, Lee YC, Drucker DJ. Divergent tissue-specific and developmental expression of receptors for glucagon and glucagon-like peptide-1 in the mouse. Endocrinology. 1994;134(5):2156–64.
Srivastava G, Apovian CM. Current pharmacotherapy for obesity. Nat Rev Endocrinol. 2018;14(1):12–24.
Date Y, Kojima M, Hosoda H, Sawaguchi A, Mondal MS, Suganuma T, et al. Ghrelin, a novel growth hormone-releasing acylated peptide, is synthesized in a distinct endocrine cell type in the gastrointestinal tracts of rats and humans. Endocrinology. 2000;141(11):4255–61.
Higgins SC, Gueorguiev M, Korbonits M. Ghrelin, the peripheral hunger hormone. Ann Med. 2007;39(2):116–36.
Asakawa A, Inui A, Kaga T, Yuzuriha H, Nagata T, Ueno N, et al. Ghrelin is an appetite-stimulatory signal from stomach with structural resemblance to motilin. Gastroenterology. 2001;120(2):337–45.
Wren AM, Seal LJ, Cohen MA, Brynes AE, Frost GS, Murphy KG, et al. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab. 2001;86(12):5992.
Myers MG Jr, Olson DP. Central nervous system control of metabolism. Nature. 2012;491(7424):357–63.
Davis JD, Wirtshafter D, Asin KE, Brief D. Sustained intracerebroventricular infusion of brain fuels reduces body weight and food intake in rats. Science. 1981;212(4490):81–3.
Page KA, Chan O, Arora J, Belfort-Deaguiar R, Dzuira J, Roehmholdt B, et al. Effects of fructose vs glucose on regional cerebral blood flow in brain regions involved with appetite and reward pathways. JAMA. 2013;309(1):63–70.
Obici S, Feng Z, Morgan K, Stein D, Karkanias G, Rossetti L. Central administration of oleic acid inhibits glucose production and food intake. Diabetes. 2002;51(2):271–5.
Louis-Sylvestre J, Le Magnen J. Fall in blood glucose level precedes meal onset in free-feeding rats. Neurosci Biobehav Rev. 1980;4(Suppl 1):13–5.
Campfield LA, Smith FJ, Rosenbaum M, Hirsch J. Human eating: evidence for a physiological basis using a modified paradigm. Neurosci Biobehav Rev. 1996;20:133–7.
Mayer J. Glucostatic mechanism of regulation of food intake. N Engl J Med. 1953;249(1):13–6.
Slusser PG, Ritter RC. Increased feeding and hyperglycemia elicited by intracerebroventricular 5-thioglucose. Brain Res. 1980;202(2):474–8.
Lotter EC, Woods SC. Injections of insulin and changes of body weight. Physiol Behav. 1977;18(2):293–7.
Thompson DA, Campbell RG. Hunger in humans induced by 2-deoxy-D-glucose: glucoprivic control of taste preference and food intake. Science. 1977;198(4321):1065–8.
Flatt JP. What do we most need to learn about food intake regulation? Obes Res. 1998;6(4):307–10.
Tschop M, Weyer C, Tataranni PA, Devanarayan V, Ravussin E, Heiman ML. Circulating ghrelin levels are decreased in human obesity. Diabetes. 2001;50(4):707–9.
Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, Brychta R, et al. Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity (Silver Spring). 2016;24(8):1612–9.
Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597–604.
Strohacker K, McCaffery JM, MacLean PS, Wing RR. Adaptations of leptin, ghrelin or insulin during weight loss as predictors of weight regain: a review of current literature. Int J Obes. 2014;38(3):388–96.
Martin-Soelch C, Linthicum J, Ernst M. Appetitive conditioning: neural bases and implications for psychopathology. Neurosci Biobehav Rev. 2007;31(3):426–40.
Yokum S, Ng J, Stice E. Attentional bias to food images associated with elevated weight and future weight gain: an fMRI study. Obesity. 2011;19(9):1775–83.
Jansen A. A learning model of binge eating: cue reactivity and cue exposure. Behav Res Ther. 1998;36(3):257–72.
• Boswell RG, Kober H. Food cue reactivity and craving predict eating and weight gain: a meta-analytic review. Obes Rev. 2016;17(2):159–77. Meta-analyses of 45 studies evaluating the effect of food cues on eating behavior identified that visual food cues were as effective as real food (and more that olfactory cues) in affecting eating behavior and weight gain.
Cleobury L, Tapper K. Reasons for eating ‘unhealthy’ snacks in overweight and obese males and females. J Hum Nutr Diet. 2014;27(4):333–41.
Ferriday D, Brunstrom J. ‘I just can’t help myself’: effects of food-cue exposure in overweight and lean individuals. Int J Obes. 2011;35(1):142–9.
Epstein LH, Paluch R, Coleman KJ. Differences in salivation to repeated food cues in obese and nonobese women. Psychosom Med. 1996;58(2):160–4.
Castellanos EH, Charboneau E, Dietrich MS, Park S, Bradley BP, Mogg K, et al. Obese adults have visual attention bias for food cue images: evidence for altered reward system function. Int J Obes. 2009;33(9):1063–73.
Jansen A, Theunissen N, Slechten K, Nederkoorn C, Boon B, Mulkens S, et al. Overweight children overeat after exposure to food cues. Eat Behav. 2003;4(2):197–209.
Carnell S, Wardle J. Appetite and adiposity in children: evidence for a behavioral susceptibility theory of obesity. Am J Clin Nutr. 2008;88(1):22–9.
Pursey KM, Stanwell P, Callister RJ, Brain K, Collins CE, Burrows TL. Neural responses to visual food cues according to weight status: a systematic review of functional magnetic resonance imaging studies. Front Nutr. 2014;1:7.
Stoeckel LE, Weller RE, Cook EW, Twieg DB, Knowlton RC, Cox JE. Widespread reward-system activation in obese women in response to pictures of high-calorie foods. NeuroImage. 2008;41:636–47.
Brooks SJ, Owen G, Uher R, Friederich H-C, Giampietro V, Brammer M, et al. Differential neural responses to food images in women with bulimia versus anorexia nervosa. PLoS One. 2011;6(7):e22259.
Berthoud H-R, Lenard NR, Shin AC. Food reward, hyperphagia, and obesity. Am J Phys Regul Integr Comp Phys. 2011;300(6):R1266–R77.
Volkow ND, Wang G-J, Fowler JS, Tomasi D. Addiction circuitry in the human brain. Annu Rev Pharmacol Toxicol. 2012;52:321–36.
Jastreboff AM, Lacadie C, Seo D, Kubat J, Van Name MA, Giannini C, et al. Leptin is associated with exaggerated brain reward and emotion responses to food images in adolescent obesity. Diabetes Care. 2014;37(11):3061–8.
Grosshans M, Vollmert C, Vollstadt-Klein S, Tost H, Leber S, Bach P, et al. Association of leptin with food cue-induced activation in human reward pathways. Arch Gen Psychiatry. 2012;69(5):529–37.
Demos KE, Heatherton TF, Kelley WM. Individual differences in nucleus accumbens activity to food and sexual images predict weight gain and sexual behavior. J Neurosci. 2012;32(16):5549–52.
Murdaugh DL, Cox JE, Cook EW, Weller RE. fMRI reactivity to high-calorie food pictures predicts short-and long-term outcome in a weight-loss program. NeuroImage. 2012;59(3):2709–21.
Jansen A, Stegerman S, Roefs A, Nederkoorn C, Havermans R. Decreased salivation to food cues in formerly obese successful dieters. Psychother Psychosom. 2010;79(4):257–8.
Phelan S, Hassenstab J, McCaffery JM, Sweet L, Raynor HA, Cohen RA, et al. Cognitive interference from food cues in weight loss maintainers, normal weight, and obese individuals. Obesity. 2011;19(1):69–73.
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.
Deckersbach T, Das SK, Urban LE, Salinardi T, Batra P, Rodman AM, et al. Pilot randomized trial demonstrating reversal of obesity-related abnormalities in reward system responsivity to food cues with a behavioral intervention. Nutr Diab. 2014;4:e129.
Ochner CN, Kwok Y, Conceição E, Pantazatos SP, Puma LM, Carnell S, et al. Selective reduction in neural responses to high calorie foods following gastric bypass surgery. Ann Surg. 2011;253:502–7.
• Belfort-De Aguiar R, Seo D, Naik S, Hwang J, Lacadie C, Schmidt C, et al. Food image-induced brain activation is not diminished by insulin infusion. Int J Obes (Lond). 2016;40(11):1679–86. In this study, brain responses to food cues were not affected by an intravenous insulin infusion, in comparison to a saline infusion.
Dimitropoulos A, Tkach J, Ho A, Kennedy J. Greater corticolimbic activation to high-calorie food cues after eating in obese vs. normal-weight adults. Appetite. 2012;58(1):303–12.
Le DS, Pannacciulli N, Chen K, Del Parigi A, Salbe AD, Reiman EM, et al. Less activation of the left dorsolateral prefrontal cortex in response to a meal: a feature of obesity. Am J Clin Nutr. 2006;84:725–31.
•• Sun X, Kroemer NB, Veldhuizen MG, Babbs AE, de Araujo IE, Gitelman DR, et al. Basolateral amygdala response to food cues in the absence of hunger is associated with weight gain susceptibility. J Neurosci. 2015;35(20):7964–76. Activity in the amygdala in response to tasting a milkshake in the sated, but not in the hungry state, predicted weight gain in susceptible individuals.
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;90:928–34.
• Maciejewski ML, Arterburn DE, Van Scoyoc L, Smith VA, Yancy WS Jr, Weidenbacher HJ, et al. Bariatric surgery and long-term durability of weight loss. JAMA Surg. 2016;151(11):1046–55. Study showing the 10-year sustained effect of bariatric surgery on weight loss.
Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(Suppl 3):1–203.
This work was funded in part by grants from the NIH (K23 DK098286-02 to R Belfort-DeAguiar from the NIDDK), (K08-AA023545 to D Seo from the NIAAA), and a Young Investigator Grant (Seo) from the Brain and Behavior Research Foundation. This publication was made possible by CTSA Grant Number UL1 TR00142 from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.
Conflict of Interest
Renata Belfort-DeAguiar and Dongju Seo declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
All reported studies/experiments with human subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
This article is part of the Topical Collection on Obesity Treatment
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Belfort-DeAguiar, R., Seo, D. Food Cues and Obesity: Overpowering Hormones and Energy Balance Regulation. Curr Obes Rep 7, 122–129 (2018). https://doi.org/10.1007/s13679-018-0303-1
- Food cues
- Brain activity hormone
- Energy balance