Neurophysiological Pathways to Obesity: Below Awareness and Beyond Individual Control

RAND Corporation, Santa Monica, California, USA.
Diabetes (Impact Factor: 8.1). 08/2008; 57(7):1768-73. DOI: 10.2337/db08-0163
Source: PubMed


A global obesity epidemic is occurring simultaneously with ongoing increases in the availability and salience of food in the environment. Obesity is increasing across all socioeconomic groups and educational levels and occurs even among individuals with the highest levels of education and expertise in nutrition and related fields. Given these circumstances, it is plausible that excessive food consumption occurs in ways that defy personal insight or are below individual awareness. The current food environment stimulates automatic reflexive responses that enhance the desire to eat and increase caloric intake, making it exceedingly difficult for individuals to resist, especially because they may not be aware of these influences. This article identifies 10 neurophysiological pathways that can lead people to make food choices subconsciously or, in some cases, automatically. These pathways include reflexive and uncontrollable neurohormonal responses to food images, cues, and smells; mirror neurons that cause people to imitate the eating behavior of others without awareness; and limited cognitive capacity to make informed decisions about food. Given that people have limited ability to shape the food environment individually and no ability to control automatic responses to food-related cues that are unconsciously perceived, it is incumbent upon society as a whole to regulate the food environment, including the number and types of food-related cues, portion sizes, food availability, and food advertising.

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    • "Obesity is a growing public health concern with many contributing factors (Cohen, 2008; Caballero, 2007). Numerous biological, social, and learned factors contribute to feeding behavior, including initiation and termination of food intake (Berthoud, Woods, Cowley, Levin, & Kelley, 2002; Berthoud, 2012). "
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    ABSTRACT: Defects in experiencing disgust may contribute to obesity by allowing for the overconsumption of food. However, the relationship of disgust proneness and its associated neural locus has yet to be explored in the context of obesity. Thirty-three participants (17 obese; 16 lean) completed the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R) and an fMRI paradigm where images from four categories (food, contaminates, contaminated food, or fixation) were randomly presented. Independent two-sample t-tests revealed significantly lower levels of Disgust Sensitivity for the obese group (mean score=14.7) compared to the lean group (mean score=17.6), p=0.026. The obese group had less activation in the right insula than the lean group when viewing contaminated food images. Multiple regression with interaction analysis revealed one left insula region where the association of Disgust Sensitivity scores with activation differed by group when viewing contaminated food images. These interaction effects were driven by the negative correlation of Disgust Sensitivity scores with beta values extracted from the left insula in the obese group (r=-0.59) compared to a positive correlation in the lean group (r=0.65). Given these BMI-dependent differences in Disgust Sensitivity and neural responsiveness to disgusting food images it is likely that altered Disgust Sensitivity may contribute to obesity.
    Social Cognitive and Affective Neuroscience 10/2015; DOI:10.1093/scan/nsv129 · 7.37 Impact Factor
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    • "There is little evidence to support the idea that individual behavioral change strategies will succeed at overcoming the influence of environmental factors and at overcoming automatic and subconscious influences on food consumption . Besides, as addressed above, economists inform us that a significant number of Americans choose, buy, and eat their food mainly on taste, convenience, and economic motivations and not primarily for health reasons (Cohen, 2008). The days of eating food principally for health and survival reasons have been replaced by contemporary desires and economic realities. "
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    ABSTRACT: Using and adopting Simon Szreter's framework on how economic growth had a deleterious effect on children's health during the Industrial Revolution, this article presents a parallel argument that economic growth, in modern times, also has disrupted the lives of our children expressed by increasing rates of childhood obesity. A comprehensive perspective is presented that describes how economic growth in postindustrial United States has distracted our nation's attention away from a public health's concern for the health of children and social justice. The new normal of childhood obesity represents a disconnection from the harmful reality of childhood obesity and displaces the value of childhood health too far behind adult's pursuits of utility. To provide children a fair opportunity to health, and to help children secure their own future liberty and utility, children need to be able to achieve "just levels" of health that would ordinarily exist if remediable injustices that threaten health were reasonably addressed and eliminated. © 2015 Society for Public Health Education.
    Health Education & Behavior 04/2015; 42(1 Suppl):67S-75S. DOI:10.1177/1090198114566802 · 2.23 Impact Factor
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    • "Converging evidence suggests that the experience of LOC eating, rather than objective size or frequency of amount consumed, is the characteristic of BE most associated with distress and poor outcomes (Latner, Hildebrandt, Rosewall, Chisholm, & Hayashi, 2007; Mond, Latner, Hay, Owen, & Rodgers, 2010). A growing body of literature suggests that implicit neurocognitive processes, such as executive functioning (EF), may underlie the regulation of eating behaviour and food intake (Cohen, 2008). EF deficits have been detected across a wide spectrum of eating and weight-related disorders (Fagundo et al., 2012); however, the neurocognitive characterisation of individuals with LOC eating in the absence of compensatory behaviour (e.g. "
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    ABSTRACT: Objective: The current study sought to examine executive function (EF) in overweight individuals with and without loss-of-control (LOC) eating. Method: Eighty overweight and obese individuals entering a behavioural weight loss trial with (n=18) and without (n=62) LOC eating were administered a clinical interview and neuropsychological battery designed to assess self-regulatory control, planning, delayed discounting and working memory. Results: After controlling for age, IQ and depression, individuals with LOC eating performed worse on tasks of planning and self-regulatory control and did not differ in performance on other tasks. Discussion: Results indicate that overweight individuals with LOC eating display relative deficits in EF compared with overweight individuals without LOC eating. Planning and self-regulatory control deficits in particular may contribute to dysregulated eating patterns, increasing susceptibility to LOC episodes. Future research should examine how EF deficits relate to treatment outcome.
    European Eating Disorders Review 09/2014; DOI:10.1002/erv.2304 · 2.46 Impact Factor
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