Impact of a randomized controlled trial of discounts on fruits, vegetables, and noncaloric beverages in NYC supermarkets on food intake and health risk factors.

The objective of this study was to observe the effects of a multi-level (30%, 15%, and 0%) randomized discount on fruits, vegetables, and non-caloric beverages on changes in dietary intake. This randomized controlled trial (RCT) comprised an 8-week baseline, a 32-week intervention, and a 16-week follow-up. 24-hour dietary recalls were conducted during the baseline period and before the intervention midpoint. In-person clinical measures were analyzed from Week 8 (end of baseline) and 24 (midpoint). This report is from an interim analysis up to the intervention period midpoint at Week 24, as the study is still ongoing. Participants with BMIs of 24.5-50 kg/m2 and ages 18-70 years old who were the primary household shoppers were recruited from several New York City supermarkets, starting in September 2018. Of these, we analyzed 20 in the 30% discount group, 25 in the 15% discount group, and 19 in the 0% discount group. The 30% discount group reported greater intake of vegetables (+98.4 g ± 48.9 SD, P = 0.049) and diet soda (+63.3 g ± 29.3, P = 0.035) relative to the baseline period, compared to the 0% discount group. The clinical measures including body weight remained unchanged. The participants who experienced the COVID-19 pandemic had a marginal increase in body weight of 1.5 kg, P = 0.053. In conclusion, we observed a significant increase in intake of vegetables and diet soda in the 30% discount group relative to the 0% discount group.

Binge Eating (BE) and Obesity: Brain Activity and Psychological Measures before and after Roux-En-Y Gastric Bypass (RYGB).

Brain activity in response to food cues following Roux-En-Y Gastric Bypass (RYGB) in binge eating (BE) or non-binge eating (NB) individuals is understudied. Here, 15 RYGB (8 BE; 7 NB) and 13 no treatment (NT) (7 BE; 6 NB) women with obesity underwent fMRI imaging while viewing high and low energy density food (HEF and LEF, respectively) and non-food (NF) visual cues. A region of interest (ROI) analysis compared BE participants to NB participants in those undergoing RYGB surgery pre-surgery and 4 months post. Results were corrected for multiple comparisons using liberal (p < 0.006 uncorrected) and stringent (p < 0.05 FDR corrected) thresholds. Four months following RYGB (vs. no treatment (NT) control), both BE and NB participants showed greater reductions in blood oxygen level-dependent (BOLD) signals (a proxy of local brain activity) in the dorsomedial prefrontal cortex in response to HEF (vs. LEF) cues (p < 0.006). BE (vs. NB) participants showed greater increases in the precuneus (p < 0.006) and thalamic regions (p < 0.05 corrected) to food (vs. NF). For RYGB (vs. NT) participants, BE participants, but not NB participants, showed lower BOLD signal in the middle occipital gyrus (p < 0.006), whilst NB participants, but not BE participants, showed lower signal in inferior frontal gyrus (p < 0.006) in response to HEF (vs. LEF). Results suggest distinct neural mechanisms of RGYB in BE and may help lead to improved clinical treatments.

Obesity and acute stress modulate appetite and neural responses in food word reactivity task.

Obesity can result from excess intake in response to environmental food cues, and stress can drive greater intake and body weight. We used a novel fMRI task to explore how obesity and stress influenced appetitive responses to relatively minimal food cues (words representing food items, presented similarly to a chalkboard menu). Twenty-nine adults (16F, 13M), 17 of whom had obesity and 12 of whom were lean, completed two fMRI scans, one following a combined social and physiological stressor and the other following a control task. A food word reactivity task assessed subjective food approach (wanting) as well as food avoidant (restraint) responses, along with neural responses, to words denoting high energy-density (ED) foods, low-ED foods, and non-foods. A multi-item ad-libitum meal followed each scan. The obese and lean groups demonstrated differences as well as similarities in activation of appetitive and attention/self-regulation systems in response to food vs. non-food, and to high-ED vs. low-ED food words. Patterns of activation were largely similar across stress and non-stress conditions, with some evidence for differences between conditions within both obese and lean groups. The obese group ate more than the lean group in both conditions. Our results suggest that neural responses to minimal food cues in stressed and non-stressed states may contribute to excess consumption and adiposity.

Body weight, dietary intake, and health risk factors pre-COVID and during the COVID-19 pandemic.

The objective of this study was to assess changes in body weight, body fat, food intake, and clinical risk factors during the 2020 COVID-19 pandemic (COVID group) vs. the pre-COVID period (pre-COVID group). Clinical measurements were collected and Food Frequency Questionnaires (FFQs) were administered at two time points for each group (211 days ± 114 SD). For the pre-COVID group, the data were collected before February 20, 2020. For the COVID group, the data were collected either before and after February 20, 2020, or both between February 20, 2020 and April 1, 2021, excluding a 6.5-month pandemic-related pause of hospital visits. Increases in the following outcome measures were seen in the COVID group relative to the preCOVID group: body weight (t = 3.40, p = 0.004), body fat mass (t = 2.29, p = 0.024), diastolic blood pressure (BP) (t = 2.10, p = 0.039), total cholesterol (t = 1.81, p = 0.074, marginal), and fat/oil intake (t = 2.44, p = 0.017). In contrast, there were decreases in fruit intake (t = -1.88, p = 0.064, marginal) in the COVID group compared to the preCOVID group. The COVID period relative to pre-COVID was associated with unfavorable changes in body weight and composition, food intake, and health risk factors. This appears to be the first report of in-person direct measures of changes in body weight and risk factors.

Incidence and Relative Risk of COVID-19 in Adolescents and Youth Compared With Older Adults in 19 US States, Fall 2020.

Importance: Adolescents have been thought to be low in susceptibility to COVID-19 compared with older adults. Data regarding incidence and risk of COVID-19 are needed to convey risk of infection and inform prevention messaging, especially because US states such as Florida are recommending against vaccinating individuals ages 5 to 17 years and because more infections among adolescents could signal potentially higher incidence of long COVID. Objective: To compare incidence rates and relative risk of infection among US adolescents and youth with those of older adults for wild-type SARS-CoV-2. Design, Setting, and Participants: This cross-sectional study included persons living in 19 US states that experienced surges from the start of the pandemic through fall 2020. Participants were all individuals reported as cases on state health department websites for the age groups and states studied. Age groups included adolescents (ages 10 to 19 years), youth (ages 15 to 24 years or 18 to 24 years), adolescents and youth combined (ages 10 to 24 years), and older adults (either age 60 years or 65 years and older), with age thresholds dependent on individual state data. Data were analyzed between June 2021 and January 2022. Main Outcomes and Measures: Incidence rates for the wild-type SARS-CoV-2 strain; the relative risk of infection in adolescents and youth compared with older adults, based on the incidence rate ratio (IRR). Results: In 16 of 19 states, the IRR of COVID-19 infection in adolescents and youth was significantly greater than in older adults. For example, in Florida, the incidence rate in adolescents and youth was 0.055 compared with 0.028 in older adults-adolescents and youth had 1.94 times the risk of contracting COVID-19 compared with older adults (IRR, 1.94; 95% CI, 1.92-1.95). Conclusions and Relevance: Results from this cross-sectional study with US data were contrary to studies from Asia and Europe indicating lower susceptibility of adolescents than older adults. Our findings with the wild-type strain were consistent with findings reported in the UK for the Delta variant and underscored that even with the wild-type lineage, incidence among adolescents and youth exceeded that in older adults.

Time of day differences in appetite and gut hormone responses to meal and stress challenges in adults with normal-weight and obesity.

BACKGROUND: Lifestyle factors like time of eating and stress exposure may impact physiology to promote excess weight gain. To understand behavioral and physiological mechanisms underlying these potential effects, we compared appetite and gut hormone responses to a series of meal and stress challenges beginning in the morning and the afternoon, in adults with normal-weight and obesity. METHOD: Thirty-two adults (16 with normal-weight, 16 with obesity) underwent the same test protocol on different days, each following an 8 h fast. On one day the protocol began in the morning (AM condition); on the other day it began in the late afternoon (PM condition). On each day they first received a standardized liquid meal (9:00am/4:00pm), then a stress test (Socially-Evaluated Cold Pressor Test, 11:10am/6:10pm), then an ad libitum buffet meal (11:40am/6:40pm). Appetite and stress ratings were obtained, and blood was drawn for measures of ghrelin, PYY, GLP-1, insulin, glucose, cortisol and leptin. Acetaminophen was administered as a tracer to assess gastric emptying of the liquid meal. RESULTS: Across all three challenges, AUC cortisol was lower in the PM vs. AM condition (all p<.001), and AUC insulin and leptin were higher in the obesity vs. normal-weight group (all p<.001). For the standardized liquid meal only, AUC hunger, desire to eat and ghrelin were greater in the PM vs. AM condition (all p<0.05), and AUC ghrelin was lower in the obesity vs. normal-weight group, even when controlling for baseline values (p<0.05). AUC glucose was higher in the evening for the normal-weight group only (condition x group interaction p<0.05). Post-liquid meal gastric emptying as indexed by AUC acetaminophen was slower in the PM vs. AM (p<.01). For the stress test, AUC cortisol was lower in the PM than the AM condition even when controlling for baseline values (p<.05). AUC leptin was lower in the evening in the obesity group only (condition x group interaction p<0.01). PYY showed an acute decrease post-stressor in the normal-weight but not the obesity group (p<.05). Post-stress ad libitum buffet meal intake was similar in the evening and morning conditions, and higher in the obesity group (p<0.05). Only among the obesity group in the evening condition, higher stressor-associated stress and cortisol were associated with greater meal-associated appetite (p<0.05). CONCLUSIONS: Normal-weight individuals and those with obesity may be at risk of evening overeating as a result of differential appetite and gut hormone responses following meal intake and stress exposure.

Prevalence of COVID-19 in adolescents and youth compared with older adults in states experiencing surges.

PURPOSE: There has been considerable controversy regarding susceptibility of adolescents (10-19 years) and youth (15-24 years) to COVID-19. However, a number of studies have reported that adolescents are significantly less susceptible than older adults. Summer 2020 provided an opportunity to examine data on prevalence since after months of lockdowns, with the easing of restrictions, people were mingling, leading to surges in cases. METHODS: We examined data from Departments of Health websites in six U.S. states experiencing surges in cases to determine prevalence of COVID-19, and two prevalence-related measures, in adolescents and youth as compared to older adults. The two other measures related to prevalence were: (Percentage of cases observed in a given age group) ÷ (percentage of cases expected based on population demographics); and percentage deviation, or [(% observed-% expected)/ % expected] x 100. RESULTS: Prevalence of COVID-19 for adolescents and for youth was significantly greater than for older adults (p < .00001), as was percentage observed ÷ percentage expected (p < .005). The percentage deviation was significantly greater in adolescents/youth than in older adults (p < 0.00001) when there was an excess of observed cases over what was expected, and significantly less when observed cases were fewer than expected (p< 0.00001). CONCLUSIONS: Our results are contrary to previous findings that adolescents are less susceptible than older adults. Possible reasons for the findings are suggested, and we note that public health messaging targeting adolescents and youth might be helpful in curbing the pandemic. Also, the findings of the potential for high transmission among adolescents and youth, should be factored into decisions regarding school reopening.

Changes in food intake during the COVID-19 pandemic in New York City.

The COVID-19 pandemic and stay-at-home orders across the nation have had substantial consequences on access to food and dietary behaviors. We investigated the dietary intake of adults in NYC, before and during the COVID-19 period. A subset of participants (n = 31) from an NIH-funded multi-level discount supermarket study were assessed. In this study, the experimental groups received a 0% (control), 15%, or 30% discount on fruits, vegetables, and noncaloric beverages for 8 months. The discount level for the participants who were selected for this study did not change from the pre-COVID to during COVID periods. Dietary intake data was collected using three unannounced 24-h dietary recalls (2 weekdays, 1 weekend) during each period. Changes in total daily kcal of food and beverages, total g of solid food, energy density of solid food (kcal/g), and g of fruit and vegetables, soda, non-caloric beverages, and snack foods were analyzed using multivariate linear regression. Energy density (ED) increased during COVID (+0.02 ± 0.5 [SD], F[4,26] = 3.0, p = 0.038). There was an interaction by gender (t = -3.2, p = 0.0035) such that ED increased for females (+0.27 ± 0.46, p = 0.037) and decreased for males (-0.22 ± 0.32, p = 0.012). The change in ED is likely due to the circumstances surrounding COVID-19, e.g. being at home, stress, and food shortages.

fMRI Food Cue Reactivity as a Predictor for BMI Change Following Roux-en-Y Gastric Bypass (RYGB) or Diet Intervention.

Prevalence of severe obesity continues to increase, with only bariatric surgery showing long-term efficacy for sustained weight loss. Individuals with severe obesity (vs normal weight) show greater fMRI responsivity to high energy dense (ED) vs low ED food cues and reduced responsivity post-surgery. We examined responsivity to high vs low ED cues pre-intervention in association with postsurgical (RYGB) or dietary weight-loss (dWL) change in BMI at 4 and 18 mo. Region of interest (ROI) analysis employed separate ANCOVA models; group as single factor with three levels and baseline activation and interaction with group covarying for age and gender as nuisance covariates. Significant results were identified at p < 0.1 false discovery rate (FDR) corrected, following multiple comparisons across ROIs. In the precentral gyrus (motor and motor readiness area), higher baseline activation was associated with greater %BMI reduction in RYGB at 4 and 18 mo and less %BMI reduction in dWL at 4 mo (p = 0.006 uncorrected, P < 0.1 FDR corrected). The findings show opposite directionality in predicting change in BMI for RYGB vs. dWL from responsivity to high vs low ED food cues in the precentral gyrus. Greater baseline motor planning to ingest high ED foods may be associated with reduced weight loss in dWL, and with greater weight loss in RYGB due to neuromodulatory effects of surgery.

Relationship between binge eating and associated eating behaviors with subcortical brain volumes and cortical thickness.

BACKGROUND: Binge eating disorder (BED) is the most prevalent eating disorder. We examined the presence of binge eating (BE) and three associated eating behaviors in relation to subcortical regional volumes and cortical thickness from brain scans. METHODS: We processed structural MRI brain scans for 466 individuals from the Nathan Kline Institute Rockland Sample using Freesurfer. We investigated subcortical volumes and cortical thicknesses among those with and without BE and in relation to the scores on dietary restraint, disinhibition, and hunger from the Three-Factor Eating Questionnaire (TFEQ). We conducted a whole-brain analysis and a region of analysis (ROI) using a priori regions associated with BE and with the three eating factors. We also compared scores on the three TFEQ factors for the BE and non-BE. RESULTS: The BE group had higher scores for dietary restraint (p = .013), disinhibition (p = 1.22E-07), and hunger (p = 5.88E-07). In the whole-brain analysis, no regions survived correction for multiple comparisons (FDR corrected p<0.01) for either BE group or interaction with TFEQ. However, disinhibition scores correlated positively with left nucleus accumbens (NAc) volume (p < 0.01 FDR corrected). In the ROI analysis, those with BE also had greater left NAc volume (p = 0.008, uncorrected) compared to non-BE. LIMITATIONS: Limitations include potential self-report bias on the EDE-Q and TFEQ. CONCLUSIONS: The findings show that BE and disinhibition scores were each associated with greater volumes in the left NAc, a reward area, consistent with a greater drive and pleasure for food.

Psychosocial Predictors of Weight Loss and Quality of Life at 1 Year Post-Bariatric Surgery: A Cohort Study.

Background: Psychosocial factors, identified in pre-bariatric surgery evaluation, may affect surgical outcomes, as well as defer surgery, making it important to identify psychosocial predictors of surgery outcomes. Methods: Baseline depressive and social anxiety symptom scores were analyzed as predictors of post-surgical weight loss (WL) and quality of life (QOL) following Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB). Eighty-nine (82F, 7M) participants underwent surgery and completed depression, anxiety and QOL questionnaires 3-weeks pre-surgery and 1-year post-surgery. Results: Depressive scores and QOL scores improved post-surgery (P < 0.001), whereas social anxiety scores did not (P = 0.20). Baseline depressive (P = 0.90) and social anxiety (P = 0.20) scores did not predict % weight loss (WL) at 1 year, but higher baseline depressive (P = 0.04) and social anxiety (P = 0.005) scores predicted lower post-surgical QOL at 1 year. RYGB showed greater improvement in %WL (P < 0.001) than AGB, but no difference between the groups in QOL (P = 0.10). Improvement in QOL correlated with %WL (P < 0.001), whereas improvement in depressive scores did not correlate with %WL (P = 0.70) but did correlate with improvement in QOL (P = 0.01). Conclusions: Baseline depressive and social anxiety scores predicted QOL but not %WL. Depressive and QOL scores improved post-surgery, but social anxiety scores did not. The findings suggest that patients who present with depressive or social anxiety symptoms pre-surgery perhaps should not be deferred; however, more studies are needed to confirm this. Patients with pre-operative social anxiety symptoms may benefit from counseling.

Factor structure of the Night Eating Diagnostic Questionnaire (NEDQ) and an evaluation of the diagnostic criteria of the night eating syndrome.

BACKGROUND: The Night Eating Diagnostic Questionnaire (NEDQ) is a validated assessment of the night eating syndrome (NES) based on the proposed diagnostic criteria. While past results show that NEDQ is associated with psychopathology and body mass index (BMI), the relationships between the proposed NES diagnostic criteria and psychopathology and BMI have not been investigated. Thus, the relationships between the proposed NES diagnostic criteria and factors previously associated with NES, namely depression, "food addiction" (FA), sleep quality, and BMI were examined. Finally, the NEDQ factor structure was examined for the first time in order to determine whether the NEDQ is assessing NES appropriately. METHODS: The NEDQ, depression, sleep quality, and FA questionnaires were administered to a sample of older community members (n = 468) and a student sample (n = 254). Principal Components Analysis (PCA) was performed to examine the factor structure of the NEDQ. The relationships between the proposed diagnostic criteria and depression, sleep quality, FA, and BMI were examined using multiple regression. RESULTS: The proposed NES criteria were highly intercorrelated. PCA revealed a single factor solution for the NEDQ. In the community sample, depression was associated with the presence of five of nine proposed diagnostic criteria while poor sleep quality and FA were associated with the presence of seven and six criteria respectively. In the community sample, only the sleep problems and impairment/distress criteria were positively associated with BMI. In the student sample, fewer criteria were associated with psychopathology, and no criteria were associated with BMI. CONCLUSIONS: These findings support the proposed criteria for diagnosis of NES. All proposed criteria were associated with at least one psychopathology measure. BMI was only associated with the sleep problems and impairment/distress criteria in the community sample. The PCA finding of a single factor indicates that the NEDQ is a cohesive assessment of NES, and that the NEDQ is a good measure of NES criteria.

A Longitudinal Preliminary Study of Addiction-Like Responses to Food and Alcohol Consumption Among Individuals Undergoing Weight Loss Surgery.

Reductions in addiction-like food behaviors and increases in alcohol intake have been reported after weight loss surgery. However, no studies have tracked these measures in combination and prospectively. In this preliminary study, 27 participants underwent bariatric surgery (Roux-en-Y gastric bypass (RYGB) (n = 10) and sleeve gastrectomy (SG) (n = 6)), dietary weight loss (n = 6), or no treatment (n = 5). Participants were weighed, completed the Yale Food Addiction Scale (YFAS), and reported alcohol intake frequency before intervention and at 4 and 24 months after baseline. At 24 months, only the surgery group showed significant reductions in BMI. Between baseline and 24 months, YFAS scores decreased (p = .006) and alcohol intake increased in the surgery group (p = .005). Significant changes were not observed in the diet or no treatment groups.

Weight Loss Following Use of a Smartphone Food Photo Feature: Retrospective Cohort Study.

BACKGROUND: Tracking of dietary intake is key to enhancing weight loss. Mobile apps may be useful for tracking food intake and can provide feedback about calories and nutritional value. Recent technological developments have enabled image recognition to identify foods and track food intake. OBJECTIVE: We aimed to determine the effectiveness of using photography as a feature of a smartphone weight loss app to track food intake in adults who were overweight or obese. METHODS: We analyzed data from individuals (age, 18-65 years; body mass index≥25 kg/m2; ≥4 days of logged food intake; and ≥2 weigh-ins) who used a mobile-based weight loss app. In a retrospective study, we compared those who used the photo feature (n=9871) and those who did not use the feature (n=113,916). Linear regression analyses were used to assess use of the photo feature in relation to percent weight loss. RESULTS: Weight loss was greater in the group using the photo feature (Δ=0.14%; 95% CI 0.06-0.22; P<.001). The photo feature group used the weight loss app for a longer duration (+3.5 days; 95% CI 2.61-4.37; P<.001) and logged their food intake on more days (+6.1 days; 95% CI 5.40-6.77; P<.001) than the nonusers. Mediation analysis showed that the weight loss effect was absent when controlling for either duration or number of logged days in the program. CONCLUSIONS: This study was the first to examine the effect of a food photo feature to track food intake on weight loss in a free-living setting. Use of photo recognition was associated with greater weight loss, which was mediated by the duration of app use and number of logged days in the program.

Meal-Related Acyl and Des-Acyl Ghrelin and Other Appetite-Related Hormones in People with Obesity and Binge Eating.

OBJECTIVE: Potential mechanisms of abnormal food intake, such as dysregulation of meal-related appetite hormones, including acyl ghrelin (AG) and des-acyl ghrelin (DAG), were investigated among men and women with obesity, with and without binge eating (BE). METHODS: Participants (n = 42: 19 female, 23 male) were assigned to a liquid meal and water condition in counterbalanced order, and blood samples for measuring hormones were obtained before and after these conditions. RESULTS: Participants with BE had significantly lower fasting and postingestive AG concentrations than participants without BE in both conditions. During the meal condition, postprandial decreases in AG concentrations were significantly smaller for the BE group than for the non-BE group. There were no significant differences in DAG by BE group. Leptin increased significantly less after meals for those with BE compared with those without BE. There were no differences in other hormones by BE group. Fasting and postmeal hunger ratings were significantly higher for those with BE than for those without BE. CONCLUSIONS: In individuals with BE, lower fasting AG may be due to downregulation by habitual overeating, and a smaller postmeal decline in AG may contribute to overeating. Lower postmeal leptin concentrations may also contribute to overeating.

Combined effects of cholecystokinin-8 and gastric distension on food intake in humans.

In a previous study (Kissileff HR, Carretta JC, Geliebter A, Pi-Sunyer FX. Am J Physiol Regul Integr Comp Physiol 285: R992-R998, 2003), when subthreshold gastric distension (300 ml) and a low dose of cholecystokinin octapeptide (CCK-8) (112 ng/min for 21 min) were concurrently administered to human participants, intake of a test meal was significantly reduced. However, the supra-additive interaction of CCK-8 and gastric distension was not significant. The purpose of the present study was to determine whether a significant interaction would be obtained when CCK-8 and gastric distension were each increased by 50% above levels used in the previous study. Twelve normal-weight, healthy participants were tested four times each with either CCK-8 (168 ng/min for 30 min) or saline infusion crossed with gastric distension (450 ml) or no distension. The combination of CCK-8 and gastric distension reduced food intake by a mean of 405 ± 86 g (SE) in comparison with the saline nondistension condition (P < 0.001), which is a 51% reduction. Although there were some differences in the protocols, the combined effect was double that seen in the previous study. Although the interactive effect was larger [118 ± 109 g (SE)] than it was previously [73 ± 86 (SE)], it was not significant (P = 0.29). There were also reports of a short-lived sick feeling after CCK-8, with and without distension, that was not observed in the previous study. Thus the combination of CCK-8 at 1.5 times threshold and gastric distension at 450 ml (increased from 300 ml) resulted in a combined effect to reduce food intake, which was also 1.5 times its previous value, and thus appears linear.

Functional Magnetic Resonance Imaging (fMRI) of Neural Responses to Visual and Auditory Food Stimuli Pre and Post Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG).

Of current obesity treatments, bariatric surgery induces the most weight loss. Given the marked increase in the number of bariatric surgeries performed, elucidating the mechanisms of action is a key research goal. We compared whole brain activation in response to high-energy dense (HED) vs. low-energy dense (LED) visual and auditory food cues before and approximately 4 months after Roux-en-Y Gastric Bypass (RYGB) (n = 16) and Sleeve Gastrectomy (SG) (n = 9). We included two control groups: a low-calorie diet weight loss group (WL) (n = 14) and a non-treatment group (NT) (n = 16). Relative to the control groups, the surgery groups showed increased dorsolateral prefrontal cortex (dlPFC) and decreased parahippocampal/fusiform gyrus (PHG/fusiform) activation in response to HED vs. LED, suggesting greater cognitive dietary inhibition and decreased rewarding effects and attention related to HED foods. dlPFC activation was significantly more increased in RYGB vs. SG. We also found that postprandial increases in GLP-1 concentrations (pre to postsurgery) correlated with postsurgical decreases in RYGB brain activity in the inferior temporal gyrus and the right middle occipital gyrus in addition to increases in the right medial prefrontal gyrus/paracingulate for HED > LED stimuli, suggesting involvement of these attention and inhibitory regions in satiety signaling postsurgery.

Change in brain volume and cortical thickness after behavioral and surgical weight loss intervention.

Obesity is associated with reduced cortical thickness and brain volume, which may be related to poor nutrition. Given that brain atrophy in anorexia nervosa recovers with nutritional improvements and weight gain, it is worth examining how brain structure changes at the other end of the weight spectrum with weight loss. Thus, this study aimed to examine change in cortical thickness and brain volume in 47 patients with severe obesity who participated in no treatment, behavioral weight loss, or bariatric surgery. T1-weighted MRI scans were conducted pre-treatment and approximately four months later. Measures of cortical thickness, gray matter volume, and white matter volume were compared between time points. Despite overall reduction in BMI, there was no significant change in cortical thickness. There was a significant increase in left hemisphere gray matter and white matter volumes across the sample. At baseline and follow-up, there was no relationship between cortical thickness or brain volumes and BMI. This study is the first to examine changes in cortical thickness and brain volume with weight loss in adults with obesity and the findings show partial support for the hypotheses that weight loss results in increased cortical gray and white matter.