Neural Features of Obesity and Intervention: A Food-Cue fMRI Study

Abstract

Obesity is a global epidemic associated with alterations in reward processing and inhibitory control. Pharmacological interventions, such as Contrave® (naltrexone/bupropion), combined with dietary modification, may influence these neural processes; however, the short-term neural effects of such interventions remain unknown. This is a double-blind, placebo-controlled, and randomized phase four clinical trial investigating neural responses to food cues before and after a 4-week Contrave® and diet intervention (total N=15 at baseline and N=11 pre/post). At baseline, we identified activity in several regions (notably the insula) across different food-viewing conditions. Baseline brain responses to food cues were also associated with in-scanner food cue ratings in the Rolandic operculum, as well as reward motivation traits in the dorsolateral prefrontal cortex, and more. The 4-week intervention induced changes in brain activity in the hippocampus and precuneus, among other regions. Changes in brain activity were also associated with reward motivation traits in several regions, including the insula and frontal cortex. This study contributes evidence regarding the neural correlates of obesity and the potential impact of a short-term drug/diet intervention. To our knowledge, it is the only study to combine fMRI with a pharmacological and dietary weight-loss intervention in men and women with obesity. Overall, we hope that this research will improve obesity-related patient care and the clinical use of Contrave®.