Through the Brain’s Lens – Visualizing Obesity’s Neural Pathways

Arpana Church, PhD
ObesityWeek 2024 – Oral presentation

Key messages

  • Food addiction is eating for pleasure rather than homeostatic need.
  • Higher levels of food addiction lead to increased risk in anxiety and depression.
  • Food addiction can impact the microbiome in both the brain and gut.
  • Psychosocial factors also impact the brain and increase the risk of food addiction and obesity.

DOWNLOAD SLIDES

Background

What do we already know about this topic?

  • Obesity prevalence rates in the US are 41%, and projected to rise to 51% by 2030.1
  • Understanding of the underlying pathophysiology of obesity remains insufficient.
  • Key gaps remain around the biology of food addiction and the impact of obesity on brain–gut microbiome interactions. 
The Brain and Obesity

Food addiction:

  • There has been resistance to the idea of food addiction, but the hedonic component of eating can override the homeostatic need.
  • Brain signatures are very similar for food to other addictive substances.
  • Not everyone with obesity has a food addiction, but 25–40% of people with a high body mass index (BMI) meet the criteria.2,3
  • Higher levels of food addiction lead to a 12% increased risk for anxiety, and 7% for depression.
  • New data show 21% of subjects with overweight have food addiction, and 32% of those with obesity.
  • There is an extended reward network in the brain related to obesity and food addiction.4
  • Women report 3-times higher levels of food addiction and cravings, which can impact how weight is gained between men and women.5,6
  • In women, weight gain is linked to the emotional arousal region, whereas in men it is the sensorimotor stimulation region.7,8

Brain-gut microbiome:

  • The brain-gut microbiome system is interconnected.
  • People with food addiction have lower levels of indolepropionate – a neuroprotective metabolite linked to serotonin production.9
  • They also have reduced levels of three protective gut bacteria: Akkermansia, Bacteroides, and Eubacterium.9
  • Akkermansia is a keystone strain for a healthy gut, helping keep the gut lining intact, but it is also anti-inflammatory and involved in the production of glucagon-like peptide-1 (GLP-1).9

Psychological factors and obesity:

  • Psychosocial factors impact the brain and the gut microbiome, thus impacting food addiction.
  • Obesity can be caused by psychosocial factors, including environmental and behavioral.
  • For example, racial discrimination can lead to 6-times increased odds of obesity.10
  • Experiencing racial discrimination leads to food cravings and alters the brain’s response to unhealthy sweet and savory foods.11
  • Living in a disadvantaged neighborhood also affects food choice, weight gain, and the brain.
Conclusions
  • People with obesity often have food addiction, with increased connectivity in the reward network of the brain.
  • Reasons for weight gain differ between men and women, and this may impact treatment.
  • The link with the microbiome also has treatment and clinical implications.
  • In the future, brain- or gut-directed interventions may be an option.

Source: Church A. Through the Brain’s Lens – Visualizing Obesity’s Neural Pathways Presented at ObesityWeek® 2024.

The information and data provided are for informational purposes only. The author(s) of the original presentation had no involvement in the creation of this content.

Resources
  1. CDC. Obesity Trends Among U.S. Adults, 2023. https://www.cdc.gov/obesity/data-and-statistics/adult-obesity-prevalence-maps.html
  2. Gearhardt AN, Grilo CM, DiLeone RJ, et al. Can food be addictive? Public health and policy implications. Addiction 2011;106(7):1208–12.
  3. Ziauddeen H, Farooqi IS, Fletcher PC. Obesity and the brain: how convincing is the addiction model? Nature Rev Neurosci 2012;13(4):279–86.
  4. Gupta A, Poe MD, Styner MA, et al. Regional differences in fiber tractography predict neurodevelopmental outcomes in neonates with infantile Krabbe disease. Neuroimag Clin 2015;7:792–98.
  5. Striegel-Moore RH, Bedrosian R, Wang C, Schwartz S. Why men should be included in research on binge eating: results from a comparison of psychosocial impairment in men and women. Int J Eat Disord 2012;45(2):233–40.
  6. Pursey KM, Stanwell P, Gearhardt AN, et al. The prevalence of food addiction as assessed by the Yale Food Addiction Scale: a systematic review. Nutrients 2014;6(10):4552–90.
  7. Ravichandran S, Bhatt RR, Pandit B, et al. Alterations in reward network functional connectivity are associated with increased food addiction in obese individuals. Sci Rep 2021;11(1):3386.
  8. Bhatt RR, Todorov S, Sood R, et al. Integrated multi-modal brain signatures predict sex-specific obesity status. Brain Commun 2023;5(2):fcad098.
  9. Dong TS, Mayer EA, Osadchiy V, et al. A Distinct Brain-Gut-Microbiome Profile Exists for Females with Obesity and Food Addiction. Obesity 2020;28(8):1477–86.
  10. Hunte HE, Williams DR. The Association Between Perceived Discrimination and Obesity in a Population-Based Multiracial and Multiethnic Adult Sample. Am J Public Health 2009;99(7):1285–92.
  11. Zhang X, Wang H, Kilpatrick LA, et al. Discrimination exposure impacts unhealthy processing of food cues: crosstalk between the brain and gut. Nat Ment Health 2023;11:841–52.

© 2026 The Obesity Society. ObesityWeek is a registered trademark of The Obesity Society. The Best of ObesityWeek is an affiliated program. All rights reserved.