Attentional bias to food-related visual cues: is there a role in obesity?

Abstract

The incentive sensitisation model of obesity suggests that modification of the dopaminergic associated reward systems in the brain may result in increased awareness of food-related visual cues present in the current food environment. Having a heightened awareness of these visual food cues may impact on food choices and eating behaviours with those being most aware of or demonstrating greater attention to food-related stimuli potentially being at greater risk of overeating and subsequent weight gain. To date, research related to attentional responses to visual food cues has been both limited and conflicting. Such inconsistent findings may in part be explained by the use of different methodological approaches to measure attentional bias and the impact of other factors such as hunger levels, energy density of visual food cues and individual eating style traits that may influence visual attention to food-related cues outside of weight status alone. This review examines the various methodologies employed to measure attentional bias with a particular focus on the role that attentional processing of food-related visual cues may have in obesity. Based on the findings of this review, it appears that it may be too early to clarify the role visual attention to foodrelated cues may have in obesity. Results however highlight the importance of considering the most appropriate methodology to use when measuring attentional bias and the characteristics of the study populations targeted while interpreting results to date and in designing future studies.Incentive sensitisation: Weight status: Eye tracking: Visual probe: Stroop Prevalence of overweight and obesity has now reached epidemic proportions with more than 1·4 billion adults considered as overweight and of these, over 500 million being obese worldwide (1) . On a fundamental level the cause of obesity is linked to an imbalance of energy intake v. energy expenditure; however, it is now evident that obesity is a multifactorial condition that arises from interactions between genetic and environmental factors (2) . One such factor is the present 'obesogenic' environment that is characterised by a wealth of highly palatable, energy-dense foods (3) . These foods are heavily represented in the visual environment for example, through advertising and it has been suggested that frequent exposure to these forms of food-related cues may impact on eating behaviours and food choices (4)(5)(6) .According to the theory of incentive sensitisation, 'addictive substances' modify reward-related pathways in the brain leading to hypersensitisation of rewardrelated stimuli (7) . This results in increased salience to reward-related stimuli resulting in these stimuli becoming more 'attention grabbing'. It has been proposed that this heightened awareness is the consequence of repeated exposure to a particular stimulus and the association between the stimulus and a rewarding experience, which results in related cues becoming salient. The stimulus related to the rewarding experience may then attract g...

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