Child neurobiology impacts success in family-based behavioral treatment for children with obesity

Schur, Ellen A.; Melhorn, Susan J.; Scholz, Kelley; Leon, Mary Rosalynn B. De; Elfers, Clinton; Rowland, Maya G; Saelens, Brian E.; Roth, Christian

doi:10.1038/s41366-020-0644-1

Cited by 10 publications

(16 citation statements)

References 57 publications

(43 reference statements)

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“…23 24 Functional MRI (fMRI) of obese children demonstrated hyper-responsiveness to food rewards in their amygdala compared with normalweight children. 29 Schur et al 30 showed that obese children (9-11 years old) with greater reduction in brain activity in the appetite-processing brain regions (including the amygdala), when shown visual cues of high calorie foods, had greater BMI z-score reduction. Others have observed increased amygdala connectivity with the ventromedial prefrontal cortex in lean individuals compared with obese adult participants.…”

Section: Significance Of This Studymentioning

confidence: 99%

Neonatal amygdala microstructure mediates the relationship between gestational glycemia and offspring adiposity

Cai

Aris

Yuan

et al. 2021

BMJ Open Diab Res Care

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IntroductionTo determine if variations in the neonatal amygdala mediate the association between maternal antenatal glycemia and offspring adiposity in early childhood.Research design and methods123 non-obese pregnant women with no pregnancy complications aside from gestational diabetes underwent a 75 g 2-hour oral glucose tolerance test at 26–28 weeks’ gestation. Volume and fractional anisotropy (FA) of the neonatal amygdala (5–17 days old) were measured by MRI. The Body Mass Index (BMI) z-scores and sum of skinfold thickness (subscapular and triceps) of these children were tracked up to 60 months of age (18, 24, 36, 48, 54 and 60 months).ResultsMaternal fasting glucose levels were positively associated with the offspring’s sum of skinfold thickness at age 48 months (β=3.12, 95% CI 0.18 to 6.06 mm) and 60 months (β=4.14, 95% CI 0.46 to 7.82 mm) and BMI z-scores at 48 months (β=0.94, 95% CI 0.03 to 1.85), 54 months (β=0.74, 95% CI 0.12 to 1.36) and 60 months (β=0.74, 95% CI 0.08 to 1.39). Maternal fasting glucose was negatively associated with the offspring’s FA of the right amygdala (β=−0.019, 95% CI −0.036 to −0.003). Right amygdala FA was negatively associated with the sum of skinfold thickness in the offspring at age 48 months (β=−56.95, 95% CI −98.43 to −15.47 mm), 54 months (β=−46.18, 95% CI −88.57 to −3.78 mm), and 60 months (β=−53.69, 95% CI −105.74 to −1.64 mm). The effect sizes mediated by right amygdala FA between fasting glucose and sum of skinfolds were estimated at β=5.14 (95% CI 0.74 to 9.53) mm (p=0.022), β=4.40 (95% CI 0.08 to 8.72) (p=0.049) mm and β=4.56 (95% CI −0.17 to 9.29) mm (p=0.059) at 48, 54 and 60 months, respectively.ConclusionsIn the offspring of non-obese mothers, gestational fasting glucose concentration is negatively associated with neonatal right amygdala FA and positively associated with childhood adiposity. Neonatal right amygdala FA may be a potential mediator between maternal glycemia and childhood adiposity.

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Section: Significance Of This Studymentioning

confidence: 99%

Neonatal amygdala microstructure mediates the relationship between gestational glycemia and offspring adiposity

Cai

Aris

Yuan

et al. 2021

BMJ Open Diab Res Care

View full text Add to dashboard Cite

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“…Likewise, compared with healthy weight children, children with obesity failed to exhibit reduced reward response to palatable food cues following meal consumption, even though both groups exhibited appropriate circulating satiety hormone responses to the meal [ 67 •]. Additionally, children who failed to exhibit reduced reward response to palatable food cues following meal consumption exhibited the least body weight loss during a family-based behavioral treatment for obesity [ 68 ••]. Interventions that reduced reward region responses to food cues through food response training have promoted weight loss [ 69 , 70 ].…”

Section: Introductionmentioning

confidence: 99%

An Exploration of the Role of Sugar-Sweetened Beverage in Promoting Obesity and Health Disparities

Sigala

Stanhope

2021

Curr Obes Rep

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Purpose of Review The mechanistic role of sugar-sweetened beverage (SSB) in the etiology of obesity is undetermined. We address whether, compared to other foods, does consumption of SSB (1) automatically lead to failure to compensate for the energy it contains? (2) fail to elicit homeostatic hormone responses? (3) promote hedonic eating through activation of the brain's reward pathways? We followed the evidence to address: (4) Would restriction of targeted marketing of SSB and other unhealthy foods to vulnerable populations decrease their prevalence of obesity? Recent Findings The data are lacking to demonstrate that SSB consumption promotes body weight gain compared with isocaloric consumption of other beverages or foods and that this is linked to its failure to elicit adequate homeostatic hormone responses. However, more recent data have linked body weight gain to reward activation in the brain to palatable food cues and suggest that sweet tastes and SSB consumption heightens the reward response to food cues. Studies investigating the specificity of these responses have not been conducted. Nevertheless, the current data provide a biological basis to the body of evidence demonstrating that the targeted marketing (real life palatable food cues) of SSB and other unhealthy foods to vulnerable populations, including children and people of color and low socioeconomic status, is increasing their risk for obesity. Summary While the mechanisms for the association between SSB consumption and body weight gain cannot be identified, current scientific evidence strongly suggests that proactive environmental measures to reduce exposure to palatable food cues in the form of targeting marketing will decrease the risk of obesity in vulnerable populations. Keywords Obesity. Weight gain. Sugar-sweetened beverages. Health disparities. Targeted marketing. Palatable food cues This article is part of the Topical Collection on Etiology of Obesity

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“…This overview provided a consistent picture on the role of CNS mechanisms for treatment outcome in obesity. For example, the importance of dopaminergic reward areas was underlined by CR studies showing that cue-evoked activity in these areas is negatively related to treatment outcome [173][174][175][176][177]. The relevance of goal-directed control regions comprising frontal and parietal areas as well as insula was demonstrated in DD tasks directly designed to study goal-directed control [18,97,104,106] and in CR tasks by showing that cue-related activity of these areas has a positive effect on treatment outcome [86,169,[178][179][180].…”

Section: Discussionmentioning

confidence: 99%

Computational approaches to predicting treatment response to obesity using neuroimaging

Kozarzewski

Maurer

Mähler

et al. 2021

Rev Endocr Metab Disord

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Obesity is a worldwide disease associated with multiple severe adverse consequences and comorbid conditions. While an increased body weight is the defining feature in obesity, etiologies, clinical phenotypes and treatment responses vary between patients. These variations can be observed within individual treatment options which comprise lifestyle interventions, pharmacological treatment, and bariatric surgery. Bariatric surgery can be regarded as the most effective treatment method. However, long-term weight regain is comparably frequent even for this treatment and its application is not without risk. A prognostic tool that would help predict the effectivity of the individual treatment methods in the long term would be essential in a personalized medicine approach. In line with this objective, an increasing number of studies have combined neuroimaging and computational modeling to predict treatment outcome in obesity. In our review, we begin by outlining the central nervous mechanisms measured with neuroimaging in these studies. The mechanisms are primarily related to reward-processing and include “incentive salience” and psychobehavioral control. We then present the diverse neuroimaging methods and computational prediction techniques applied. The studies included in this review provide consistent support for the importance of incentive salience and psychobehavioral control for treatment outcome in obesity. Nevertheless, further studies comprising larger sample sizes and rigorous validation processes are necessary to answer the question of whether or not the approach is sufficiently accurate for clinical real-world application.

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Child neurobiology impacts success in family-based behavioral treatment for children with obesity

Cited by 10 publications

References 57 publications

Neonatal amygdala microstructure mediates the relationship between gestational glycemia and offspring adiposity

Neonatal amygdala microstructure mediates the relationship between gestational glycemia and offspring adiposity

An Exploration of the Role of Sugar-Sweetened Beverage in Promoting Obesity and Health Disparities

Computational approaches to predicting treatment response to obesity using neuroimaging

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