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Wired for Obesity?

The central nervous system (CNS) plays an important role in the regulation of appetite, energy expenditure, and body weight. Understanding the neural pathways involved is essential to the development of mechanism-based approaches to the prevention and treatment of obesity and diabetes (Fig. 1). Recent advances in MRI of fast acquisition sequences and image-processing software now enable us to noninvasively examine patterns of brain neuronal activation in vivo using functional MRI (fMRI). Using this technique, several studies have demonstrated the complex interplay of activation in cortical and subcortical regions that control the affective/emotional responses to food that modulate feeding/eating behavior (1,2). These responses may have an important role in driving and sustaining energy intake over and above pure requirement, contributing to the obesity epidemic.



Figure 1 
Neurohormonal regulation of appetite and reward (modified from http://gut-brain-axis.org/). PYY, peptide tyrosine tyrosine.



An example of this approach is the elegant work of van Bloemendaal et al. (3), which appears in this issue. The authors examined the effects of GLP-1 agonists on regional brain responses to food cues (images of food) using fMRI. Their aim was to …