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Reduction in high‐calorie food reward after a lifestyle intervention in obese endometrial cancer survivors

Obesity is associated with an increased risk of endometrial cancer (EC) and, EC patients have the highest risk of death among all obesity‐associated cancers. Yet, only two lifestyle interventions targeting EC survivors have been completed. EC patients lost weight in these trials but food disinhibition, as determined by the Three‐Factor Eating Questionnaire, decreased, suggesting an increase in emotional eating and, possibly, food reward. We evaluated food behavior using a visual functional magnetic resonance imaging (fMRI) task involving paired stimulus presentation of high‐calorie, low‐calorie and non‐food images in 11 obese, Stage I/II EC patients enrolled in Survivors in Uterine Cancer Empowered by Exercise and a Healthy Diet (SUCCEED), a lifestyle intervention aimed at improving nutritional and exercise behaviors in 16 group sessions over 6 months using social cognitive theory. At 6 months post‐intervention compared to baseline, we observed a decrease in activation in brain regions involved in food reward and motivation (posterior cingulate, globus pallidus, thalamus; cluster corrected p<0.005) in response to high‐calorie vs. non‐food contrasts in the fed state in the Tx group (n=8). These changes were not found in the UC group (n=3). To our knowledge, this is the first study to demonstrate that a behavioral lifestyle intervention helps to reduce high‐calorie food reward in obese EC survivors.