Changes in brain activation to food pictures after adjustable gastric banding.

Background: Adjustable gastric banding is an effective weight-loss treatment, but little is known about the neural mechanisms underlying weight loss. The purpose of the present study was to determine whether gastric banding affects brain function in regions previously implicated in food motivation, reward, and cognitive control. The setting for the study was the University of Missouri-Kansas City, Department of Psychology; Hoglund Brain Imaging Center, University of Kansas Medical Center; and private practice in the United States.

Methods: Ten obese participants were recruited before adjustable gastric banding surgery (mean body mass index before surgery 40.6 ± 1.96 kg/m2). Their mean body mass index at 12 weeks after surgery was 36.1 ± 2.32 kg/m2, with a mean percentage of excess weight loss of 25.21% ± 8.41%. Functional magnetic resonance imaging scans were conducted before and 12 weeks after adjustable gastric banding surgery. At each assessment point, the participants completed questionnaires assessing food motivation and were scanned while hungry (before eating) and immediately after a standardized meal (after eating). During the functional magnetic resonance imaging scans, the participants viewed food pictures, nonfood pictures (animals), and blurred baseline control pictures. The functional magnetic resonance imaging data were analyzed using BrainVoyager QX.

Results: After surgery, the participants reported significantly less food motivation and more cognitive restraint. The participants also showed decreased brain activation to food versus nonfood pictures in regions implicated in food motivation and reward, including the parahippocampus, medial prefrontal cortex, insula, and inferior frontal gyrus. In contrast, they demonstrated increased activation to food versus nonfood pictures in anterior prefrontal cortex, a region implicated in cognitive control and inhibition.

Conclusion: This is the first study to examine the functional brain changes after gastric banding surgery and 1 of the first studies to longitudinally examine neural changes associated with weight loss. These results have provided preliminary evidence that adjustable gastric banding alters brain function in regions known to regulate reward and cognitive control.