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Less activation in the left dorsolateral prefrontal cortex in the reanalysis of the response to a meal in obese than in lean women and its association with successful weight loss^1,2,3

¹ From the Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology & Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Phoenix, AZ (DSNTL, NP, ADS, and JK); Banner Alzheimer Institute and the Banner Positron Emission Tomography Center, Banner Good Samaritan Medical Center, Phoenix, AZ (KC and EMR); the Center for Human Nutrition, University of Colorado Health Sciences Center, Denver, CO (JOH); and the Miriam Hospital Weight Control and Diabetes Research Center, Brown University Medical School, Providence, RI (RRW)

Background: We previously found that obese men have less activation in the left dorsolateral prefrontal cortex (LDLPFC) in response to a meal than do lean men, which indicates an association between this altered neuronal response and the pathophysiology of obesity.

Objectives: The objectives of the study were to extend this finding in obese women and to investigate activity in this region in women with a history of severe obesity who have successfully lost weight (ie, formerly obese women, sometimes called postobese women).

Design: We reanalyzed previously collected data to compare postmeal (after receiving a liquid meal) with premeal (after a 36-h fast) regional cerebral blood flow, a marker of neuronal activity, by using ¹⁵O-water positron emission tomography in 10 lean [26 ± 6% body fat (BF)], 9 obese (39 ± 3%BF) and 8 formerly obese (28 ± 4%BF) right-handed women. Data were analyzed by using a 2-level, random-effect analysis of variance.

Results: The regional cerebral blood flow in the LDLPFC differed in response to the meal across the 3 groups (P < 0.001, uncorrected for multiple comparisons). Post hoc group comparisons showed that obese women had significantly less activation in this area than did lean and formerly obese women. No significant difference between formerly obese and lean women was found.

Conclusions: These results extend our previous findings, indicating that obese women have less activation in the LDLPFC in response to a meal than do lean or formerly obese women. Neuronal activity in this region did not differ significantly between the latter 2 groups. Longitudinal studies are needed to determine whether these differences in neuronal activity change with or predict weight change.

Key Words: Dorsolateral prefrontal cortex • neuronal activity • fixture of obesity • weight loss • satiety • formerly obese • positron emission tomography • PET