Resting State Brain Connectivity After Surgical and Behavioral Weight Loss

OBJECTIVE: We previously reported changes in food-cue neural reactivity associated with behavioral and surgical weight loss interventions. Resting functional connectivity represents tonic neural activity that may contribute to weight loss success. Here we explore whether intervention type is associated with differences in functional connectivity after weight loss. METHODS: Fifteen obese participants were recruited prior to adjustable gastric banding surgery. Thirteen demographically matched obese participants were selected from a separate behavioral diet intervention. Resting state fMRI was collected three months after surgery/behavioral intervention. ANOVA was used to examine post-weight loss differences between the two groups in connectivity to seed regions previously identified as showing differential cue-reactivity after weight loss. RESULTS: Following weight loss, behavioral dieters exhibited increased connectivity between left precuneus/superior parietal lobule (SPL) and bilateral insula pre- to post-meal and bariatric patients exhibited decreased connectivity between these regions pre- to post-meal (p(corrected)<.05). CONCLUSIONS: Behavioral dieters showed increased connectivity pre- to post-meal between a region associated with processing of self-referent information (precuneus/SPL) and a region associated with interoception (insula) whereas bariatric patients showed decreased connectivity between these regions. This may reflect increased attention to hunger signals following surgical procedures, and increased attention to satiety signals following behavioral diet interventions.