Modeling interactions between brain function, diet adherence behaviors, and weight loss success

INTRODUCTION: Obesity is linked to altered activation in reward and control brain circuitry; however, the associated brain activity related to successful or unsuccessful weight loss (WL) is unclear. METHODS: Adults with obesity (N = 75) completed a baseline functional magnetic resonance imaging (fMRI) scan before entering a WL intervention (ie,3‐month diet and physical activity [PA] program). We conducted an exploratory analysis to identify the contributions of baseline brain activation, adherence behavior patterns, and the associated connections to WL at the conclusion of a 3‐month WL intervention. Food cue‐reactivity brain regions were functionally identified using fMRI to index brain activation to food vs nonfood cues. Food consumption, PA, and class attendance were collected weekly during the 3‐month intervention. RESULTS: The left middle frontal gyrus (L‐MFG, BA 46) and right middle frontal gyrus (R‐MFG; BA 9) were positively activated when viewing food compared with nonfood images. Structural equation modeling with bootstrapping was used to investigate a hypothesized path model and revealed the following significant paths: (1) attendance to 3‐month WL, (2) R‐MFG to attendance, and (3) indirect effects of R‐MFG through attendance on WL. CONCLUSION: Findings suggest that brain activation to appetitive food cues predicts future WL through mediating session attendance, diet, and PA. This study contributes to the growing evidence of the importance of food cue reactivity and self‐regulation brain regions and their impact on WL outcomes.