Loss of lateral prefrontal cortex control in food-directed attention and goal-directed food choice in obesity

Loss of lateral prefrontal cortex (lPFC)-mediated attentional control may explain the automatic tendency to eat in the face of food. Here, we investigate the neurocognitive mechanism underlying attentional bias to food words and its association with obesity using a food Stroop task. We tested 76 healthy human subjects with a wide body mass index (BMI) range (19–35 kg/m2) using fMRI. As a measure of obesity we calculated individual obesity scores based on BMI, waist circumference and waist-to-hip ratio using principal component analyses. To investigate the automatic tendency to overeat directly, the same subjects performed a separate behavioral outcome devaluation task measuring the degree of goal-directed versus automatic food choices. We observed that increased obesity scores were associated with diminished lPFC responses during food attentional bias. This was accompanied by decreased goal-directed control of food choices following outcome devaluation. Together these findings suggest that deficient control of both food-directed attention and choice may contribute to obesity, particularly given our obesogenic environment with food cues everywhere, and the choice to ignore or indulge despite satiety