Weight Loss Maintenance: Have We Missed the Brain?

Even though obese individuals often succeed with weight loss, long-term weight loss maintenance remains elusive. Dietary, lifestyle and psychosocial correlates of weight loss maintenance have been researched, yet the nature of maintenance is still poorly understood. Studying the neural processing of weight loss maintainers may provide a much-needed insight towards sustained obesity management. In this narrative review, we evaluate and critically discuss available evidence regarding the food-related neural responses of weight loss maintainers, as opposed to those of obese or lean persons. While research is still ongoing, available data indicate that following weight loss, maintainers exhibit persistent reward related feeling over food, similar to that of obese persons. However, unlike in obese persons, in maintainers, reward-related brain activity appears to be counteracted by subsequently heightened inhibition. These findings suggest that post-dieting, maintainers acquire a certain level of cognitive control which possibly protects them from weight regaining. The prefrontal cortex, as well as the limbic system, encompass key regions of interest for weight loss maintenance, and their contributions to long term successful weight loss should be further explored. Future possibilities and supportive theories are discussed