Obesity (Silver Spring)

Objective:Look AHEAD was a randomized trial comparing the effects of an intensive lifestyle intervention (ILI) vs. a diabetes support and education (DSE) control group in adults with type 2 diabetes and overweight/obesity. We used functional magnetic resonance imaging (fMRI) to determine if neural food cue-reactivity differed for these groups 10 years after randomization.Methods:232 participants (ILI n=125, 72% female, DSE n=107, 64% female) were recruited at 3 Look AHEAD sites for fMRI. Neural response to high-calorie foods compared to non-foods was assessed in DSE vs. ILI. Exploratory correlations were conducted within ILI to identify regions where activity was associated with degree of weight loss.Results:Voxel-wise whole-brain comparisons revealed greater reward-processing activity in left caudate in DSE compared to ILI and greater activity in attention/visual processing regions in ILI than DSE (p<0.05, Family Wise Error Corrected). Exploratory analyses revealed greater weight loss among intervention participants from baseline was associated with brain activation indicative of increased attention/visual processing and cognitive control in response to high-calorie food cues (p