title: Decision-making deficits and overeating: a risk model for obesity.
abstract: OBJECTIVE
  To demonstrate that human overeating is not just a passive response to salient environmental triggers and powerful physiological drives; it is also about making choices. The ventromedial prefrontal cortex has been strongly implicated in the neural circuitry necessary for making advantageous decisions when various options for action are available. Decision-making deficits have been found in patients with ventromedial prefrontal cortex lesions and in those with substance dependence--impairments that reflect an inability to advantageously assess future consequences. That is, they choose immediate rewards in the face of future long-term negative consequences.
  
  
  METHODS
  We extended this research to the study of overeating and overweight, testing a regression model that predicted that poor decision making (as assessed by a validated computerized gambling task) and a tendency to overeat under stress would correlate with higher BMI in a group of healthy adult women (N = 41) representing a broad range of body weights.
  
  
  RESULTS
  We found statistically significant main effects for both independent variables in the predicted direction (p < 0.05; R2 = 0.35). Indeed, the decision-making impairments across the 100 trials of the computer task were greater in those with high BMI than in previous studies with drug addicts.
  
  
  CONCLUSIONS
  Findings suggested that cortical and subcortical processes, which regulate one's ability to inhibit short-term rewards when the long-term consequences are deleterious, may also influence eating behaviors in a culture dominated by so many, and such varied, sources of palatable and calorically dense sources of energy.
authors.affiliation: York University, 343 Bethune College, 4700 Keele Street, Toronto, ON M3J 1P3, Canada. cdavis@yorku.ca
authors.forename: Caroline
authors.initials: C
authors.lastname: Davis
authors.forename: Robert D
authors.initials: RD
authors.lastname: Levitan
authors.forename: Pierandrea
authors.initials: P
authors.lastname: Muglia
authors.forename: Carmen
authors.initials: C
authors.lastname: Bewell
authors.forename: James L
authors.initials: JL
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002755:Choice Behavior / Q000502:physiology; D003657:Decision Making / Q000502:physiology*; D004435:Eating / Q000502:physiology / Q000523:psychology; D005260:Female; D005715:Gambling / Q000523:psychology; D006801:Humans; D006963:Hyperphagia / Q000209:etiology* / Q000523:psychology; D008954:Models, Biological; D009483:Neuropsychological Tests; D009765:Obesity / Q000209:etiology* / Q000523:psychology; D017397:Prefrontal Cortex / Q000503:physiopathology; D012044:Regression Analysis; D011795:Surveys and Questionnaires