Emotional eating is associated with increased brain responses to food-cues and reduced sensitivity to GLP-1 receptor activation.
OBJECTIVE
The neural correlates and pathophysiology of emotional eating are insufficiently known. Glucagon-like peptide-1 (GLP-1), a postprandial hormone, plays a role in feeding behavior by signaling satiety to the brain. GLP-1 receptor agonists, used for treatment of type 2 diabetes (T2DM), promote weight loss. This study investigated the association between emotional eating and responses to food-cues in brain areas involved in satiety and reward processing, as well as GLP-1 receptor agonist-induced effects on these brain responses.


METHODS
T2DM patients with obesity, normoglycemic individuals with obesity, and lean individuals (n = 48) were studied in a randomized placebo-controlled crossover study. Using functional MRI, we determined the relation between emotional eating and regional brain responses to visual food stimuli and acute effects of intravenous administration of the GLP-1 receptor agonist exenatide on these responses.


RESULTS
Emotional eating scores positively correlated with responses to food-cues in lean subjects in the insula, in normoglycemic subjects with obesity in the insula, and in T2DM patients in the amygdala, orbitofrontal cortex, and insula. Emotional eating scores negatively correlated with exenatide-induced reductions in responses to food-cues in normoglycemic subjects with obesity in the amygdala and in T2DM patients in the insula.


CONCLUSIONS
Our findings indicate that emotional eaters have altered brain responses to food-cues and are less sensitive to the central effects of GLP-1 receptor activation.
Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Liselotte
L
van Bloemendaal
Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands.
Dick J
DJ
Veltman
Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Jennifer S
JS
ten Kulve
Department of Internal Medicine/Endocrine Section/Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
Madeleine L
ML
Drent
Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Frederik
F
Barkhof
Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Michaela
M
Diamant
Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Richard G
RG
IJzerman
D001921:Brain / Q000502:physiology*; D018592:Cross-Over Studies; D004435:Eating / Q000187:drug effects; D004644:Emotions / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology* / Q000523:psychology*; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000235:genetics / Q000378:metabolism*; D000067757:Glucagon-Like Peptide-1 Receptor / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
D000067757:Glucagon-Like Peptide-1 Receptor; D052216:Glucagon-Like Peptide 1