Reward, reinforcement, and impulsivity in obesity

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Individual differences on reward sensitivity and impulsivity are associated with the risk of obesity, and unhealthy diets and adiposity can ultimately impair reward processing and cognitive control. Here I review findings from personality, neuropsychological and neuroimaging measures of reward processing and impulse control in pediatric and adult populations with excess weight. Personality measures reflect general dispositional traits of these populations, including sensitivity to reward and punishment, and cognitive and emotional facets of impulsivity. Neuropsychological measures assess the current function of specific cognitive processes relevant to reward and impulse control, including attention/motivation toward food vs. non-food stimuli, response (dis)inhibition and decision-making (e.g. preference for immediate rewards or disregard of potential outcomes). Neuroimaging measures are utilized to unveil the neural underpinnings of these traits and processes. Findings suggest that both young and adult populations with obesity are characterized by dispositionally lower sensitivity to reward (reward deficiency), coupled with higher responsivity to food rewards, poorer response inhibition and steeper discounting of delayed rewards, all of which are longitudinally associated with weight gain. These deficits are manifested in somatosensory (insula/frontal operculum), reward seeking (striatum, extended amygdala, cerebellum), stimulus-oriented attention (dorsolateral prefrontal cortex), and decision-making (orbitofrontal cortex) brain systems dysfunction
Original languageEnglish
Title of host publicationTreatment of the Obese Patient
EditorsRobert F Kushner, Daniel H Bessesen
Place of PublicationNew York NY USA
Number of pages13
ISBN (Electronic)9781493912032
ISBN (Print)9781493912025
Publication statusPublished - 2014

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