Hypothalamic Networks in Adolescents With Excess Weight: Stress-Related Connectivity and Associations With Emotional Eating

Objective: Adolescents with excess weight are particularly sensitive to stress, which may contribute to the presence of emotional eating behaviors. It is proposed that this may be due to alterations in the connectivity between hypothalamic networks and regions of the emotional nervous system, involved in the regulation of energy balance and stress processing. However, this remains to be clarified in adolescents with excess weight. Method: We investigated whole-brain differences in the functional connectivity of the medial and lateral hypothalamus (MH and LH) between adolescents with excess weight (EW, n = 53; mean age = 14.64 years, SD = 1.78) and normal weight (NW, n = 51; mean age = 15.29 years, SD = 1.75) using seed-based resting-state analyses. Then, in a subset of 22 adolescents with EW (mean age = 15.75 years, SD = 1.70) and 32 with NW (mean age = 15.27, SD = 2.03), we explored for group interactions between the MH/LH networks and stress response in the Trier Social Stress Task (TSST) and emotional eating, assessed with the Dutch Eating Behavior Questionnaire (DEB-Q). Results: Compared to NW, EW showed higher functional connectivity in the LH-orbitofrontal cortex, ventral striatum, anterior insula, and in the MH-middle temporal cortex networks. EW also showed lower connectivity in the LH-cerebellum, and in the MH-middle prefrontal, pre-, and postcentral gyri networks. In EW, higher connectivity of the LH-nucleus accumbens and LH-midbrain networks were associated with stress response. Higher connectivity in the LH-midbrain was also associated with a greater presence of emotional eating behaviors in EW. Conclusion: Adolescents with EW showed functional connectivity alterations within both MH/LH networks. Alterations in the LH network were linked with higher levels of stress response and emotional-driven eating patterns.