Successful dieters have increased neural activity in cortical areas involved in the control of behavior

Objective: To investigate whether dietary restraint, a landmark of successful dieting, is associated with specific patterns of brain responses to the sensory experience of food and meal consumption. Design and subjects: Cross-sectional study of the brain's response to the sensory experience of food and meal consumption in nine successful dieters ( age: 38 +/- 7 years, body fat (%): 28 +/- 3) and 20 non-dieters ( age: 31 +/- 9 years, body fat (%): 33 +/- 9), all women. Measurements: Changes in brain activity in response to the sensory experience of food and meal consumption were assessed by using positron emission tomography and O-15 water as a radiotracer. Body fatness was assessed by dual X-ray absorptiometry. Subjective ratings of hunger and fullness were measured by visual analogue scale. Dietary restraint, disinhibition and hunger were assessed by the Three Factor Eating Questionnaire. Results: Successful dieters had a significantly higher level of dietary restraint compared to non-dieters. In response to meal consumption, successful dieters had a greater activation in the dorsal prefrontal cortex ( DPFC), dorsal striatum and anterior cerebellar lobe as compared to non-dieters. In response to the same stimulation, the orbitofrontal cortex (OFC) was significantly more activated in non-dieters as compared to successful dieters. Dietary restraint was positively correlated with the response in the DPFC and negatively with the response in the OFC. The responses in the DPFC and OFC were negatively intercorrelated. Conclusion: Cortical areas involved in controlling inappropriate behavioral responses, such as the DPFC, are particularly activated in successful dieters in response to meal consumption. The association between the degree of dietary restraint and the coordinated neural changes in the DPFC and OFC raises the possibility that cognitive control of food intake is achieved by modulating neural circuits controlling food reward.