Decision-making deficits and overeating: A risk model for obesity

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. Research Methods and Procedures: 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; R-2 = 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. Discussion: 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.