肥胖的神经脆弱性理论

The Neurovulnerability Theory of Obesity

摘要: 食物奖赏对食物摄入和肥胖形成有着重要的影响。从食物奖赏的机制与肥胖的关系角度，研究者通过横断面和前瞻性神经成像研究，提出了可能增加暴饮暴食和体重增长风险的神经脆弱性因素。文章回顾了这些研究的证据，这些研究发现，肥胖或有肥胖风险的个体表现出奖赏脑区对高热量食物线索的高反应性及对奖赏反应进行抑制控制的能力缺失，从而增加了高热量食物的摄入和肥胖风险，支持了刺激敏感化理论、奖赏过度理论和抑制控制缺陷理论。对于奖赏不足理论的支持相对较少。这些研究可以对肥胖的预防和治疗提供一些启示，减少奖赏脑区对食物线索的反应并增加抑制控制能力的干预措施可以减少暴饮暴食和体重增加。

Abstract: Food rewards have an important influence on food intake and obesity formation. From the perspective of the mechanisms of food reward in relation to obesity, researchers have used cross-sectional and prospective neuroimaging studies to suggest neuro vulnerability factors that may increase the risk of binge eating and weight gain. This paper reviews the evidence from these studies, which found that individuals who are obese or at risk of obesity exhibit high responsiveness of reward brain regions to high-calorie food cues and deficits in inhibitory control of reward responses, thereby increasing high-calorie food intake and obesity risk. These findings support the Incentive Sensitization Theory of Obesity, Reward Surfeit Theory of Obesity, and Inhibitory Control Deficit Theory of Overeating. There is relatively little support for the Reward Deficit Theory of Obesity. These studies may provide some insight into the prevention and treatment of obesity, where interventions that reduce the response of rewarding brain regions to food cues and increase inhibitory control may reduce binge eating and weight gain.