Cited by 275Regulation of Appetite and ObesityNeurotransmitter Receptor Influence on BehaviorEating Disorders and Behaviors

The DOI matches its Crossref record; 208 of the 208 references it cites were found in a registry or an index; none of the 153 sources its claims cite is checked for support yet.

Food reward, hyperphagia, and obesity

Open access
Berthoud, Hans-Rudolf, Lenard, Natalie R., Shin, Andrew C.·2011·American Journal of Physiology-Regulatory, Integrative and Comparative Physiology

Abstract

Given the unabated obesity problem, there is increasing appreciation of expressions like “my eyes are bigger than my stomach,” and recent studies in rodents and humans suggest that dysregulated brain reward pathways may be contributing not only to drug addiction but also to increased intake of palatable foods and ultimately obesity. After describing recent progress in revealing the neural pathways and mechanisms underlying food reward and the attribution of incentive salience by internal state signals, we analyze the potentially circular relationship between palatable food intake, hyperphagia, and obesity. Are there preexisting individual differences in reward functions at an early age, and could they be responsible for development of obesity later in life? Does repeated exposure to palatable foods set off a cascade of sensitization as in drug and alcohol addiction? Are reward functions altered by secondary effects of the obese state, such as increased signaling through inflammatory, oxidative, and mitochondrial stress pathways? Answering these questions will significantly impact prevention and treatment of obesity and its ensuing comorbidities as well as eating disorders and drug and alcohol addiction.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that food reward (“liking,” “wanting,” and learning) interacts with homeostatic metabolic signals and may contribute to hyperphagia and obesity through preexisting reward differences, addiction-like neuroadaptation to palatable foods, and secondary effects of the obese state. It concludes that evidence remains largely indirect/correlative, with mesolimbic dopamine implicated in “wanting” but still unclear whether over- or under-activity drives hyperphagia.

Key findings

  • Food reward is a composite of “liking” (hedonic impact), “wanting” (incentive salience), and learning, with separable brain systems: μ-opioid-mediated “liking” hotspots in nucleus accumbens shell/ventral pallidum, and mesolimbic dopamine for “wanting”; leptin, ghrelin, and insulin modulate these processes.
  • Three non-exclusive mechanisms may link reward to obesity: preexisting differences in reward function, repeated palatable-food intake as an escalating addictive process, and obesity-induced changes in reward circuitry; among ~20 major obesity genes, none are directly implicated in reward, and combined effects account for less than ∼5% of human obesity.
  • In Wistar rats, a palatable cafeteria diet produced sustained hyperphagia over 40 days and increased lateral hypothalamic self-stimulation threshold in parallel with weight gain; after 14 days of abstinence, reward threshold did not normalize despite hypophagia and ∼10% body weight loss, unlike the relatively rapid ∼48 h normalization seen after cocaine abstinence.
  • Obesity/high-fat diet can alter reward: obesity-prone rats on chow or high-fat diet without extra weight gain showed reduced progressive ratio break point for sucrose, amphetamine-induced conditioned place preference, and nucleus accumbens dopamine turnover; leptin-deficient humans showed exaggerated nucleus accumbens activation to food images that was abolished by leptin.

Methods

  • Narrative review, not a primary empirical study; it synthesizes rodent, nonhuman primate, and human literature on food reward, hyperphagia, and obesity.
  • Data/sample: cited animal models (rats, mice, primates) and human neuroimaging/clinical studies; no new sample or original dataset.
  • Main analysis: conceptual synthesis of neural pathways and three hypothesized reward–obesity mechanisms; no meta-analysis or statistical pooling.

Limitations

  • The paper states there is “no smoking gun” for a single specific neural pathway or molecule, and it is not yet clear whether over- or under-activity of dopamine signaling is at the origin of hyperphagia or which mesolimbic dopamine projections are specifically involved.
  • The paper notes that few studies dissociate preexisting reward differences from secondary effects of the obese state, and that only longitudinal studies in genetically defined populations will provide more conclusive answers; controlled human studies showing long-term effects of palatability on energy balance are few.
  • Evident from the text: as a narrative review, conclusions rely heavily on indirect and correlative evidence from heterogeneous animal models and methodologies, without systematic review or meta-analytic quantification.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1152/ajpregu.00028.2011

Cites

208 of 208 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

85 Not checked yet · 47 Own interpretation

Verify all 153 references — free account

Show all 83 claims

  • It may state two separate claims as one. 44
  • Probably not a substantial claim. 8
49 of 49
  • The paper relies on this without support.

    The anatomy, chemistry, and functions of the elaborate neural systems involved in food reward and their interactions with the hypothalamic homeostatic regulator are poorly understood.

    “Regrettably, the anatomy, chemistry, and functions of these elaborate neural systems and their interactions with the homeostatic regulator in the hypothalamus are poorly understood.”
  • The paper relies on this without support.

    Dysregulated brain reward pathways may contribute to increased intake of palatable foods and ultimately obesity.

    “recent studies in rodents and humans suggest that dysregulated brain reward pathways may be contributing not only to drug addiction but also to increased intake of palatable foods and ultimately obesity.”
  • The paper relies on this without support.

    Eating is typically experienced as pleasurable and rewarding.

    “Eating is typically experienced as pleasurable and rewarding”
  • The paper relies on this without support.

    Food is a powerful natural reinforcer that outcompetes most other behaviors, particularly when an individual is metabolically hungry.

    “Thus, food is a powerful natural reinforcer that out competes most other behaviors, particularly when an individual is metabolically hungry.”
  • The paper relies on this without support.

    Metabolic hunger increases motivation to find food and to eat.

    “It has long been known that metabolic hunger increases motivation to find food and to eat, but the neural mechanisms involved were obscure.”
  • The paper relies on this without support.

    The hypothalamus is the epicenter of homeostatic regulation.

    “Given that the hypothalamus was recognized as the epicenter of homeostatic regulation, it was assumed that the metabolic hunger signal originates in this brain area and propagates through neural projections to other areas important for the organization of goal-directed behavior.”
  • The paper relies on this without support.

    There is no hunger center and no pleasure center in the brain.

    “Just as there is no hunger center, there is no pleasure center in the brain.”
  • The paper relies on this without support.

    In animals, only the subconscious components of pleasure (core “liking”) and aversion are experimentally accessible.

    “In animals, only the subconscious components of pleasure (Berridge's core “liking”) and aversion are experimentally accessible, and one of the few specific test paradigms is measurement of positive and negative orofacial expressions when tasting pleasurable (typically sweet) or aversive stimuli ([11](#B11)).”
  • The paper relies on this without support.

    A general feeling of satisfaction lingers long after meal termination and contributes to the reinforcing power of a meal.

    “Rather than the acute pleasure of tasty food in the mouth, there is a general feeling of satisfaction that lingers on long after termination, and most likely contributes to the reinforcing power of a meal.”
  • The paper relies on this without support.

    Leptin and other metabolic signals act on a large number of brain systems.

    “However, during the last few years it became increasingly clear that leptin and the plethora of other metabolic signals not only act on the hypothalamus, but on a large number of brain systems.”
  • The paper relies on this without support.

    Not all subjects exposed to the same toxic environment gain weight.

    “this simple explanation does not account for the fact that not all subjects exposed to the same toxic environment gain weight.”
  • The paper relies on this without support.

    Environmental pressure pushes the general population to higher food intake and body weight.

    “Although environmental pressure undoubtedly pushes the general population to higher food intake and body weight”
  • The paper relies on this without support.

    Obesity-prone rats develop some degree of obesity even on regular chow diet.

    “Because obesity-prone rats develop some degree of obesity even on regular chow diet, it is also not clear to what extent the genetic difference depends on availability of palatable diet vs. chow, to be phenotypically expressed (susceptibility genes).”
  • The paper relies on this without support.

    The homeostatic regulatory system has a strong inherent bias to defend against energy depletion more strongly than energy surplus.

    “Given these external conditions together with the strong inherent bias of the homeostatic regulatory system to defend against energy depletion more strongly than energy surplus, weight is easily gained but not so easily lost.”
  • The paper relies on this without support.

    The reward system is complex and cannot be easily manipulated with drugs or genetic deletions.

    “This is most likely because the reward system is complex and cannot be easily manipulated with drugs or genetic deletions.”
  • The paper relies on this without support.

    The concept of food addiction is still not generally accepted, and its behavioral and neurological mechanisms remain obscure.

    “While the field of drug addiction has a long tradition (e.g., Refs. [96](#B96), [132](#B132)), the concept of food addiction is still not generally accepted, and its behavioral and neurological mechanisms remain obscure.”
16 of 16

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Citations

Cites

Show all 208 references

Research works printed but not linked: 2

  1. Rosenbaum M, 2008, J Clin Invest, 118, 2583
  2. Verhagen JV, 2006, Brain Res Brain Res Rev

Cited by

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Metadata

Authors
Berthoud, H.-R., Lenard, N. R., & Shin, A. C.
Affiliations
Pennington Biomedical Research Center (US)
Corresponding author
Berthoud, Hans-Rudolf
Venue
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology
Published
2011-06
Volume
300
Issue
6
Pages
R1266-R1277
ISSN
  • 0363-6119 (ISSN-L)
  • 1522-1490
OpenAlex
W2141794225
Cited by
275
References
208
Citations by year
2026: 8 · 2025: 8 · 2024: 4 · 2023: 16 · 2022: 10 · 2021: 24 · 2020: 18 · 2019: 52 · 2018: 11 · 2017: 12 · 2016: 17 · 2015: 20 · 2014: 27 · 2013: 25 · 2012: 18
FWCI
2.47
Type
journal article
Language
en
Open access
Locations
  • American Journal of Physiology-Regulatory, Integrative and Comparative Physiology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (DK-47348, R01DK071082, DK071082, R01DK047348)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Keywords
food reward, hyperphagia, obesity, incentive salience, palatable food intake, brain reward system, sensitization, inflammatory signaling, oxidative stress, mitochondrial stress, drug addiction, alcoholism, eating disorders, obesity-related comorbidities
MeSH terms
Animals, Humans, Hyperphagia, Neural Pathways, Obesity, Reward, Signal Transduction, Behavior, Addictive, Models, Animal

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