Appetite regulation during food cue exposure: A comparison of normal-weight and obese women

► fMRI study on appetite regulation in obese and normal-weight women. ► Instruction to increase or decrease appetite during visual food cue exposure. ► Increased DLPFC engagement during down-regulation attempts in obese women. ► A more effortful control strategy of food-related craving in obesity. Obese individuals react to cues of high caloric food with enhanced craving and brain reward system activation. In the present study, we analyzed neural correlates of craving regulation and expected a regulatory deficit in obesity. We conducted an event-related functional magnetic resonance imaging study, where 12 obese women and 14 normal-weight women were exposed to pictures depicting high-caloric food and non-food items. The participants were instructed to either passively look at the pictures, or to regulate (increase, decrease) their appetite. During the passive viewing of food cues, the obese participants showed greater insula activation than the lean participants. Moreover, the obese group displayed stronger dorsolateral prefrontal cortex involvement when attempting to attenuate food-elicited craving. Our data point to an enhanced food cue reactivity and a more effortful strategy for appetite control in obese individuals.