Review

. 2018 Sep 11;8(9):174.

doi: 10.3390/brainsci8090174.

Weight Loss Maintenance: Have We Missed the Brain?

Dimitrios Poulimeneas¹, Mary Yannakoulia², Costas A Anastasiou^{3

4}, Nikolaos Scarmeas^{5

6}

Affiliations

¹ Department of Nutrition and Dietetics, Harokopio University, GR 17676 Athens, Greece. dpoul@hua.gr.
² Department of Nutrition and Dietetics, Harokopio University, GR 17676 Athens, Greece. myiannak@hua.gr.
³ Department of Nutrition and Dietetics, Harokopio University, GR 17676 Athens, Greece. acostas@hua.gr.
⁴ Eginition Hospital, 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, GR 15772 Athens, Greece. acostas@hua.gr.
⁵ Eginition Hospital, 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, GR 15772 Athens, Greece. ns257@columbia.edu.
⁶ Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY 10027, USA. ns257@columbia.edu.

PMID: 30208568
PMCID: PMC6162665
DOI: 10.3390/brainsci8090174

Review

Weight Loss Maintenance: Have We Missed the Brain?

Dimitrios Poulimeneas et al. Brain Sci. 2018.

. 2018 Sep 11;8(9):174.

doi: 10.3390/brainsci8090174.

Authors

Dimitrios Poulimeneas¹, Mary Yannakoulia², Costas A Anastasiou^{3

4}, Nikolaos Scarmeas^{5

6}

Affiliations

¹ Department of Nutrition and Dietetics, Harokopio University, GR 17676 Athens, Greece. dpoul@hua.gr.
² Department of Nutrition and Dietetics, Harokopio University, GR 17676 Athens, Greece. myiannak@hua.gr.
³ Department of Nutrition and Dietetics, Harokopio University, GR 17676 Athens, Greece. acostas@hua.gr.
⁴ Eginition Hospital, 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, GR 15772 Athens, Greece. acostas@hua.gr.
⁵ Eginition Hospital, 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, GR 15772 Athens, Greece. ns257@columbia.edu.
⁶ Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY 10027, USA. ns257@columbia.edu.

PMID: 30208568
PMCID: PMC6162665
DOI: 10.3390/brainsci8090174

Abstract

Even though obese individuals often succeed with weight loss, long-term weight loss maintenance remains elusive. Dietary, lifestyle and psychosocial correlates of weight loss maintenance have been researched, yet the nature of maintenance is still poorly understood. Studying the neural processing of weight loss maintainers may provide a much-needed insight towards sustained obesity management. In this narrative review, we evaluate and critically discuss available evidence regarding the food-related neural responses of weight loss maintainers, as opposed to those of obese or lean persons. While research is still ongoing, available data indicate that following weight loss, maintainers exhibit persistent reward related feeling over food, similar to that of obese persons. However, unlike in obese persons, in maintainers, reward-related brain activity appears to be counteracted by subsequently heightened inhibition. These findings suggest that post-dieting, maintainers acquire a certain level of cognitive control which possibly protects them from weight regaining. The prefrontal cortex, as well as the limbic system, encompass key regions of interest for weight loss maintenance, and their contributions to long term successful weight loss should be further explored. Future possibilities and supportive theories are discussed.

Keywords: functional neuroimaging; maintainers; neural processing; obesity; regainers; weight loss maintenance.

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Conflict of interest statement

Mary Yannakoulia was the PI of the MedWeight study (2012–2015), that was partially funded by the Coca Cola Foundation (KA 221). Nikolaos Scarmeas reportspersonal fees from Merck Consumer Health. Dimitrios Poulimeneas and Costas A. Anastasiou declare no conflicts of interest.

Figures

**Figure 1**
A summary of regional brain activity and proposed function in maintainers compared to obese and normal weight individuals.

See this image and copyright information in PMC

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Weight Loss Maintenance: Have We Missed the Brain?

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Weight Loss Maintenance: Have We Missed the Brain?

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