Neural Vulnerabilities for Obesity: A Contextualized, Longitudinal Study in Adolescence

Project Summary Obesity is a prevalent and impairing condition that poses a major public health challenge in the United States. To face this challenge, there is a need for ground-breaking research aimed at identifying modifiable factors that contribute to obesity risk at pivotal junctures, thus informing novel interventions. Studies aimed at elucidating specific neural vulnerability factors that predict future excess weight gain during the critical period of adolescence hold particular promise. Findings from the parent R01 point to the potential role of top-down regulation in emerging obesity risk in adolescence. Top-down regulation deficits are associated with higher body mass index (BMI) and more obesogenic eating behaviors. While these results suggest the importance of top-down regulation in emerging obesity risk, critical questions remain and present opportunities for novel investigation, including the relative impact of food-specific versus non-food regulation, the impact of regulation within the context of reward sensitivity, and the interactions between neural vulnerabilities and food environment in predicting adolescent weight trajectories. Guided by our Contextualized Neural Vulnerabilities Model of Obesity, the proposed renewal addresses each of these issues within a highly contextualized longitudinal study exploring regulation, reward, and environment – and the interplay between these factors – in predicting adolescent weight trajectories. We propose to follow a diverse sample of adolescents for a longitudinal multimethod study leveraging rigorous measures of neural vulnerability factors (measured via fMRI tasks), diet (via multiple 24-hour recall), weight status (via BMI and body fat %), and obesogenic food environment (via multidimensional assessment, including geocoded risk score). The long-term goal is to inform specific targets of novel interventions to reduce long-term obesity risk. The objective of the proposed research, therefore, is to elucidate the role of theoretically relevant neural vulnerability factors for obesity in context within a longitudinal study. The central hypothesis is that food- specific regulation plays a uniquely critical role in adolescent diet and weight trajectories, particularly in the context of high reward sensitivity and obesogenic food environment. The specific aims are to: 1) Determine the unique relative impacts of food-specific versus non-food regulation on adolescent diet and weight trajectories; 2) Determine the impact of food-specific regulation on adolescent diet and weight trajectories, in the context of reward sensitivity; and 3) Explore the interaction between neural vulnerabilities factors (regulation, reward) and obesogenic food environment in predicting adolescent diet and weight trajectories. The study is innovative in its conceptual framework, novel focus on neural vulnerabilities in context, and integration of diverse data collection modalities within a developmentally informed longitudinal design. The significance of this research is that it will directly inform the specific targets of interventions as well as the individual and environmental contexts in which these targets may be most relevant. These results will contribute to more personalized prevention approaches, with the potential to substantially strengthen obesity prevention efforts during a key developmental period.