Do scores on the Food Craving Inventory and Three-Factor Eating Questionnaire correlate with expected brain regions of interest in people with obesity?

Objective: To examine whether subscales of Food Craving Inventory (FCI) and Three-factor Eating Questionnaire (TFEQ) correlate with brain functional magnetic resonance imaging food-cue reactivity (fMRI-FCR) in the brain.

Methods: Thirty-two male and female adults with obesity (19-60years; 30-39.9kg/m²) participated in a 3-week dietary intervention (1120kcal/day from either 1) total meal replacement shakes, 2) portion-controlled typical food. FCI, TFEQ and fMRI-FCR were measured pre- and post-intervention. Correlations between pre-intervention fMRI-FCR and standardized pre-intervention FCI and TFEQ subscales; and also post- versus pre-intervention change in fMRI-FCR (ΔfMRI-FCR) and standardized changes in FCI and TFEQ subscales were examined at the whole brain level using tools in FMRIB Software Library.

Results: Twenty-eight subjects completed the intervention. Pre-intervention high-fat food cravings (P=0.041) and fast-food cravings (P=0.017) were negatively correlated with fMRI-FCR of several brain regions that regulate executive control over ingestion (i.e. bilateral lateral frontal pole, dorsolateral prefrontal cortex and dorsal anterior cingulate cortex). Post- vs. pre-intervention change in sweet (P=0.012) and fast food cravings (P=0.004) were negatively correlated with ΔfMRI-FCR of bilateral lateral frontal pole, dorsolateral prefrontal cortex, inferior frontal gyrus (pars opercularis) and dorsal anterior cingulate cortex (i.e. brain regions that regulate executive control over ingestion). Negative correlations were also observed between the changes in sweet and fast food cravings and ΔfMRI-FCR of brain regions that regulate food reward (i.e. bilateral mid-anterior insula, right nucleus accumbens), motor readiness to ingest (i.e. bilateral precentral gyrus), internally focused attention (i.e. bilateral precuneus and posterior cingulate cortex) and visual object recognition (i.e. occipital pole, lateral occipital cortex and middle and inferior temporal cortices). Changes in cravings for starchy food (P=0.032) and overall food cravings (P=0.027) were also negatively correlated with ΔfMRI-FCR of brain regions involved in regulating internally focused attention and visual object recognition.

Conclusions: In individuals with obesity, decreased food cravings seem to be reflective of increased fMRI-FCR of brain regions that regulate executive control over ingestion. Taken together, constructs measured by FCI seem to be reflective of neurophysiological processes underlying ingestive behavior and the changes in neurophysiological processes occurring during calorie restriction.

Clinical trials registry number: NCT02637271; the protocol is available at https://clinicaltrials.gov/ct2/show/NCT02637271.