Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109-1043, USA.
Appetite. 2022 Oct 1;177:106146. doi: 10.1016/j.appet.2022.106146. Epub 2022 Jun 23.
Obesity and other eating disorders are marked by dysregulations to brain metabolic, hedonic, motivational, and sensory systems that control food intake. Classic approaches in hunger research have distinguished between hedonic and homeostatic processes, and have mostly treated these systems as independent. Hindbrain structures and a complex network of interconnected hypothalamic nuclei control metabolic processes, energy expenditure, and food intake while mesocorticolimbic structures are though to control hedonic and motivational processes associated with food reward. However, it is becoming increasingly clear that hedonic and homeostatic brain systems do not function in isolation, but rather interact as part of a larger network that regulates food intake. Incentive theories of motivation provide a useful route to explore these interactions. Adapting incentive theories of motivation can enable researchers to better understand how motivational systems dysfunction during disease. Obesity and addiction are associated with profound alterations to both hedonic and homeostatic brain systems that result in maladaptive patterns of consumption. A subset of individuals with obesity may experience pathological cravings for food due to incentive sensitization of brain systems that generate excessive 'wanting' to eat. Further progress in understanding how the brain regulates hunger and appetite may depend on merging traditional hedonic and homeostatic concepts of food reward and motivation.
肥胖症和其他饮食失调症的特点是大脑代谢、享乐、动机和感官系统的失调，这些系统控制着食物的摄入。经典的饥饿研究方法将享乐和体内平衡过程区分开来，并且大多将这些系统视为独立的。后脑结构和相互连接的下丘脑核的复杂网络控制着代谢过程、能量消耗和食物摄入，而中脑边缘皮质结构则被认为控制着与食物奖励相关的享乐和动机过程。然而，越来越明显的是，享乐和体内平衡的大脑系统并非孤立地运作，而是作为调节食物摄入的更大网络的一部分相互作用。动机的激励理论为探索这些相互作用提供了一条有用的途径。适应动机的激励理论可以使研究人员更好地理解在疾病过程中，动机系统是如何出现功能障碍的。肥胖症和成瘾与享乐和体内平衡的大脑系统发生深刻改变有关，导致了适应不良的消费模式。由于产生过度“想吃”的大脑系统的激励敏感化，一部分肥胖症患者可能会经历病理性的对食物的渴望。进一步理解大脑如何调节饥饿和食欲可能取决于将传统的享乐和体内平衡概念的食物奖励和动机融合在一起。
