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, 31 (11), 1460-1474

Interactions Between Metabolic, Reward and Cognitive Processes in Appetite Control: Implications for Novel Weight Management Therapies


Interactions Between Metabolic, Reward and Cognitive Processes in Appetite Control: Implications for Novel Weight Management Therapies

Suzanne Higgs et al. J Psychopharmacol.


Traditional models of appetite control have emphasised the role of parallel homeostatic and hedonic systems, but more recently the distinction between independent homeostatic and hedonic systems has been abandoned in favour of a framework that emphasises the cross talk between the neurochemical substrates of the two systems. In addition, evidence has emerged more recently, that higher level cognitive functions such as learning, memory and attention play an important role in everyday appetite control and that homeostatic signals also play a role in cognition. Here, we review this evidence and present a comprehensive model of the control of appetite that integrates cognitive, homeostatic and reward mechanisms. We discuss the implications of this model for understanding the factors that may contribute to disordered patterns of eating and suggest opportunities for developing more effective treatment approaches for eating disorders and weight management.

Keywords: Food reward; appetite control; cognition; metabolic signals.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: C Dourish is an employee, director and shareholder of P1vital Ltd and a director and shareholder of P1vital Products Ltd. S Higgs is a member of P1vital Ltd’s Advisory Panel. No other conflicts are reported by the remaining authors.


Figure 1.
Figure 1.
Cognitive processes throughout the day that influence eating behaviour. The outer circle provides an overview of the processes that operate before a meal: the expectation and sight of the food to be consumed, and the interplay between any (health) goals, memory of the taste and pleasure of the food and attention to food cues will determine if individuals will start eating and what kind of food they will choose. The middle circle represents within-meal processes that influence the amount consumed: pleasantness and reward values will decrease while eating and ultimately lead to meal termination. Additionally, attention to the process of eating and cognitive control also will influence the termination of the meal. The inner circle represents the processes operating between meals, for example episodic memory of a meal will influence decisions about when to eat a next meal. dlPFC: dorsolateral prefrontal cortex; OFC: orbitofrontal cortex; vmPFC: ventromedial-prefrontal cortex.
Figure 2.
Figure 2.
Schematic diagram outlining a model of appetite control involving interactions between homeostatic, reward and cognitive processes (indicated by solid arrows) and the modulation of these processes by metabolic signals such as insulin, leptin, glucagon-like peptide 1 (GLP-1), 5-HT and ghrelin (indicated by dashed arrows).

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