Central Nervous System and Peripheral Hormone Responses to a Meal in Children

J Clin Endocrinol Metab. 2019 May 1;104(5):1471-1483. doi: 10.1210/jc.2018-01525.


Context: Behavioral studies suggest that responses to food consumption are altered in children with obesity (OB).

Objective: To test central nervous system and peripheral hormone response by functional MRI and satiety-regulating hormone levels before and after a meal.

Design and setting: Cross-sectional study comparing children with OB and children of healthy weight (HW) recruited from across the Puget Sound region of Washington.

Participants: Children (9 to 11 years old; OB, n = 54; HW, n = 22), matched for age and sex.

Intervention and outcome measures: Neural activation to images of high- and low-calorie food and objects was evaluated across a set of a priori appetite-processing regions that included the ventral and dorsal striatum, amygdala, substantia nigra/ventral tegmental area, insula, and medial orbitofrontal cortex. Premeal and postmeal hormones (insulin, peptide YY, glucagon-like peptide-1, active ghrelin) were measured.

Results: In response to a meal, average brain activation by high-calorie food cues vs objects in a priori regions was reduced after meals in children of HW (Z = -3.5, P < 0.0001), but not in children with OB (z = 0.28, P = 0.78) despite appropriate meal responses by gut hormones. Although premeal average brain activation by high-calorie food cues was lower in children with OB vs children of HW, postmeal activation was higher in children with OB (Z = -2.1, P = 0.04 and Z = 2.3, P = 0.02, respectively). An attenuated central response to a meal was associated with greater degree of insulin resistance.

Conclusions: Our data suggest that children with OB exhibit an attenuated central, as opposed to gut hormone, response to a meal, which may predispose them to overconsumption of food or difficulty with weight loss.

Trial registration: ClinicalTrials.gov NCT02484976.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Appetite*
  • Biomarkers / metabolism*
  • Brain / physiopathology*
  • Case-Control Studies
  • Child
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Ghrelin / metabolism
  • Glucagon-Like Peptide 1 / metabolism
  • Humans
  • Insulin / metabolism
  • Magnetic Resonance Imaging / methods
  • Male
  • Meals*
  • Obesity / metabolism
  • Obesity / physiopathology*
  • Peptide YY / metabolism
  • Postprandial Period
  • Prognosis
  • Satiation*


  • Biomarkers
  • Ghrelin
  • Insulin
  • Peptide YY
  • Glucagon-Like Peptide 1

Associated data

  • ClinicalTrials.gov/NCT02484976