Watching the Brain Reveals Willpower in Action

I think I can, I think I can.

Sep 25, 2009

For most of us, the biggest problem with losing lots of weight is the demoralizing process of watching ourselves gain it all back. But some people who lose weight manage to keep it off for good. How do they do it? Researchers from the Miriam Hospital recently examined their brain activity with functional magnetic resonance imaging and actually saw their restraint in action.

Functional magnetic resonance imaging, or fMRI, reveals what parts of the brain are working, based on the increase in blood flow to those portions of the brain. Consequently, it enables researchers to determine which brain structures are involved in specific mental operations. Once they have figured out which brain structures correspond to which mental processes, they can use fMRI to see which of those processes are going on during various activities.

The Miriam Hospital researchers wanted to determine which brain functions are activated when long-term weight-loss maintainers are presented with food. So they divided their subjects into three groups: 18 people of normal weight, 16 obese individuals, and 17 participants who had lost at least 30 pounds and had maintained that weight loss for at least three years. After the participants had fasted for four hours and were nicely hungry, the researchers showed them pictures of low-calorie foods, pictures of high-calorie foods, and a few pictures of rocks and shrubs just for the sake of comparison. Then they used the fMRI to peer into their brains and see which regions of their brains were activated in response to each image.

What they found was that the people who had kept the weight off showed much more activity in the left superior frontal and right middle temporal regions of the brain. Those regions are associated with greater inhibitory control and greater visual attention. In short, it appears that the long-term weight-loss maintainers were examining the food closely to see if it had a lot of calories, and if it did, they were marshalling their resources to not eat it.

What the researchers don't know yet is whether these people were born with their ability to restrain themselves, or whether they developed it throughout years of practice. More research, say the researchers, is called for.

Jeanne McCaffery, PhD, of the Miriam Hospital's Weight Control and Diabetes Research Center and her team published their findings in the American Journal of Clinical Nutrition.

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News Release - Miriam Hospital, Providence, Rhode Island

Columbia University Program for Imaging and Cognitive Sciences

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Categories: Diabetes, Diabetes, Food, Losing weight, Pre-Diabetes, Research, Type 2 Issues, Weight Loss

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Posted by Steve Parker, M.D. on 25 September 2009

The journal Clinical Diabetes in 2008 published an article on evidence-base ways to prevent weight regain. I doubt they would mind my summary here:
1) Maintain high levels of physical activity. Consider at least 60 minutes daily of moderate activity. Ouch!
2) Limit television to less that a few hours a day.
3) Eat a diet low in fat and calories. [I disagree with the accross-the-board low-fat recommendation.]
4) Maintain a consistent eating pattern throughout the week and year. Successful losers often report less variety, compared to other people, in all food groups except for fruits.
5) Eat breakfast routinely.
6) Control emotional eating.
7) Weigh frequently, whether daily or weekly.
8) Catch and address weight regain early, before it gets out of hand.
9) Consider sequential medications. E.g., sibutramine for months, then orlistat for months. [Last resort, in my practice.]
10) Individual and/or group follow-up support. Even follow-up by phone works.
11) Have realistic expectations. Most dieters only lose about half the weight they expected in the first place. The resulting sense of disappointment sabotages efforts to keep the weight off. Anticipate the universal tendency to regain lost weight.
12) Helpful diet patterns: eat more than five servings a day of fruits and vegetables, watch portion sizes, self-record food intake, plan meals, limit fast food.
13) “Exercise is central to weight loss maintenance.”

I hope you find this helpful while awaiting results of more research.


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