Obesity and the brain

The world-wide increase in obesity has markedly stimulated research on the possibility that its cause can be found the brain. However, this research has produced little that can be used to treat obesity. The reason for the limited success of this approach may be that it relies on the hypothesis that the brain controls behavior. We suggest that this hypothesis is an artefact of the powerful tools used in behavioral neuroscience and that the brain has a permissive rather than causal role in eating behavior. Drugs affecting brain function are largely ineffective in treating obesity and may remain ineffective. Instead, we hypothesize that humans need external support to control body weight because they have evolved to pay a high physical price for food and are able to eat large amounts of food without constraints when that price is minimal. Two randomized controlled trials verify the hypothesis that support on how to eat normally and how to feel a normal level of fullness by use of on-line, real time feedback on a computer screen enables under- as well as overweight patients to adjust their eating behavior and improve their health.