Differentiating the abnormalities of food and monetary reward cue processing associated with overweight/obesity: an...

Obesity represents a critical global health challenge, yet the neurocognitive distinctions in processing different rewards among individuals with overweight/obesity (OW/OB) remain poorly characterized. This meta-analysis aims to synthesize functional MRI evidence to delineate common and distinct neural abnormalities during processing of food or monetary reward cues in individuals with OW/OB compared to normal-weight (NW) controls.

Searches were conducted in Web of Science, PubMed, and PsycInfo to identify eligible citations from inception until May 2025. The review protocol was registered in PROSPERO (No. CRD42024595608). Data analyses were carried out using the Activation Likelihood Estimation (ALE) algorithm. MRIcroGL was used to show the results with MNI coordinates.

We systematically reviewed 26 studies with 1065 participants, comprising 6 monetary reward and 20 food reward studies. Overlapping reduced activation occurred in the left posterior cingulate cortex (PCC) and insula across both reward types; the left middle frontal gyrus (MFG) exhibited decreased activation in response to food reward cues, while it showed increased activation in response to monetary reward cues in individuals with OW/OB. During food-reward tasks, individuals with OW/OB exhibited increased activation in the bilateral caudate nucleus, hippocampus, anterior cingulate cortex (ACC), and medial prefrontal cortex, alongside decreased activation in amygdala responses. For monetary-reward tasks, increased activation was observed in the right lateral nucleus and hypothalamus, while decreased activation was observed in the right subthalamic nucleus (STN) and posterior ventral lateral nucleus.

Obesity represents a critical global health challenge, yet the neurocognitive distinctions in processing different rewards among individuals with OW/OB remain poorly characterized. Our findings reveal both dissociable and overlapping neural alterations during the processing of primary (food) versus secondary (monetary) rewards in OW/OB, implicating altered reward sensitivity, decision-making, and inhibitory control. The results underscore the necessity for reward-type-specific interventions targeting these neural mechanisms to address obesity-related dysregulation. Contrasts in brain activation during food and monetary reward processing between individuals with overweight/obesity (OW/OB) and normal weight (NW).