Summary

Obesity in adults and children is associated with alterations in brain structure and function, as assessed by neuroimaging methods. However, the majority of extant literature, although informative, has been limited by reliance on small samples and cross-sectional data. This has made it challenging to establish reliable obesity-associated differences and to distinguish between two possible explanations. One explanation is that observed brain differences precede the development of excess weight and could thereby function as predictors of weight gain and potentially illuminate central mechanisms driving weight gain. An alternative is that observed brain differences occur subsequent to weight gain and instead reflect downstream effects of metabolic or other physiological sequelae of heightened adiposity.