Reward Processing in a Child's Brain May Put Them at Higher Risk of Obesity

“There has historically been a misunderstanding that individuals with obesity lack self-control compared to those without obesity,” says Diane Gilbert-Diamond, ScD, professor of pediatrics, of epidemiology, and of medicine at Geisel School of Medicine. “We now know that genetic factors may cause some individuals to have a stronger drive to eat compared with others. We must acknowledge the rewarding aspects of food.”

She explains that ultra-processed foods (junk foods) such as cookies, chips, and candy are engineered to be especially rewarding to eat, and some people are genetically predisposed to have a higher attraction to food—their dopamine reward for eating is higher—creating a cycle that is hard to break. These individuals have more motivation to eat, making it more challenging to maintain a healthy weight, even with high levels of self-control.

Understanding the biological differences in children at risk for obesity will help caretakers and healthcare providers develop personalized interventions to help them manage their weight and grow healthily, Gilbert-Diamond says.

In addition, she says there are steps we can take collectively as a nation to help reduce child obesity rates, starting with re-evaluating food advertising.

Children themselves frequently encounter food marketing, and that can lay the groundwork for long-term challenges with weight, points out Jennifer Emond, MS, PhD, associate professor of pediatrics and of biomedical data science, and the assistant dean of the health sciences master’s program at Geisel.

During the COVID-19 pandemic, she noticed one of the educational websites her daughter used for remote learning showed ads for sugary cereals and McDonald’s Happy Meals. Emond partnered with the Center for Science in the Public Interest to urge the website to remove the ads.

The website agreed to do so, but Emond stresses that food marketing to children remains a problem because there are no federal policies to hold companies accountable.

Emond has conducted numerous research studies measuring how food advertising targets children and correlates to weight gain. For example, one study showed that when a company targeted children, ads focused on entertainment, often showcasing a toy more than the food. When targeting parents, however, the company’s ads emphasized love and bonding.

“These ads are reaching kids when they’re really young, and that shapes their attitudes toward food, which can persist as they get older,” Emond says. “Legislators need to support policies to monitor food advertising and create repercussions for companies that target children.”

Emond and Gilbert-Diamond are both member researchers at the C. Everett Koop Institute at Dartmouth, which generates rigorous science examining the influences—such as advertising and genetics—that drive unhealthy, disease-causing behaviors. With this knowledge, researchers at the Institute have become advocates for policies that protect public health, especially in children.

Gilbert-Diamond notes that other countries have seen results after implementing such laws to curb food advertisements that target children. For example, after Chile enacted stronger regulations on the marketing of unhealthy foods—including marketing to children and bans on sales of these foods in schools—research showed that fewer households bought beverages labeled as unhealthy (high in sugar, sodium, saturated fat, and/or calories). The study noted that purchases of healthy foods increased slightly as well.

Gilbert-Diamond is encouraged by those results and what it could mean closer to home. “Our research helps lay the groundwork to support similar action in the U.S.”

To learn more about child health research at the Geisel School of Medicine at Dartmouth contact Polly Antol at 603-646-5316 or at Polly.Antol@hitchcock.org.