Obesity and tobacco smoking represent two of the most substantial causes of morbidity and mortality in theUnited States. Stress and diminished self-control are two important factors associated with obesity, tobaccosmoking, and other behaviors with addictive potential. However, no studies have systematically examinedthe neural correlates of self-control, stress, food-related, and smoking-related responses in obese andtobacco smoking subjects. Here we propose examining obese smokers, obese non-smokers, normal weightsmokers, and normal weight non-smokers in a guided imagery paradigm that we have adapted for functionalmagnetic resonance imaging (fMRI) in conjunction with behavioral measures of self-control and relatedconstructs (e.g., impulsivity and decision-making). Our prior fMRI work using the guided imagery paradigmhas examined how brain activation patterns to stress, drug cue, or neutral-relaxing conditions differ inindividuals with addictions to cocaine or alcohol from those without these addictions. Our findings indicatethat subjects with cocaine or alcohol dependence show relatively greater activations within limbic regionsand diminished activation within prefrontal cortex as compared to control comparison subjects. The extent towhich similar patterns extend or do not to tobacco smokers or obese people has important clinicalimplications. That is, the identification of common and unique neural substrates to tobacco smoking andobesity has important implications not only for how we conceptualize the disorders, but also for thedevelopment of improved prevention and treatment strategies for these conditions that currently impactmillions of people in the United States. The examination of the influence of self-control and relatedconstructs in relation to the fMRI measures in the tobacco smoking and obese groups should provideadditional information with relevance to the development of targeted prevention and treatment strategies.
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