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CompletedNCT02241603IRRSOUpdated May 12, 2026

Insulin Resistance and Reward Signaling in Obesity

A Phase 1 interventional study of Weight loss in Obesity, sponsored by VA Office of Research and Development. Completed at 1 site in United States. Open to participants aged 25 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-05-12.

Sponsored by VA Office of Research and Development · Phase 1, Interventional, and Other

Phase
Phase 1
Study type
Interventional
Enrollment
37
Allocation
Non-randomized
Ages
25 Years to 60 Years
Sex
All
01

Study summary

Obesity is a common problem in the Veteran population as at least 1 in 3 Veterans have obesity. When people with obesity taste food they have less response in areas of the brain that sense pleasure (reward). Decreased pleasure response to food predicts future weight gain. It is not known if this poor brain response is reversible or why obese people's brains respond this way. Insulin in the brain regulates the brain's sensing of pleasure. As people gain weight the function of insulin becomes impaired. The investigators will study if impaired function of insulin is related to a lessened brain response to food and if this brain response predicts voluntary intake of food and response to a low-calorie diet. The investigators will also study if improving the function of insulin with weight loss improves the brain response. These studies will improve the understanding as to why weight loss is difficult and inform us if improving insulin signaling is a potential way to treat obesity.

Read the detailed description

The current research proposal will investigate the relationship of insulin sensitivity to brain reward signaling. In most individuals with obesity, insulin signaling is impaired (insulin resistance). Preclinical animal studies suggest that insulin resistance in brain regions important for reward contribute to overeating. This proposal aims to test these hypotheses in humans and to determine if these characteristics are pertinent to clinical outcomes (food intake and weight loss). In humans increased body mass index (BMI) and weight gain occur with decreased food consumption-induced neural activation (consummatory reward) in the caudate of the dorsal striatum. It has been speculated that diminished consummatory reward causes overeating and prevents weight loss, however, this hypothesis has not been directly tested. Further, mechanisms for impaired food consumption-induced neural activation in obesity have not been investigated.

The research outcomes of the proposed study are: 1) taste-induced neural activation as determined by blood-oxygen dependent functional magnetic resonance imaging (BOLD fMRI) scanning, 2) caloric intake at a buffet meal, and 3) food craving. Based on screening and baseline outcome assessments participants with insulin resistance (metabolically unhealthy obesity) will be enrolled in a weight loss intervention to lose 5-10% body weight and then repeat outcomes measures after intervention. Those who are metabolically healthy at baseline (MHO) will only complete baseline outcome measures.

02

Conditions studied

  • Obesity

Keywords

  • Insulin resistance
  • Consummatory Reward
03

In context

Obesity

6,296 studies on the registry are indexed under Obesity; 1,692 are open to participants now.

This study's enrollment of 37 is below the median of 78 across 4,878 interventional studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

VA Office of Research and Development is the lead sponsor of 1,733 studies on the registry; 396 are open to participants now.

Of its 206 completed or terminated interventional studies of FDA-regulated products, 180 (87%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
25 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age 25-60yoa, inclusive.
  • BMI 30.0 and 45.0 kg/m2, inclusive.
  • Normal visual acuity with correction.
  • Able to travel regularly to the St. Louis VA and Washington University for research visits.
  • Completed signed informed consent form.

Exclusion criteria

Exclusion Criteria:

  • Current or history of significant psychiatric disease, including Binge Eating Disorder (BED).
  • Current or history of significant substance abuse or extended use of tobacco.
  • Contraindications for MRI (e.g., pregnancy, claustrophobia, pacemaker, circumference > 54 inches, weight > 400 lbs, etc.);
  • Significant cardiovascular, pulmonary, renal, liver, neurologic, or metabolic disease.
  • Diabetes mellitus.
  • Significant anemia.
  • Treatment with a medication the affects insulin sensitivity.
  • Treatment with centrally acting medications.
  • Frequent shift work.
  • Significant in-mobility or unable to lay on back still for 1 hour.
  • History of bariatric surgery.
  • Food allergies/ intolerance that would prevent completing study.
  • Symptoms concerning for untreated active mental health disease
05

Study design

Phase
Phase 1
Primary purpose
Other
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
37 participants (actual)

Study arms

  • Experimental
    MUO (metabolically unhealthy)

    Veterans with obesity and determined metabolically unhealthy, weight stable before attempting to lose 5-10% body weight with caloric restriction intervention Weight loss completers through dietary education for caloric restriction to lose 5-10% of body weight.

    Behavioral: Weight loss

  • No intervention
    MHO (metabolically healthy)

    Veterans with obesity determined to be metabolically healthy and weight stable

Interventions

  • BehavioralWeight loss

    Veterans with obesity who are metabolically unhealthy will undergo dietary intervention aiming for 5-10% weight loss

06

What researchers measure

Primary outcomes

  1. food consumption-induced neural activation

    food consumption-induced neural activation as determined by blood-oxygen dependent functional magnetic resonance imaging (BOLD fMRI) scanning

    Time frame: ~4-9months

07

Study locations

1 site
  • St. Louis VA Medical Center John Cochran Division, St. Louis, MO
    St Louis, Missouri 63106, United States
08

References and documents

Publications

  • Dunn JP, Lamichhane B, Smith GI, Garner A, Wallendorf M, Hershey T, Klein S. Dorsal striatal response to taste is modified by obesity and insulin resistance. Obesity (Silver Spring). 2023 Aug;31(8):2065-2075. doi: 10.1002/oby.23799. PubMed 37475685 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 12, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02241603
Lead sponsor
VA Office of Research and Development
Collaborators
Washington University School of Medicine
Responsible party
Sponsor
First posted
Sep 16, 2014
Start date
Nov 17, 2014
Primary completion
Jul 1, 2020
Completion
Jul 6, 2020
Last update
May 12, 2026

Study contacts

Julia P Dunn, MD
principal investigator · St. Louis VA Medical Center John Cochran Division, St. Louis, MO

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2026. You cannot join it, but the record below documents what was studied.

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