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Behavior, Psychology and Sociology

Differentiating the abnormalities of food and monetary reward cue processing associated with overweight/obesity: an ALE meta-analysis

International Journal of Obesity (2026)Cite this article

Subjects

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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).

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Fig. 1
Fig. 2: Results of the ALE meta-analysis showing similar brain regions activation to food cues and monetary cue of the obesity/overweight compared with the healthy weight uncorrected p < 0.001, cluster size > 100 mm3.
Fig. 3: Results of the ALE meta-analysis showing increased/decreased activation to food cues of the obesity/overweight compared with the healthy weight uncorrected p < 0.001 cluster size > 100 mm3.
Fig. 4: Results of the ALE meta-analysis showing increased/decreased activation to monetary cue of the obesity/overweight compared with the healthy weight uncorrected p < 0.001 cluster size > 100 mm3.

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Funding

This work was funded by the National Natural Science Foundation of China (32300926) and the Provincial Key Research Project of Henan Province (No. 232102310081). The funding agents had no role in the design and conduct of the study, including the collection, management, analysis, and interpretation of the data and the preparation, review, or approval of the manuscript.

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Author notes

  1. These authors contributed equally: Na Wang, Mingyue Xiao.

Authors and Affiliations

  1. Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, PR China

    Na Wang, Mingyue Xiao, Chenxuan Lu, Ruyin Yuan, ChiFong Lam, Hong Chen & Bing Cao

  2. Laboratory of Magnetic Resonance, The Affiliated Brain Hospital of Zhengzhou University (Zhumadian Second People’s Hospital), Henan, PR China

    Xiaofang Hou

  3. National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, PR China

    Hong Chen & Bing Cao

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  1. Na Wang
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Contributions

Na Wang and Mingyue Xiao proposed the research question, designed the study protocol, wrote the initial draft of the paper, and interpreted the analysis results; Na Wang and Ruyin Yuan were responsible for data collection and screening and participated in data analysis; Chenxuan Lu and Lam ChiFong assisted with data collection and participated in discussions of the paper; and Bing Cao, Mingyue Xiao, and Hong Chen provided methodological guidance and reviewed and revised the paper, ensuring the scientific rigor and accuracy of the research. All of the authors contributed substantially to the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hong Chen or Bing Cao.

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Wang, N., Xiao, M., Hou, X. et al. Differentiating the abnormalities of food and monetary reward cue processing associated with overweight/obesity: an ALE meta-analysis. Int J Obes (2026). https://doi.org/10.1038/s41366-026-02026-1

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