The food addiction model suggests neurobiological similarities between substance‐related and addictive disorders and obesity. While structural brain differences have been consistently reported in these conditions, little is known about the neuroanatomical correlates of food addiction. We therefore aimed to determine whether symptoms of food addiction related to body mass index (BMI), personality, and brain structure in a large population‐based sample. Participants of the LIFE‐Adult study (n = 625; 20–59 years old, 45% women) answered the Yale Food Addiction Scale (YFAS) and further personality measures, underwent anthropometric assessments and high‐resolution 3T‐neuroimaging. A higher YFAS symptom score correlated with higher BMI, eating behavior traits, neuroticism, and stress. Higher BMI predicted significantly lower thickness of (pre)frontal, temporal and occipital cortex and increased volume of left nucleus accumbens. In a whole‐brain analysis, YFAS symptom score was not associated with significant differences in cortical thickness or subcortical gray matter volumes. A hypothesis‐driven Bayes factor analysis suggested a small, additional contribution of YFAS symptom score to lower right lateral orbitofrontal cortex thickness over the effect of BMI. Our study indicates that symptoms of food addiction do not account for the major part of the structural brain differences associated with BMI in the general population. Yet, symptoms of food addiction might explain additional variance in orbitofrontal cortex, a hub area of the reward network. Longitudinal studies implementing both anatomical and functional MRI could further disentangle the neural mechanisms of addictive eating behaviors.

Key Points Question Does estradiol mitigate the negative association of visceral fat with structural brain networks and cognitive health? Findings In this cross-sectional study of a German population-based cohort of 974 adults, higher estradiol levels were associated with increased structural brain network covariance and a reduction in the negative association of visceral fat with network covariance, but only for women. In women, higher estradiol levels were associated with better structural network covariance and cognitive performance during midlife. Meaning Assessing visceral adipose tissue and hormone profiles, particularly in women during midlife, may be essential for promoting a healthy brain aging trajectory.

The food addiction model suggests neurobiological similarities between substance-related and addictive disorders and obesity. While structural brain differences have been consistently reported in these conditions, little is known about the neuroanatomical correlates of food addiction. We therefore assessed whether food addiction, assessed with the Yale Food Addiction Scale (YFAS), related to obesity, personality and brain structure in a large population-based sample (n=625; 20-59 years old, 45% women). A higher YFAS symptom score correlated with obesity and disinhibited eating. In a whole-brain analysis, YFAS symptom score was not associated with cortical thickness nor subcortical gray matter volumes. Higher body mass index (BMI) correlated with reduced thickness of (pre)frontal, temporal and occipital cortex. Bayes factor analysis suggested that BMI and -to a smaller extent -YFAS symptom score contributed independently to right lateral orbitofrontal cortex thickness. Our study shows that food addiction is not associated with neuroanatomical differences in a large population-based sample, and does not account for the major part of obesity-associated gray matter alterations. Yet, food addiction might explain additional variance in orbitofrontal cortex, a hub area of the reward network. Longitudinal studies implementing both anatomical and functional MRI could further disentangle the neural mechanisms of addictive eating behaviors.

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