The Influence of Obesity and Insulin Sensitivity on Reward Processing and Decision Making

Reward learning and decision-making processes, which operate largely outside of conscious control, shape food choices and eating behaviors. Excess adiposity is associated with differences in brain structure and functional connectivity underlying these processes, and insulin resistance, which commonly co-occurs with excess adiposity, has been linked with dopamine signaling that is crucial for these processes. However, whether and how excess adiposity and insulin resistance affect reward learning and decision-making remains poorly understood. This study will address that gap, examining the effects of excess adiposity and insulin resistance, and their interaction, on processes of reward learning and decision-making in food-specific and general contexts.

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Key information

Conditions

Adiposity Body Weight Decision-Making Glucose Metabolism Disorders Hyperinsulinism Insulin Resistance Insulin Sensitivity/Resistance Metabolic Diseases Nutrition Disorders Nutritional and Metabolic Diseases Obesity Overnutrition Overweight Pathological Conditions, Signs and Symptoms Reward Learning Signs and Symptoms

Age range

18 year–45 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

18 to 45 years of age
Self-reported weight stable (within 5 lbs) for previous 3 months
Not pregnant or planning to become pregnant during study participation
Weigh more than 110 lbs (due to blood draws used in study)
Residing in Roanoke, VA, area and/or willing to attend sessions at the Fralin Biomedical Research Institute

Exclusion criteria

BMI < 18.5 or > 40 kg/m2
Hemoglobin A1c > 6.4%
Fasting blood glucose > 126 mg/dL
2-hour blood glucose > 200 mg/dL
Self-reported current diagnosis of diabetes or other endocrine/metabolic disorder
Self-reported current inhaled nicotine use
Self-reported history of alcohol dependence
Self-reported use of medications known to influence study measures (including antiglycemic agents, thyroid medications, etc.)
Self-reported neurological or psychological disorder
Self-reported claustrophobia or discomfort with mock fMRI training
Self-reported history of head injury resulting in loss of consciousness for more than 10 minutes
Contraindications to MRI, including pacemaker, aneurysm clip, neurostimulator, cochlear implant, metal in eyes, steel worker, other implants
Self-reported previous metabolic/weight loss surgery
Self-reported adherence to special or restrictive diet within the past 3 months (e.g., low-carb, ketogenic, exclusion of food groups/specific macronutrients, etc.)
Self-reported allergy to ingredient used in the study drinks

Treatment and study plan

Beverage: Conditioned Stimulus -

Other

Participants will consume flavored beverage solutions sweetened with sucralose during 6 conditioning sessions.

Beverage: Conditioned Stimulus +

Other

Participants will consume flavored beverage solutions sweetened with sucralose and containing 110 calories of maltodextrin during 6 conditioning sessions.

Primary outcomes

Rated Liking

Time frame: On the first day of enrollment to the post-test session approximately 1-2 weeks later

Participants will rate liking of flavors that will be paired with conditioned stimulus (CS) + and CS- drinks on a labeled hedonic scale during an enrollment session. In a post-test session, after all conditioning sessions have occurred, participants will rate liking of flavors that were previously paired with CS+ and CS- drinks.

Secondary outcomes

Rated Wanting

Time frame: On the first day of enrollment to the post-test session approximately 1-2 weeks later

Participants will rate wanting of flavors that will be paired with conditioned stimulus (CS) + and CS- drinks on a visual analog scale during an enrollment session. In a post-test session, after all conditioning sessions have occurred, participants will rate wanting of flavors that were previously paired with CS+ and CS- drinks.
Proportion Correct on a Probabilistic Learning Task

Time frame: Approximately 30-45 minutes during the enrollment/screening session at the start of the study

Participants will complete a probabilistic learning task in which they choose between abstract stimuli and observe probabilistic outcomes with the goal of maximizing accuracy. The proportion of trials in which the objectively optimal choice has been selected will be computed as the proportion correct.

Sponsors and collaborators

Lead sponsor

Virginia Polytechnic Institute and State University

Other

Collaborators

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Registry information

Acronym: No acronym

Important dates

Study start: 2026
Primary completion: 2029
Study completion: 2029
First posted: Jun 10, 2026
Registry last updated: Jun 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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