To Predict Weight Loss Response to Liraglutide (Saxenda®), From fMRI-based Determination of Food Cue Reactivity

Inclusion criteria

• Age 18-60 years
• BMI 30-50 kg/m2

Exclusion criteria

• Participants unable or unwilling to provide informed consent.
• Participants with motor, visual or hearing impairment.
• Females with irregular menstrual cycles (onset of menstruation greater than 1 week from expected data during the last 3 months).
• Females who are currently breastfeeding or intend to start breastfeeding.
• Participants with diagnosed diabetes mellitus (type 1 or type 2) or uncontrolled hypertension, history of ischemic heart disease, stroke, neurological disease.
• Participants with current severe psychiatric illnesses (e.g. psychosis, schizophrenia, bipolar disorders, depression).
• Participants experiencing current suicidal ideation, and recent or past suicide attempts.
• Participants with history of psychiatric hospitalization.
• Participants who are currently on (or have been on within the past 4 weeks) any medication in the broader drug classes of anti-depressant, anti-epileptic, or anti-anxiety medicines will be excluded (as these affect fMRI-FCR in the brain).
• Participants with contraindications for MRI scanning.

• aneurism clips
• any implanted medical devices (pacemaker, neurostimulator)
• known pregnancy
• shrapnel in body or any injury to eye involving metal
• any ferrous metal in body
• Participants with a history of diagnosed eating disorders such as bulimia nervosa, anorexia nervosa and severe binge eating disorder.
• Participants with a history of diagnosed substance abuse or alcohol abuse.
• Patients experiencing persistent loss of appetite, nausea or vomiting within the last 4 weeks without known cause (e.g. flu, food poisoning).
• Participants who have been involved in a weight loss intervention program (including anti-obesity medication) within the past 3 months (and or loss >10% of body weight) or who have ever had bariatric surgery or have weight loss devices implanted.
• Current smokers (smoked within the last 30 days).
• The receipt of any investigational drug within (3 months) prior to this trial.
• Previous participation in this trial (i.e. randomized).
• Unable or unwilling to consume required study meals for any reason (e.g. dietary restrictions, allergies, or aversions to any of the food items used in the study).
• Contraindications to study medications,

• Subject with a personal or family history of medullary thyroid carcinoma (MTC).
• Subject with multiple endocrine neoplasia syndrome 2 (MEN 2).
• Allergic to Liraglutide or any of the ingredients in Saxenda® (i.e. Active ingredient: liraglutide; Inactive ingredients: disodium phosphate dehydrate, propylene glycol, phenol and water for injection)
• Women who are pregnant, or have the intention of becoming pregnant.
• Taking other GLP-1 receptor agonists (currently or in the past 3 months).
• Current severe problems with stomach, such as slowed emptying of the stomach (gastroparesis) or problems with digesting food.
• Current or past known serious chronic illness of liver, kidney and pancreas.
• Current or recent (30 days) depression or suicidal thoughts.
• Current fasting plasma glucose 126mg/dL or higher or HbA1c 6.5% or higher, or alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, blood urea nitrogen (BUN) 10% above normal range for the assay.