Dr Tony Goldstone | Experimental medicine studies including functional MRI of human eating and addictive behaviours in obesity and interaction with appetitive gut hormones

There is evidence from pre-clinical studies that food intake and appetitive gut hormones, including ghrelin and glucagon-like peptide-1 (GLP-1), not only alter appetite, but also food and non-food reward processing, as well as addictive behaviours influencing eating behaviour. There is more limited evidence from human studies. This talk will review our human studies using multi-modal phenotyping, including functional MRI, to study the food-gut-brain axis in eating and addictive behaviours. Using a platform of experimental medicine outcome measures including functional MRI paradigms with a food picture evaluation task (to assess cue reactivity or anticipatory reward), we have studied the effects of food intake, acute administration of orexigenic hormone acyl ghrelin, and comparison of Roux-en-Y gastric bypass (RYGB) with gastric banding surgery for obesity, and acute pharmacological suppression of satiety gut hormones post-bariatric surgery, on eating behaviour and food cue reactivity. Our more recent studies have examined: (i) the longitudinal effects of RYGB surgery, endoscopic insertion of the duodenal-jenunal bypass liner (Endobarrier) device for obesity and diabetes (compared with standard medical management), (ii) in our Gut Hormone in Addiction (GHADD) study, the effects of acute infusion of the GLP-1 analogue, Exenatide, in obesity, ex-smokers or abstinent alcohol dependence, (iii) differences in eating and addictive behaviour in adults with obesity and binge eating symptoms, and (iv) ongoing studies for the role of the recently identified endogenous anorexigenic liver/intestinal hormone LEAP2 that is an inverse agonist at the ghrelin GHSR receptor.

Brief bio:

Dr. Tony Goldstone is a Clinical Associate Professor in PsychoNeuroEndocrinology at the Division of Psychiatry, Department of Brain Sciences, Imperial College London, UK. He attended medical school at Cambridge and Oxford Universities, and obtained his PhD from Imperial College London. He is a Fellow of The Obesity Society. His clinical experimental medicine research uses multi-modal phenotyping, including functional neuroimaging, to examine body-brain interactions in regulation of eating and addictive behaviours, including studies of appetitive gut hormone administration and bariatric surgery, as a means to investigate novel treatments for obesity and addiction. He is an adult Consultant Endocrinologist at Imperial College Healthcare NHS Trust, running a specialist clinic for genetic obesity, including Prader-Willi syndrome. Web: https://profiles.imperial.ac.uk/tony.goldstone. Bluesky: @TonyGoldstone.bsky.social.