DESCRIPTION (provided by applicant): This is an application for a VA Career Development Award II that will provide protected time and resources for the applicant to bridge to independence. Under the mentorship of leaders acclaimed in their fields, she will be able to mature into an independent clinical investigator. In order to achieve this, her primary career development objectives under this award include: 1) establish expertise in in vivo insulin and glucose metabolism measurements 2) develop skills in functional MRI (fMRI) neuroimaging and analyses 3) enhance understanding of obesity related neuroscience, 4) develop expertise in conducting weight loss intervention trials, 5) collect preliminary data for a VA merit award application, 6) continue to develop cross-disciplinary collaborations, and 7) continue training in responsible conduct of research. The current research proposal will explore the hypothesis that insulin resistance contributes to decreased food consumption reward signaling, thereby increasing vulnerability to overeat and impairing weight loss. In most obese individuals, insulin signaling is impaired (insulin resistance). Preclinical animal studies suggest that insulin resistance in brain regions important for reward contribute to overeating. This proposal aims to test these hypotheses in humans and to determine if these characteristics are pertinent to clinical outcomes (food intake and weight loss). In humans increased body mass index (BMI) and weight gain occur with decreased food consumption-induced neural activation (consummatory reward) in the caudate of the dorsal striatum. It has been speculated that diminished consummatory reward causes overeating and prevents weight loss; however, this hypothesis has not been directly tested. Further, mechanisms for impaired food consumption-induced neural activation in obesity have not been investigated. The primary research outcomes of the proposed study are: 1) insulin sensitivity determined by the gold standard hyperinsulinemic euglycemic clamp, 2) food consumption-induced neural activation in the caudate as determined by blood-oxygen dependent functional magnetic resonance imaging (BOLD fMRI) scanning, 3) caloric intake at a buffet meal, and 4) weight loss during a weight loss intervention and 6 months after completing the intervention. We will enroll 55 obese Veterans, 40 who are insulin resistant and 15 who are insulin sensitive. The groups will be stratified by gender and be similar in age and BMI. All will complete baseline assessment of outcomes. After this, the insulin resistant obese will be randomized to: 1) lose 5-10% of total body weight (TBW) over 4-6 months or 2) maintain current body weight for 4-6months before completing the post assessment of outcomes. Participants will return 6 months after completion of their respective intervention for a weight measurement. This approach will permit us to explore 3 aims: 1) determine whether weight loss-induced improvements i...