GLP-1 Receptor Agonist Effects on Food-Related Cognition: A Cognitive Neuroscience Framework

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed the treatment of type 2 diabetes and obesity by reducing appetite, cravings and caloric intake. Growing evidence suggests effects on the central nervous system, with cognitive and neuroprotective benefits that cannot be explained by weight loss or glycaemic control alone. However, the underlying neurocognitive mechanisms remain unclear. This review proposes a cognitive neuroscience framework for investigating the effects of GLP-1RAs across multiple levels of food-related information processing. Theoretical models and experimental paradigms are integrated to dissociate perceptual, attentional, motivational, semantic and executive components. The model identifies four levels: (1) early perceptual processing, in which the brain extracts properties including caloric content and transformation; (2) attentional capture and motivational salience, which determine priorities and wanting; (3) semantic organisation, which integrates sensory and functional characteristics of foods and (4) decision-making and executive control, including inhibitory control and effort allocation. GLP-1RAs may differentially modulate these levels, which can be investigated using specific experimental paradigms. This cognitive neuroscience-based approach goes beyond descriptive measures to identify the mechanisms through which GLP-1RAs influence perception, motivation and food decisions. This framework can guide future studies, improve the interpretation of cognitive effects and contribute to the development of more targeted interventions.