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It remains unclear whether these heterogeneous loci converge on a reproducible large\u2010scale network, and whether weight\u2010loss\u2013related increases in gray matter map onto the same network or a distinct set of functional systems. We identified loci of adiposity\u2010related gray matter reduction and post\u2010weight\u2010loss increases from 38 published whole\u2010brain voxel\u2010based morphometry studies, including case\u2013control, dimensional adiposity, and longitudinal weight\u2010loss contrasts. Using coordinate\u2010based connectome mapping applied to a large normative resting\u2010state functional connectome, we reconstructed networks associated with adiposity\u2010related structural alterations. We further performed imaging transcriptomic and gene set enrichment analyses to characterize the molecular programs associated with the adiposity\u2010related network. Gray matter reductions associated with adiposity converged on a reproducible, distributed large\u2010scale network primarily involving frontoparietal control, cingulo\u2010opercular, default mode, and Visual1 systems. In contrast, GMV\/GMD increases following weight loss showed a distinct system\u2010level distribution, with the largest contributions in cingulo\u2010opercular, somatomotor, and dorsal attention systems, and comparatively limited representation in default mode and frontoparietal control networks. Imaging transcriptomic analyses further linked the adiposity\u2010related network to coordinated gene expression patterns, and gene set enrichment analyses highlighted pathways related to mitochondrial energy metabolism, synaptic signaling, ion transport, and cellular protein homeostasis. Adiposity\u2010related gray matter alterations converge on a reproducible large\u2010scale network, but the system\u2010level pattern differs across categorical obesity, dimensional adiposity, and GMV\/GMD increases following weight loss. Weight\u2010loss\u2013related gray matter increases are not a simple mirror reversal of the cross\u2010sectional network, and imaging transcriptomic analyses implicate coordinated molecular programs related to mitochondrial energetics, synaptic signaling, ion transport, and protein homeostasis.<\/jats:p>","DOI":"10.1002\/hbm.70563","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:21:45Z","timestamp":1781068905000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Network\u2010Level Convergence of Adiposity\u2010Related Gray Matter Alterations: A Coordinate\u2010Based Connectome Mapping Meta\u2010Analysis With Imaging Transcriptomics"],"prefix":"10.1002","volume":"47","author":[{"given":"Yingxian","family":"Li","sequence":"first","affiliation":[{"name":"Department of Medical Imaging The Second Affiliated Hospital of Shantou University Medical College  Shantou Guangdong Province 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