Evidence of executive dysfunction in extremely obese adolescents: a pilot study

doi:10.1016/j.soard.2009.05.008

Surgery for Obesity and Related Diseases

Volume 5, Issue 5, September–October 2009, Pages 547-552

https://doi.org/10.1016/j.soard.2009.05.008 Get rights and content

Abstract

Background

Obesity in children and adolescents is 1 of the most urgent and serious health threats confronting the United States. Extremely obese adolescents (body mass index >99th percentile for age and gender) are a unique subgroup of obese youth who are at considerable medical and psychosocial risk. Little is known about the cognitive function of extremely obese adolescents. The present study sought to examine the cognitive performance of a sample of extremely obese adolescents seeking primary treatment for weight loss.

Methods

Adolescents were recruited during regularly scheduled medical appointments at a children's center for weight management associated with a major children's hospital in the Southeast United States. A computerized battery of cognitive tests was administered to obese adolescents (body mass index >99th percentile; n = 25).

Results

Obese adolescents exhibited deficits in many cognitive domains, including impairment in attention and executive functions (e.g., mental flexibility, disinhibition) compared with the normative data.

Conclusion

Although preliminary, these data have provided evidence for specific cognitive deficits in extremely obese adolescents. These findings highlight a need to determine whether early weight loss interventions, such as bariatric surgery, for obese adolescents could potentially prevent or reverse cognitive deficits and/or reduce the risk of future adverse neurocognitive outcome.

Section snippets

Participants and procedures

The participants for the present study were 25 adolescents (15 girls and 10 boys) recruited during regularly scheduled medical appointments at a children's center for weight management associated with a major children's hospital in the Southeast United States. These adolescents had a BMI greater than the 99th percentile for their gender and age and thus were classified as extremely obese [3].

The hospital institutional review board approved the present study. The potential participants and their

Results

The average age of the participants was 16 years, and the average grade in school was the 10th. Of these 25 adolescents, 15 identified as white, 9 identified as black, and 1 identified as Hispanic. The mean BMI for the sample was 54.01 kg/m² (range 34.74–77.57). The mean intelligence quotient of the sample was in the average range of ability (average full scale intelligence quotient 92). The participant characteristics are listed in Table 1.

The performance of our extremely obese sample on the

Discussion

The findings of the present study support our hypothesis that extreme obesity in adolescence is associated with decreased cognitive performance compared with the normative data, specifically in the realm of executive function. The estimated full scale intelligence quotient of the extremely obese adolescents was in the average range of ability, and the neurocognitive deficits were confined to tests measuring executive functions (e.g., complex attention, mental flexibility, and disinhibition).

Conclusion

We found specific cognitive impairments in a small sample of extremely obese adolescents in addition to the intelligence quotient, emotional symptoms, and an obesity-associated medical condition (OSA). We believe the present study was an important first step in providing additional support for the growing body of evidence of a relationship between obesity and impaired neurocognitive function.

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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: Participant payment funded through the University of Alabama at Birmingham Clinical Nutrition Research Center Pilot and Feasibility Grant Program.

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Original articleEvidence of executive dysfunction in extremely obese adolescents: a pilot study

Abstract

Background

Methods

Results

Conclusion

Section snippets

Participants and procedures

Results

Discussion

Conclusion

Disclosures

J Pediatr

J Pediatr

Cognition

Appetite

Appetite

Compr Psychiatry

Arch Clin Neuropsychol

Prevalence of overweight and obesity in the United States, 1999–2004

JAMA

A potential decline in life expectancy in the United States in the 21st century

N Engl J Med

Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight obesity: summary report

Pediatrics

Comorbid type 2 diabetes mellitus and hypertension exacerbates cognitive decline: evidence from a longitudinal study

Age Ageing

School performance and weight status of children and young adolescents in a traditional society in Thailand

Int J Obes Relat Metab Disord

Overweight is associated with decreased cognitive functioning among school-age children and adolescents

Obesity

Beck depression inventory-II manual

Wide range achievement test–IV

Original article
Evidence of executive dysfunction in extremely obese adolescents: a pilot study