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Executive Functioning in Extreme Obesity: Contributions from Metabolic Status, Medical Comorbidities, and Psychiatric Factors

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Abstract

Purpose

Extreme obesity has been associated with cognitive deficits across the lifespan and may be a risk factor for dementia in later life. However, the relationship between obesity and domain-specific cognitive deficits is complicated by a body of literature that often fails to adequately account for medical and psychiatric conditions frequently co-occurring with extreme obesity.

Materials and Methods

The present study included a cross-sectional evaluation of adults with extreme obesity (n=117) compared to lean control (n=46) participants on a brief cognitive battery using the NIH Toolbox and Rey Auditory Verbal Learning Test. Specifically, this study evaluated measures of executive functioning, attention, processing speed, learning, and memory while accounting for many common obesity-related medical and psychiatric comorbidities with known cognitive effects.

Results

Results revealed group differences with lower performances on measures of executive functioning, processing speed, and learning (ps<0.01) for participants with obesity. Reduced executive functioning was associated with abdominal obesity and medication use (ps<0.01) and together contributed significantly to overall modeling of cognition in individuals with obesity.

Conclusion

Individuals with extreme obesity in this sample showed lower cognitive performance on measures of executive functioning, processing speed, and learning compared to lean controls. Abdominal obesity was associated with executive functioning deficits independent of many common medical and psychiatric factors.

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Authors and Affiliations

  1. University of Michigan, 500 S. State Street, Ann Arbor, MI, 48109, USA

    Kyler Mulhauser, Evan L. Reynolds, Brian C. Callaghan, Cassandra Fierro, Bruno Giordani & Kristen Votruba

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  1. Kyler Mulhauser
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  2. Evan L. Reynolds
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  3. Brian C. Callaghan
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  4. Cassandra Fierro
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  6. Kristen Votruba
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Corresponding author

Correspondence to Kyler Mulhauser.

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Ethical Approval and Informed Consent Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Competing Interests

Dr. Callaghan consults for DynaMed, performs medical legal consultations including consultations for the Vaccine Injury Compensation Program, and receives research support from the American Academy of Neurology (AAN). Dr. Callaghan is funded by a NIH NIDDK R-01 award (DK115687). Dr. Reynolds is supported by NIH T32 (NS0007222). The authors declare no additional competing interests.

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Mulhauser, K., Reynolds, E.L., Callaghan, B.C. et al. Executive Functioning in Extreme Obesity: Contributions from Metabolic Status, Medical Comorbidities, and Psychiatric Factors. OBES SURG 31, 2669–2681 (2021). https://doi.org/10.1007/s11695-021-05319-8

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  • DOI: https://doi.org/10.1007/s11695-021-05319-8

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