Adolescent weight history and adult cognition: before and after bariatric surgery

Abstract

Background Cognitive deficits occur in a subset of individuals with obesity. Deficits can be reversed with bariatric surgery, though cognitive recovery is not equally exhibited across patients. Recent work shows obesity during adolescence portends medical complications in adulthood; it is unknown if obesity in adolescence predicts adult cognition or cognitive recovery following weight loss surgery. Objectives The current study examines the relationship between weight history and cognitive function in obese adults undergoing bariatric surgery. Setting Academic medical centers with bariatric care services. Methods Seventy-eight bariatric surgery patients (mean age=43.2) enrolled in an ancillary study to the Longitudinal Assessment of Bariatric Surgery (LABS) project completed a questionnaire recalling weight history at age 18. Cognitive testing was completed pre-operatively and at 12-month follow-up. Results Weight status at age 18 was linked to performance in several aspects of cognition. Higher BMI at age 18 predicted poorer pre-operative verbal fluency (B=−0.26, p=0.045) as well as post-operative cognitive recovery in attention (B=−0.30, p=0.01) at 12 month follow-up. Conclusions Higher BMI at age 18 predicts verbal fluency performance in adults with obesity, as well as post-operative recovery of attention following bariatric surgery. The mechanisms underlying this connection are not fully clear, though findings may reflect effects of obesity on the brain during a crucial period of neural maturation, or duration of obesity and cumulative impact of comorbidities on cognition. Future work examining possible causal factors involved in these relationships is needed.

Longitudinal Associations Between Childhood Obesity and Academic Achievement: Systematic Review with Focus Group Data

“…The current evidence is also limited on the impact of mediating factors. None of the included longitudinal studies evaluated the mediating effects of sleep deprivation, physical activity levels, type of physical activity, diet/nutritional status and co-morbidities, despite the literature suggesting an important role of these factors in the causal pathway between childhood obesity and academic achievement [ 12 , 13 , 15 – 17 , 83 ]. However, most recently (after our literature search was performed), new findings were published on the link between meeting lifestyle-behaviour recommendations at age 11 years and academic achievement at age 12 years ( n = 4253).…”

Cognitive functioning in adolescents with severe obesity undergoing bariatric surgery or intensive non-surgical treatment in Sweden (AMOS2): a multicentre, open-label, randomised controlled trial

“…A study from the USA in adults undergoing bariatric surgery showed less recovery of attention in participants who had had obesity during adolescence, and it was suggested that cognitive alterations associated with early onset obesity are less responsive to weight loss in comparison to those related to obesity with adulthood onset. 19 …”

Pediatric obesity—Long‐term consequences and effect of weight loss

“…The negative impact of childhood obesity on educational level may partly be reversed by successful obesity treatment in childhood [ 8 ], and in adults, cognitive deficits may be improved after weight loss [ 181 , 185 ]. Regardless of mechanisms, it is of great importance to increase awareness of the association between obesity and school achievement.…”