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

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.