Functional Relationship between Inhibitory Control, Cognitive Flexibility, Psychomotor Speed and Obesity

Abstract

In the last decades, it has been proposed that executive functions may be particularly vulnerable to weight-related issues. However, evidence on the matter is mixed, especially when the effects of sociodemographic variables are weighted. Thus, the current study aimed at further examining the relationship between executive functions and obesity. To this aim, we compared treatment-seeking overweight, obese, and morbidly obese patients with normal-weight control participants. We examined general executive functioning (Frontal Assessment Battery–15) and different executive subdomains (e.g., inhibitory control, verbal fluency, and psychomotor speed) in a clinical sample including 208 outpatients with different degrees of BMI (52 overweight, BMI 25–30, M age = 34.38; 76 obese, BMI 30–40, M age = 38.00; 80 morbidly obese, BMI > 40, M age = 36.20). Ninety-six normal-weight subjects served as controls. No difference on executive scores was detected when obese patients were compared with over- or normal-weight subjects. Morbidly obese patients reported lower performance on executive scores than obese, overweight, and normal-weight subjects. Between-group difference emerged also when relevant covariates were taken into account. Our results support the view that morbid obesity is associated with lower executive performance, also considering the critical role exerted by sociodemographic (i.e., sex, age, and education) variables. Our results support the view that executive functioning should be accounted into the management of the obese patient because of non-negligible clinical relevance in diagnostic, therapeutic, and prognostic terms.

Factorial Model of Obese Adolescents: The Role of Body Image Concerns and Selective Depersonalization—A Pilot Study

“…According to the “corticolimbic disconnection hypothesis” [ 147 , 148 ], fronto-limbic suppressive mechanisms would mediate an inhibitory response generating a state of emotional numbness. During depersonalization experiences, activation of the prefrontal cortex (PFC) interacts with the anterior cingulate cortex (ACC) and amygdala, generating low emotionality, attentive difficulties, autonomic mitigation, and indifference to pain [ 152 , 153 , 154 , 155 ]. In addition, hypoactivity of posterior parietal regions has been associated with deficits in processing and integrating somatosensory information [ 156 , 157 , 158 , 159 , 160 , 161 ] and low self-awareness.…”

The Neglected Factor in the Relationship between Executive Functioning and Obesity: The Role of Motor Control

“…For instance, decreased EFs have been associated with reduced food intake inhibition [ 12 , 13 , 14 ], high-fat food ingestion [ 15 ], lower appetite regulation [ 16 ], decreased energy expenditure [ 17 ], increased emotional eating [ 18 ], inability to learn from past experiences [ 19 ], delayed weight loss [ 12 ], poor adherence to healthy nutrition [ 20 , 21 ], and poor outcomes to weight loss interventions [ 22 ]. In line with these findings, some studies have found poor executive performance in patients with obesity [ 11 , 23 , 24 , 25 ]; furthermore, neuroimaging evidence exists on the relationship between decreased neural activity within the frontal cortex—the main cortical substrate of EFs—and obesity [ 26 , 27 , 28 ]. This evidence might be supported by studies finding a significant relationship between adipose tissue and systemic inflammation interacting with the physiology of the blood–brain barrier, likely affecting cognitive performance [ 29 , 30 , 31 , 32 , 33 ].…”

“…Still, we found that the motor domain played a non-negligible role in the dynamics of such a relationship. In a scientific context in which the link between EFs and obesity needs to be further investigated [ 11 , 16 , 23 , 24 , 25 , 103 , 104 ], these findings may contribute to extending the debate on the matter.…”

“…Moreover, we hypothesize that the relationship between EFs and body weight could be mediated by gross motor function evaluated by the finger tapping task. In this regard, obesity seems to undermine both motor and frontal/executive abilities [ 25 , 26 , 27 , 28 , 46 , 63 , 64 , 65 , 66 ]. In addition, in line with the sensorimotor interaction model [ 60 , 61 ], the integrity of the executive processes might depend on bottom-up interactive processes supported by motor behavior.…”

Higher general executive functions predicts lower body mass index by mitigating avoidance behaviors

“…It has been argued that EFs could predict body weight variability ( 18 , 25 ). For instance, EFs were found to be related with increased intake of high-fat foods ( 26 – 31 ), poor energy expenditure ( 32 ), increased susceptibility to emotional eating ( 33 ), inability to learn from past experiences ( 34 ), and worse outcomes in treatments aimed at weight decrease ( 27 , 35 ).…”