Neurological consequences of obesity

• Published in: Lancet neurology Vol. 16; no. 6; pp. 465 - 477
• Main Authors: O'Brien, Phillipe D, PhD, Hinder, Lucy M, PhD, Callaghan, Brian C, MD, Feldman, Eva L, Dr
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2017; Elsevier Limited
• Subjects: Adipocytes; Autonomic nervous system; Autonomic Nervous System Diseases - etiology; Body weight gain; Central nervous system; Central Nervous System Diseases - etiology; Cognitive ability; Cognitive Dysfunction - etiology; Cytokines; Diabetes; Diabetes mellitus; Diabetic neuropathy; Diet; Dyslipidemia; Energy balance; Fatty acids; Gastrointestinal surgery; High income; Hippocampus; Humans; Hypothalamus; Inflammation; Insulin resistance; Lifestyles; Lipids; Liver; Memory; Metabolic syndrome; Nervous system; Neurology; Obesity; Obesity - complications; Oils & fats; Parasympathetic nervous system; Peripheral Nervous System Diseases - etiology; Polyneuropathy; Somatic nervous system; Structure-function relationships; Surgery; Triglycerides; Weight control
• ISSN: 1474-4422; 1474-4465
• DOI: 10.1016/S1474-4422(17)30084-4

Summary The high prevalence of obesity is associated with an enormous medical, social, and economic burden. The metabolic dysfunction, dyslipidaemia, and inflammation caused by obesity contribute to the development of a wide variety of disorders and effects on the nervous system. In the CNS, mild cognitive impairment can be attributed to obesity-induced alterations in hippocampal structure and function in some patients. Likewise, compromised hypothalamic function and subsequent defects in maintaining whole-body energy balance might be early events that contribute to weight gain and obesity development. In the peripheral nervous system, obesity-driven alterations in the autonomic nervous system prompt imbalances in sympathetic–parasympathetic activity, while alterations in the sensory–somatic nervous system underlie peripheral polyneuropathy, a common complication of diabetes. Pharmacotherapy and bariatric surgery are promising interventions for people with obesity that can improve neurological function. However, lifestyle interventions via dietary changes and exercise are the preferred approach to combat obesity and reduce its associated health risks.