Neurocognitive Deficits In Pediatric Obesity

Abstract

In the United States, 20% of adolescents suffer from obesity (body mass index—BMI—above the 95th percentile) and 8% of adolescents suffer from severe obesity (BMI 120% above the 95th percentile). Obesity carries increased risk for medical conditions with high morbidity (e.g., cardiovascular disease, diabetes), poor sleep health, and psychopathology. In children, these risks are accompanied by lower academic achievement and worse social (e.g., discrimination) and psychological (e.g., self-esteem) outcomes. When examining cognition functioning, deficits in executive function (i.e., working memory, inhibitory control, and cognitive flexibility), motivation (i.e., reward sensitivity and reward-related decision making), and memory have been shown to be particularly relevant for the regulation of obesogenic behaviors (i.e., behaviors that contribute to risk for obesity). Simultaneously, comorbidities of obesity, such as chronic inflammation, may have deleterious effects on the neural functioning subserving these cognitive processes. The three studies included in this dissertation were conducted with the goals of 1) determining the scope and specificity of cognitive deficits in pediatric obesity; 2) identifying potential confounding (intelligence, socio-demographic characteristics) and mediating (medical and psychopathological) factors related to cognitive deficits in pediatric obesity; and 3) examining the neurological underpinnings of observed cognitive deficits in pediatric obesity.