Bariatric Surgery: Good for Mind and Body

Summary
Many studies have shown that obesity leads to poor cognitive performance, characterized by decreased memory. A recent study evaluated the improvement in memory and other intellectual capacities, after bariatric surgery. Bariatric surgeries are done for the treatment of obesity. They are performed on the stomach and the intestine, so that ingested food is not absorbed. “The results from the present study have suggested that uncomplicated bariatric surgery does not confer a significant risk of cognitive dysfunction at 12 weeks postoperatively and might actually provide some cognitive benefits.”

Introduction
It is estimated that over one third of adults in America are obese. Physical adverse effects of obesity, such as increased risk of cardiovascular disease and stroke, are well known. Recent studies have shown that obesity and poor cognitive capacity are associated. Bariatric surgeries are very effective in reducing body weight in obese individuals who do not respond to the usual drug treatment. Studies have shown that bariatric surgery patients have exhibited impairment of cognitive functions. Until now, no studies were performed to assess the changes in cognitive capacities after bariatric surgery. Hence, this study was conducted to examine the effect of bariatric surgery on such intellectual abilities as memory.

Methodology
* This study included 150 participants, of which 109 were operated and 41 did not undergo any bariatric surgery. All the participants were part of a bigger project, known as the Longitudinal Assessment of Bariatric Surgery Project.
* Body mass index, blood pressure and blood glucose levels of all the participants were assessed before and after a follow-up period of 12 weeks, to learn the physical benefits of bariatric surgeries.
* At the same time, cognitive capacities were also assessed using a computerized cognitive test battery. This test measures memory, attention (capacity to solve maze task), letter fluency (where the participant is asked to type words that begin with a specific letter), executive function etc.

Results
* Assessment of cognitive function at the beginning of the study showed that the average capacity of participants was low compared to the general population.
* Memory, attention, executive function and letter fluency improved at 12 weeks’ follow-up in most of the patients who underwent bariatric surgery.
* Better control of body mass index, blood pressure, and blood glucose levels were observed in the participants who underwent the bariatric surgeries.

Shortcomings/Next steps
The body mass index reaches the lowest point at 18 to 24 months after bariatric surgery. Hence, there is a need to reassess the cognitive capacity at around that time. It is also important to identify the mechanism of improvement of memory and other intellectual functions after the bariatric surgery. Also, neuroimaging and blood marker studies are necessary to objectively measure the improvement in brain functions.

Conclusion
This study has shown that bariatric surgeries are useful in reducing the cognitive impairments which are often seen in obese individuals. Bariatric surgery, which is a very safe and effective way of treating obesity, has now been proved to improve memory and other intellectual functions as well. There is a need to screen all the obese patients not responding to the usual medical therapy for cognitive impairment. In fact, cognitive impairment itself may be a cause for non-adherence to the given therapy. The authors hope that such patients would greatly benefit from the bariatric surgeries. However, further studies are necessary to identify the exact underlying mechanism of improvement of cognitive functions.

For More Information:
Improved Memory Function 12 Weeks after Bariatric Surgery
Publication Journal: Surgery for Obesity and Related Diseases, 2010
By John Gunstad, PhD; Gladys Strain, PhD; Kent State University, Kent, Ohio; Summa Health System, Akron, Ohio; Weill Cornell Medical College, New York, New York

*FYI Living Lab Reports Are Summaries of the Original Research.

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