America’s obese youth may have a heightened psychological reward response to food

Category: Blog

German researchers examined how weight and obesity influence math performance  in school.

  • While overweight children do not perform worse in math, obese girls and boys achieve a“ good” or “very good” math grade less frequently.
  • The likelihood of getting grade a “higher grade”  is  10 or 11 percent lower compared to children of normal weight.

Furthermore, because obese girls are bullied more often, they show lower self-confidence which leads to more behavior problems. For boys no “bully effect” was found. However obese boys also suffer from lower self-confidence, which partly explains the lower math grades.

The influence of obesity on math grades is not effected by whether a child is healthy, to what extent they exercise or participate in sports or how much TV they watch.

Obese girls and boys attend upper secondary school  less frequently. The same effect is reported for overweight boys. Whether lower math grades or other factors cause this outcome has not been fully clarified in the study. Possibly, teachers perceive obese children as  less competent and recommend them less frequently for gymnasium, or perhaps parents have lower confidence in those children and send them to a upper secondary school less often.1

In a recent study by researchers at NYU School of Medicine an association was made between metabolic syndrome and cognitive and brain impairments in adolescents. The researchers said that this calls for pediatricians to take into account discussing weight management with the child’s parents and an early treatment of childhood obesity. 2,3

As childhood obesity has increased in the U.S., so has the prevalence of metabolic syndrome – a constellation of three or more of five defined health problems, including abdominal obesity, low HDL (good cholesterol), high triglycerides, high blood pressure and pre-diabetic insulin resistance. Lead investigator of the above noted study, Antonio Convit, MD, professor of psychiatry and medicine at NYU School of Medicine said that, “the prevalence of metabolic syndrome parallels the rise in childhood obesity. There are huge numbers of people out there who have problems with their weight. If those problems persist long enough, they will lead to the development of MetS and diabetes. As yet, there has been very little information available about what happens to the brain in the setting of obesity and MetS and before diabetes onset in children.”

For the study, the researchers compared 49 adolescents with metabolic syndrome to 62 teens without the disorder. Of those who were not in the metabolic syndrome group, 40 percent were considered overweight or obese, so while they were not in ideal health, they did not have three out of the five health issues needed to fall into the MetS group. The findings reported, therefore, are conservative and reflective of the real world.

Dr. Convit and colleagues balanced each group according to age, socioeconomic status, school grade, gender and ethnicity to ensure things like cultural differences in diet and access to quality healthcare did not cloud the data. They then conducted endocrine, MRI and neuropsychological evaluations on the adolescents and found that those classified as having MetS showed significantly lower math and spelling scores, as well as decreased attention span and mental flexibility. They also showed differences in brain structure and volume, presenting with smaller hippocampal volumes – involved in the learning and recall of new information, increased brain cerebrospinal fluid and reductions of microstructural integrity in major white matter tracts in the brain. The more MetS-characterizing health problems the participants had, the more profound the effect across the board.

The kids with metabolic syndrome took longer to do tasks, could not read as well and had poorer math scores

“The kids with metabolic syndrome took longer to do tasks, could not read as well and had poorer math scores,” Dr. Convit said. “These findings indicate that kids with MetS do not perform well on things that are very relevant to school performance.”

The researchers concluded that even a few years of problems with metabolism may cause brain complications. They suggest the adverse impact of MetS on brain function in children could be used by pediatricians as a powerful motivator to get families more involved in meaningful lifestyle change.

Comment from the Magaziner Center for Wellness
Adolescents have a unique make up to them that makes it all the more important that the physician takes a detailed account and comprehensive understanding of the patient. Rather than just placing an obese patient on a restricted diet, we may analyze his or her blood to look for thyroid or endocrine problems that could have led to weight gain and may be inhibiting a patient from losing weight. We test patients’ reaction to food allergens and if a food allergy or sensitivity is discovered, we will have the patient avoid the food that may be harmful to his or her well being or we work to desensitize the patient to that food. For the long run, we help our patients understand food choices and their impact on the body.  Our goal is to help our patients maintain their weight loss for a lifetime, by educating them on proper nutrition and changing body chemistry to reduce cravings.

4.Po Lai Yau, Mary Grace Castro, BS, Adrian Tagani, Wai Hon Tsui, and Antonio Convit. Obesity and Metabolic Syndrome and Functional and Structural Brain Impairments in Adolescence. Pediatrics, September 3, 2012 DOI: 10.1542/peds.2012-0324

54. Material from a Press Release from the New York University Langone Medical Center