Skip to main content
Log in

Systematic Review: Are Overweight and Obese Individuals Impaired on Behavioural Tasks of Executive Functioning?

  • Review
  • Published:
Neuropsychology Review Aims and scope Submit manuscript

Abstract

This review was aimed at systematically investigating the evidence suggesting that obese individuals demonstrate impaired performance on behavioural tasks examining executive functioning abilities. A systematic review of literature was carried out by searching five separate databases (PsycINFO, MEDLINE, EMBASE, CINAHL and PubMed) and a hand search of relevant journals. Twenty-one empirical papers were identified from the search criteria and the results were considered in relation to different executive functioning domains. There is little consistency of results both within and across different domains of executive functioning. The review suggests that obese individuals show difficulties with decision-making, planning and problem-solving when compared to healthy weight controls, with fewer difficulties reported on tasks examining verbal fluency and learning and memory. A lack of replication and underreporting of descriptive data is a key limitation of studies in this area and further research is needed to examine the mechanisms underpinning the relationship between obesity and executive functioning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Alvarez, J., & Emory, E. (2006). Executive function and the frontal lobes: a meta-analytic review. Neuropsychology Review, 16(1), 17–42.

    Article  PubMed  Google Scholar 

  • Avenell, A., Broom, J., Brown, T., Poobalan, A., Aucott, L., Stearns, S., et al. (2004). Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technology Assessment, 8(21), 1–182.

    Google Scholar 

  • Bechara, A., Damasio, A., Damasio, H., & Anderson, S. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7–15.

    Article  PubMed  CAS  Google Scholar 

  • Benton, A., & Hamsher, K. (1976). Multilingual aphasia examination. Iowa City: University of Iowa.

    Google Scholar 

  • Boeka, A., & Lokken, K. (2008). Neuropsychological performance of a clinical sample of extremely obese individuals. Archives of Clinical Neuropsychology, 23(4), 467–474.

    Article  PubMed  Google Scholar 

  • Bolton, H. (2010). Examining perseveration in the context of depression and starvation to inform an understanding of cognitive inflexibility. Doctoral thesis, UCL (University College London).

  • Brogan, A., Hevey, D., & Pignatti, R. (2010). Anorexia, bulimia, and obesity: shared decision making deficits on the Iowa Gambling Task (IGT). Journal of the International Neuropsychological Society, 16(4), 711–715.

    Article  PubMed  Google Scholar 

  • Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M., Pories, W., Fahrbach, K., et al. (2004). Bariatric surgery. JAMA: The Journal of the American Medical Association, 292(14), 1724–1737.

  • Burgess, P., & Shallice, T. (1997). The Hayling and Brixton tests. Bury St. Edmonds: Thames Valley Test Company.

    Google Scholar 

  • Cserjési, R., Molnár, D., Luminet, O., & Lénárd, L. (2007). Is there any relationship between obesity and mental flexibility in children? Appetite, 49(3), 675–678.

    Article  PubMed  Google Scholar 

  • Cserjési, R., Luminet, O., Poncelet, A., & Lénárd, L. (2009). Altered executive function in obesity. Exploration of the role of affective states on cognitive abilities. Appetite, 52(2), 535–539.

    Article  PubMed  Google Scholar 

  • Dahl, A., Hassing, L., Fransson, E., Berg, S., Gatz, M., Reynolds, C., et al. (2010). Being overweight in midlife is associated with lower cognitive ability and steeper cognitive decline in late life. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 65(1), 1–6.

    Google Scholar 

  • Danner, U., Ouwehand, C., van Haastert, N., Hornsveld, H. & de Ridder, D. (2012). Decision‐making impairments in women with binge eating disorder in comparison with obese and normal weight women. European Eating Disorders Review, 20, 56–62.

    Google Scholar 

  • Davis, C., Levitan, R., Muglia, P., Bewell, C., & Kennedy, J. (2004). Decision-making deficits and overeating: a risk model for obesity. Obesity, 12(6), 929–935.

    Article  Google Scholar 

  • Davis, C., Patte, K., Curtis, C., & Reid, C. (2010). Immediate pleasures and future consequences. A neuropsychological study of binge eating and obesity. Appetite, 54(1), 208–213.

    Article  PubMed  Google Scholar 

  • Davis, C., Tomporowski, P., McDowell, J., Austin, B., Miller, P., Yanasak, N., et al. (2011). Exercise improves executive function and achievement and alters brain activation in overweight children: a randomised controlled trial. Health Psychology, 20, 91–98.

    Article  Google Scholar 

  • Duchesne, M., Mattos, P., Appolinário, J., de Freitas, S., Coutinho, G., Santos, C., et al. (2010). Assessment of executive functions in obese individuals with binge eating disorder. Revista Brasileira de Psiquiatria, 32, 381–388.

    Article  PubMed  Google Scholar 

  • Fergenbaum, J., Bruce, S., Lou, W., Hanley, A., Greenwood, C., & Young, T. (2009). Obesity and lowered cognitive performance in a Canadian First Nations population. Obesity, 17(10), 1957–1963.

    Article  PubMed  Google Scholar 

  • Galioto, R., Spitznagel, M., Strain, G., Devlin, M., Cohen, R., Paul, R., Crosby, R., Mitchell, J. & Gunstad, J. (2012). Cognitive function in morbidly obese individuals with and without binge eating disorder. Comprehensive Psychiatry, 53, 490–495.

    Google Scholar 

  • Gilbert, S. J., & Burgess, P. W. (2008). Executive function. Current Biology, 18, R110–R114.

    Article  PubMed  CAS  Google Scholar 

  • Gonzales, M., Tarumi, T., Miles, S., Tanaka, H., Shah, F., & Haley, A. (2010). Insulin sensitivity as a mediator of the relationship between BMI and working memory-related brain activation. Obesity, 18, 2131–2137.

    Google Scholar 

  • Grant, D., & Berg, E. (1948). A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. Journal of Experimental Psychology, 38, 404–411.

    Article  PubMed  CAS  Google Scholar 

  • Gunstad, J., Paul, R. H., Cohen, R. A., Tate, D. F., Spitznagel, M. B., & Gordon, E. (2007). Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Comprehensive Psychiatry, 48(1), 57–61.

    Article  PubMed  Google Scholar 

  • Gunstad, J., Lhotsky, A., Wendell, C. R., Ferrucci, L., & Zonderman, A. B. (2010). Longitudinal examination of obesity and cognitive function: results from the Baltimore Longitudinal Study of Aging. Neuroepidemiology, 34(4), 222–229.

    Article  PubMed  Google Scholar 

  • Harrison, A. (2010). Emotional Functioning in Eating Disorders: attentional bias, emotion recognition and emotion regulation. Psychological Medicine, 17, 1–11.

    Google Scholar 

  • Hendrick, O. M., Luo, X., Zhang, S., & Li, C. R. (2011). Saliency Processing and Obesity: A Preliminary Imaging Study of the Stop Signal Task. Obesity, 10, 1–7.

  • Joseph, R., Alonso-Alonso, M., Bond, D., Pascual-Leone, A., & Blackburn, G. (2011). The neurocognitive connection between physical activity and eating behaviour. Obesity Reviews, 12, 800–812.

    Google Scholar 

  • Lezak, M. (1995). Neuropsychological assessment. New York: Oxford University Press.

  • Logan, G. D. (1994). In D. Dagenbach & T. Carr (Eds.), Inhibitory processes in attention, memory and language (pp. 189–239). San Diego: Academic.

    Google Scholar 

  • Logan, G., Schachar, R., & Tannock, R. (1997). Impulsivity an inhibitory control. Psychological Science, 8, 60–64.

    Article  Google Scholar 

  • Lopez, C., Tchanturia, K., Stahl, D., Booth, R., Holliday, J., & Treasure, J. (2007). An examination of the concept of central coherence in women with Anorexia Nervosa. International Journal of Eating Disorders, 41, 143–152.

    Article  Google Scholar 

  • Maayan, L., Hoogendoorn, C., Sweat, V., & Convit, A. (2011). Disinhibited eating in obese adolescents is associated with orbitofrontal volume reductions and executive dysfunction. Obesity, 19, 1382–1387.

    Article  PubMed  Google Scholar 

  • Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: a latent variable analysis. Cognitive Psychology, 41, 49–100.

    Article  PubMed  CAS  Google Scholar 

  • Mobbs, O., Iglesias, K., Golay, A., & Van der Linden, M. (2011). Cognitive deficits in obese persons with and without binge eating disorder: investigation using a mental flexibility task. Appetite, 57, 263–271.

    Article  PubMed  Google Scholar 

  • Morgan, A., & Lilienfeld, S. (2000). A meta-analytic review of the relationship between antisocial behaviour and neuropsychological measures of executive function. Clinical Psychology Review, 20(1), 113–136.

    Article  PubMed  CAS  Google Scholar 

  • National Institute for Health and Clinical Excellence. (2006). Obesity: Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. CG043. London: National Institute for Health and Clinical Excellence.

    Google Scholar 

  • Nederkoorn, C., Smulders, F., Havermans, R., Roefs, A., & Jansen, A. (2006). Impulsivity in obese women. Appetite, 47(2), 253–256.

    Article  PubMed  Google Scholar 

  • Pender, S. (2011). The neuropsychology of starvation: Set-shifting, central coherence, perseveration, and persistence in a nonclinical sample. Unpublished clinical psychology doctoral thesis, Department of Clinical, Educational, and Health Psychology, University College London.

  • Pierobon, A., Giardini, A., Fanfulla, F., Callegari, S., & Majani, G. (2008). A multidimensional assessment of obese patients with obstructive sleep apnoea syndrome (OSAS): a study of psychological, neuropsychological and clinical relationships in a disabling multifaceted disease. Sleep Medicine, 9(8), 882–889.

    Article  PubMed  Google Scholar 

  • Pignatti, R., Bertella, L., Albani, G., Mauro, A., Molinari, E., & Semenza, C. (2006). Decision-making in obesity: a study using the gambling task. Eating and Weight Disorders, 11(3), 126–132.

    PubMed  CAS  Google Scholar 

  • Reitan, R. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276.

    Google Scholar 

  • Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of Royal Society London B: Biological Sciences, 298, 199–209.

    Article  CAS  Google Scholar 

  • Smith, P., Blumenthal, J., Babyak, M., Craighead, L., Welsh-Bohmer, K., Browndyke, J., et al. (2010). Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure. Hypertension, 55(6), 1331–1338.

    Article  PubMed  CAS  Google Scholar 

  • Spitznagel, M., Garcia, S., Miller, L., Strain, G., Devlin, M., Wing, R. et al. (2011). Cognitive Function Predicts Weight Loss Following Bariatric Surgery. Surgery for Obesity and Related Diseases, 20, 1–7.

  • Spreen, O., & Strauss, E. (1998). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford: Oxford University Press.

  • Stuss, D. T., & Alexander, M. P. (2007). Is there a dysexecutive syndrome? Philosophical Transactions of the Royal Society B, 362, 901–915.

    Article  Google Scholar 

  • Svaldi, J., Brand, M., & Tuschen-Caffier, B. (2010). Decision-making impairments in women with binge eating disorder. Appetite, 54, 84–92.

    Article  PubMed  Google Scholar 

  • Trenerry, M. R., Crosson, B., DeBoe, J., & Leber, W. R. (1989). The stroop neuropsychological screening test. Odessa: Psychological Assessment Resources.

    Google Scholar 

  • Van den Berg, E., Kloppenborg, R., Kessels, R., Kappelle, L., & Biessels, G. (2009). Type 2 diabetes mellitus, hypertension, dyslipidemia and obesity: a systematic comparison of their impact on cognition. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, 1792(5), 470–481.

    Article  Google Scholar 

  • Van den Eynde, F., Guillaume, S., Broadbent, H., Stahl, D., Campbell, I., Schmidt, U. et al. (2011). Neurocognition in bulimic eating disorders: a systematic review. Acta Psychiatrica Scandinavica, 124, 120–140.

    Google Scholar 

  • Verdejo-García, A., Pérez-Expósito, M., Schmidt-Río-Valle, J., Fernández-Serrano, M., Cruz, F., Pérez-García, M., et al. (2010). Selective alterations within executive functions in adolescents with excess weight. Obesity, 18, 1572–1578.

    Article  PubMed  Google Scholar 

  • Volkow, N., Wang, G., Telang, F., Fowler, J., Goldstein, R., Alia-Klein, N., et al. (2008). Inverse association between BMI and prefrontal metabolic activity in healthy adults. Obesity, 17(1), 60–65.

    Article  PubMed  Google Scholar 

  • Walsh, K. (1994). Neuropsychology: a clinical approach (3rd ed.). Edinburgh: Churchill Livingstone.

    Google Scholar 

  • Wechsler, D. (1997). WAIS-III, WMS-III, technical manual. San Antonio: Psychological Corporation.

    Google Scholar 

  • Weller, R. E., Cook, E. W., III, Avsar, K. B., & Cox, J. E. (2008). Obese women show greater delay discounting than healthy-weight women. Appetite, 51(3), 563–569.

    Article  PubMed  Google Scholar 

  • Wilson, B., Alderman, N., Burgess, P., Emslie, H., & Evans, J. (1996). Behavioral assessment of the dysexecutive syndrome. Oxford: Thames Valley Test Company.

    Google Scholar 

  • World Health Organisation (WHO) (2011) Global Database on Body Mass Index. Retrieved December 4, 2011, from http://apps.who.int/bmi/index.jsp

  • Zinzindohoue, F., Chevallier, J., Douard, R., Elian, N., Ferraz, J., Blanche, J., et al. (2003). Laparoscopic gastric banding: a minimally invasive surgical treatment for morbid obesity: prospective study of 500 consecutive patients. Annals of Surgery, 237(1), 1–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sian Fitzpatrick.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fitzpatrick, S., Gilbert, S. & Serpell, L. Systematic Review: Are Overweight and Obese Individuals Impaired on Behavioural Tasks of Executive Functioning?. Neuropsychol Rev 23, 138–156 (2013). https://doi.org/10.1007/s11065-013-9224-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11065-013-9224-7

Keywords

Navigation