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Do changes in weight status affect cognitive function in children and adolescents with obesity? A secondary analysis of a clinical trial
  1. Yvonne C Anderson1,2,
  2. Kaye Kirkpatrick1,
  3. Gerard M S Dolan3,
  4. Trecia A Wouldes4,
  5. Cameron C Grant5,6,7,
  6. Tami L Cave2,
  7. Cervantée E K Wild2,
  8. José G B Derraik2,8,
  9. Wayne S Cutfield2,6,8,
  10. Paul L Hofman2,6
  1. 1 Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
  2. 2 Liggins Institute, University of Auckland, Auckland, New Zealand
  3. 3 Taranaki District Health Board, New Plymouth, New Zealand
  4. 4 Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
  5. 5 Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
  6. 6 Starship Children’s Hospital, Auckland District Health Board, Auckland, New Zealand
  7. 7 Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Auckland, New Zealand
  8. 8 A Better Start – National Science Challenge, University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr Yvonne C Anderson; yvonne.anderson{at}


Objectives It is unclear whether an association exists between obesity in children/adolescents and cognitive function, and whether the latter can be altered by body mass index (BMI) standard deviation score (SDS) reductions. We aimed to determine whether an association exists between BMI SDS and cognitive function in children/adolescents with obesity engaged in an obesity intervention. Second, we sought to determine if BMI SDS reduction at 12 months was associated with improved cognitive function.

Design Secondary analysis of a clinical trial.

Participants Participants (n=69) were recruited from an obesity intervention. Eligible participants (recruited June 2013 to June 2015) were aged 6–16 years, with a BMI ≥98th centile or BMI >91st centile with weight-related comorbidities.

Outcome measures Primary outcome measure was change in BMI SDS from baseline at 12 months. Dependent variables of cognitive functioning and school achievement were assessed at baseline and 12 months, using dependent variables of cognitive functioning (elements of Ravens Standard Progressive Matrices, Wide Range Achievement Test-fourth edition and Wechsler Intelligence Scale for Children-fourth edition).

Results At baseline, BMI SDS was not associated with all aspects of cognitive function tested (n=69). Reductions in BMI SDS over time did not alter cognitive function overall. However, there was a greater reduction in comprehension standard scores in participants who increased their BMI SDS (adjusted estimated difference −6.1, 95% CI −11.6 to −0.6; p=0.03).

Conclusions There were no observed associations between BMI SDS and cognitive function in participants, apart from comprehension in the exploratory analyses, which may have been a random finding. Further studies need to include larger longitudinal cohorts incorporating a wider BMI range at entry to determine whether our findings persist.

Trial registration number ANZCTR12611000862943; Pre-results.

  • paediatrics
  • obesity
  • adolescents
  • lifestyle modifications
  • cognitive function

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  • Patient consent for publication Not required.

  • Contributors YCA designed the study, was involved with data interpretation and drafted the manuscript. KK undertook cognitive assessments and data entry, and was involved in study design. GMSD provided psychologist oversight, and was involved in study design. TAW was involved in interpretation of data and study design. CCG is secondary supervisor for the research team and assisted with the design of the study. TLC and CEKW assisted with data entry and analysis. JGBD analysed the data. WSC contributed to study design. PLH contributed to study design and supervises the research team. All authors critically revised the manuscript, gave final approval for the version to be published and are accountable for all aspects of the work.

  • Funding This work was supported by the Health Research Council of New Zealand, Royal Australasian College of Physicians, the Maurice and Phyllis Paykel Trust, Taranaki Medical Foundation and Lotteries Health Research.

  • Competing interests YCA and PLH have been recipients of these grants to undertake clinical research in relation to Whānau Pakari, YCA has been paid in a fellowship capacity from the Health Research Council of New Zealand, TLC and CEKW have been paid as research assistants, JGBD has been paid for data analysis.

  • Ethics approval Ethics approval for the overall trial was granted by the Central Health and Disability Ethics Committee (NZ) (CEN/11/09/054).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Anonymised and deidentified data may be made available to other investigators on request. Interested readers should contact the senior author PLH ( to obtain the data.

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