Bariatric Surgery Improves Brain Structure and Function

It is no surprise that all the systems of the human body are connected to each other in a complex way. However, this idea about obesity impacting brain structure and function is a new connection that I haven’t heard before, specifically what happens to the brain when an individual has a drastic change in their weight. 

Let’s first look at the effects of obesity on our brain. There can be alterations to the normal processing of food-related stimulus. Areas of the brain involved in feeding behavior decrease in volume in an obese individual (Nota et al., 2019). This means that the parts of the brain regulating normal feeding behavior is anatomically altered in someone who is obese. Changes in these areas of the brain that affect feeding behavior will also impact cognitive behavior and control, such as memory performance and learning ability which is decreased in obese individuals (Nota et al., 2019). It’s evident that obesity is a multi-faceted issue that attacks various aspects of the human body. 

One solution to this complex issue is bariatric surgery which is a surgery that results in drastic weight loss for morbidly obese individuals. It was shown that morbid obese individuals who underwent bariatric surgery showed noticeable changes in both grey and white matter density compared to their condition before the surgery (Nota et al., 2019). This marks an anatomical change in brain structure, but what about cognition? Some studies have shown that patients’ cognitive functioning in areas like memory, attention, executive function, and language had improved after surgery from below average to average (Nota et al., 2019). The authors justify those results with a change in patients’ gut hormone levels such as ghrelin, the hunger hormone, and also from a reduction of inflammatory cytokines and less metabolic stress (Nota et al., 2019). 

Bariatric surgery seems to be able to rescue these various neurological functions in obese individuals, however I wonder how much is physiological and how much is psychological. Presumably, obese individuals who have lost a drastic amount of weight might experience more positive emotions that could enhance their existing brain function. This would definitely be an interesting follow-up study and adds to the existing dialogue about how much can we attribute physiological changes to psychological changes. 

Sources:

Nota, M., Vreeken, D., Wiesmann, M., Aarts, E., Hazebroek, E., Kiliaan, A. (2019). Obesity affects brain structure and function – rescue by bariatric surgery?, Neuroscience & Biobehavioral Reviews. doi: https://doi.org/10.1016/j.neubiorev.2019.11.025