The Cognitive Functions of Youth With Obesity: A Meta-Analysis.
8 affiliations
- 1Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
- 2Department of Psychology, Asia University, Taichung, Taiwan.
- 3School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan.
- 4Division of Pediatric Neurology, China Medical University Children's Hospital, Taichung, Taiwan.
- 5Department of Physical Medicine and Rehabilitation, Cathay General Hospital, Taipei, Taiwan.
- 6Center for Prevention and Treatment of Internet Addiction, Asia University, Taichung, Taiwan.
- 7Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan.
- 8Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.
Abstract
Background
This meta-analysis examined the associations between obesity and performance across seven cognitive domains (inhibition, cognitive flexibility, working memory, verbal fluency, planning, attention, and intelligence quotient [IQ]) in youth under 18 years. Developmental stage (school-aged children vs. adolescents) and sample sex composition examined as moderators. Evidence on executive function in youth with comorbid obesity and attention-deficit/hyperactivity disorder (ADHD) was synthesized qualitatively.Methods
Following PRISMA guidelines, 22 studies comparing youth with obesity to normal-weight peers were included. Effect sizes (Hedges' g) were pooled using a random-effects model. Subgroup analyses compared school-aged children and adolescents; meta-regression examined age and proportion of female participants as study-level moderators.Results
Youth with obesity performed significantly worse than normal-weight peers on inhibition (g⁺ = -0.193), cognitive flexibility (g⁺ = -0.499), working memory (g⁺ = -0.652), verbal fluency (g⁺ = -0.420), attention (g⁺ = -0.526), and IQ (g⁺ = -0.288); planning could not be estimated. School-aged children showed deficits on inhibition, working memory, and attention; adolescents on working memory and attention only. Between-subgroup tests were non-significant for all domains (p ≥ 0.26), so developmental differences should be interpreted with caution. Meta-regression showed that a higher proportion of female participants in a study sample, a study-level characteristic rather than an individual-level effect, was associated with larger working memory deficits (p = 0.002); age did not moderate any domain. Two ADHD-comorbidity studies received qualitative synthesis only.Discussion
Obesity is associated with poorer cognitive performance in youth across several domains, with sex composition of the study sample emerging as a moderator of the working memory finding; differences between school-aged children and adolescents were not significant and should be interpreted cautiously. Substantial heterogeneity, predominantly observational designs, inconsistent BMI criteria, and limited ADHD-stratified data constrain causal inference. Future studies should standardize weight definitions, report age- and ADHD-stratified data, and consider bidirectional pathways.
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BibTeX
@article{lin2026cognitive,
title = {{The Cognitive Functions of Youth With Obesity: A Meta-Analysis.}},
author = {Yi-Chun Lin and Chia-Chia Chang and Yu-Tzu Chang and Wei-Lin Liu and Yu-Chi Liao and Ro-Ting Lin},
journal = {Brain and behavior},
year = {2026},
month = nov,
doi = {10.1002/brb3.71884},
url = {https://europepmc.org/article/MED/42968408},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Cognitive Functions of Youth With Obesity: A Meta-Analysis.
AU - Yi-Chun Lin
AU - Chia-Chia Chang
AU - Yu-Tzu Chang
AU - Wei-Lin Liu
AU - Yu-Chi Liao
AU - Ro-Ting Lin
PY - 2026
DA - 2026/11/01
JO - Brain and behavior
DO - 10.1002/brb3.71884
UR - https://europepmc.org/article/MED/42968408
AB - Background This meta-analysis examined the associations between obesity and performance across seven cognitive domains (inhibition, cognitive flexibility, working memory, verbal fluency, planning, attention, and intelligence quotient [IQ]) in youth under 18 years. Developmental stage (school-aged children vs. adolescents) and sample sex composition examined as moderators. Evidence on executive function in youth with comorbid obesity and attention-deficit/hyperactivity disorder (ADHD) was synthesized qualitatively.Methods Following PRISMA guidelines, 22 studies comparing youth with obesity to normal-weight peers were included. Effect sizes (Hedges' g) were pooled using a random-effects model. Subgroup analyses compared school-aged children and adolescents; meta-regression examined age and proportion of female participants as study-level moderators.Results Youth with obesity performed significantly worse than normal-weight peers on inhibition (g⁺ = -0.193), cognitive flexibility (g⁺ = -0.499), working memory (g⁺ = -0.652), verbal fluency (g⁺ = -0.420), attention (g⁺ = -0.526), and IQ (g⁺ = -0.288); planning could not be estimated. School-aged children showed deficits on inhibition, working memory, and attention; adolescents on working memory and attention only. Between-subgroup tests were non-significant for all domains (p ≥ 0.26), so developmental differences should be interpreted with caution. Meta-regression showed that a higher proportion of female participants in a study sample, a study-level characteristic rather than an individual-level effect, was associated with larger working memory deficits (p = 0.002); age did not moderate any domain. Two ADHD-comorbidity studies received qualitative synthesis only.Discussion Obesity is associated with poorer cognitive performance in youth across several domains, with sex composition of the study sample emerging as a moderator of the working memory finding; differences between school-aged children and adolescents were not significant and should be interpreted cautiously. Substantial heterogeneity, predominantly observational designs, inconsistent BMI criteria, and limited ADHD-stratified data constrain causal inference. Future studies should standardize weight definitions, report age- and ADHD-stratified data, and consider bidirectional pathways.
SN - 2162-3279
ER -