Obesity affects brain structure and function- rescue by bariatric surgery?

Obesity has a major impact on metabolic health thereby negatively affecting brain function and structure, however mechanisms involved are not entirely understood. The increasing prevalence of obesity is accompanied by a growing number of bariatric surgeries (BS). Weight loss after BS appears to improve cognitive function in patients. Therefore, unraveling mechanisms how BS influences brain function may be helpful to develop novel treatments or treatments in combination with BS preventing/inhibiting neurodegenerative disorders like Alzheimer's disease. This review shows the relation between obesity and impaired circulation to and in the brain, brain atrophy, and decreased cognitive functioning. Weight loss seems to recover some of these brain abnormalities as greater white matter and gray matter integrity, functional brain changes and increased cognitive functioning is seen after BS. This relation of body weight and the brain is partly mediated by changes in adipokines, gut hormones and gut microbiota. However, the exact underlying mechanisms remain unknown and further research should be performed.