Neurophysiological and executive function differences among underweight, overweight, and normal-weight children and adolescents

Abstract

Background: Body weight status, including both underweight and overweight, has been associated with developmental risks, yet its impact on neurophysiological and executive functions remains underexplored. This study investigated neurophysiological and executive function differences among underweight (UW), overweight (OW), and normal-weight (NW) children and adolescents (aged 8-16 years).

Method: Participants (N = 73) underwent assessments of executive functions (e.g., working memory, decision-making, attention) and EEG measurements across three phases: resting state, task reactivity, and post-task recovery.

Results: ANOVA revealed significant group differences in working memory, with the UW group performing worse on Digit Span. Although decision-making and attention did not differ substantially between groups, distinct EEG patterns were observed. Specifically, OW individuals displayed elevated theta activity during post-task phases, reflecting potential neural fatigue or inefficient cortical regulation following the task.

Conclusion: Both UW and OW groups showed atypical increases in gamma activity, suggesting compensatory or disrupted cortical functioning. These findings underscore subtle neurophysiological and cognitive vulnerabilities associated with abnormal weight statuses, highlighting the importance of early neurodevelopmental screening and intervention strategies in pediatric populations.

Impact: Children and adolescents with underweight or overweight status exhibit distinct EEG reactivity patterns during cognitive task recovery, suggesting early neurophysiological alterations not detectable through behavioral observation alone. Despite comparable daily executive functioning and behavioral symptoms across groups, subtle differences in working memory and brain activation indicate that weight-related cognitive risks may emerge before functional impairments are visible. These findings underscore the importance of integrating neurocognitive screening into pediatric health monitoring and suggest that interventions addressing childhood weight issues should encompass both physical and neurodevelopmental health domains.