Sex differences in executive functions in children with obesity

Obesity has been associated with executive functions (EF) impairments in both adults and children. Independent of obesity, age and sex have been associated with EF. Whether EF differ by sex in pediatric obesity remains understudied. The study investigated sex-dependent differences in working memory, cognitive flexibility, inhibitory control, and planning abilities among 46 children with obesity using neuropsychological tests. Z scores were used to index the performances relative to normative data.Overall, children with obesity showed performances below the norms on some but not all domains and presented clinically meaningful decreased performances in working memory. Relative to boys, girls were less efficient in planning strategies and deviated more from the norms in that domain. Although the cross-sectional design of our study precludes any firm conclusion on causal relationships between obesity and EF, our findings suggest that sex could be an important factor to consider for optimizing treatment efficacy in pediatric obesity. The trial (number NCT03615274) was registered in ClinicalTrials.gov (https://clinicaltrials.gov/) on August 3, 2018.