Can Weight Loss Surgery, Medications, and Lifestyle Changes Improve Brain Health?

Fact checked by Nick Blackmer

• More and more, evidence shows that weight loss may be an avenue to boost a person’s brain health.

• Researchers are still learning more, but it’s hypothesized that obesity can lead to inflammation, which can in turn cause brain changes linked to cognitive decline and mental health issues.

• Weight loss surgeries, GLP-1 drugs such as Wegovy, and lifestyle changes may all be able to boost brain health, though research varies.
  

Most people know that obesity is linked to chronic disease and other health issues, but more and more, research is showing obesity can be unhealthy for the brain, too.

Because of this, weight loss—whether by surgery, drugs like Ozempic and Wegovy, or lifestyle changes—may be an avenue for people with obesity to boost their cognition.

A study published in JAMA Network Open in February looked at adults with severe obesity and found that after the participants underwent bariatric surgery, 40% had improved cognition. And research published in August found that liraglutide, an anti-obesity medication, can help restore adaptive learning abilities in those with obesity.

What researchers are finding is that brain health and metabolic health go hand-in-hand.

“As one loses weight, metabolic syndrome starts to reverse and inflammation levels decrease, and brain metabolism and mitochondrial function improve,” Kristin Baier, MD, obesity medicine physician and Vice President of Clinical Development at Calibrate, told Health.

Here’s what to know about the connection between obesity and brain health and how various weight loss methods can impact cognitive function.

Obesity, Inflammation, and Worsened Brain Health

We’re still learning more about the connection between obesity and brain health, but inflammation could be the culprit behind these related cognitive issues.

Fat tissue can release molecules that lead to inflammation throughout the body, including in the brain. This neuroinflammation has been associated with changes in cerebral gray and white matter tissue. In particular, loss of gray matter in the brain has been associated with dementia and mental health issues such as depression.

This connection between weight, inflammation, and brain health has also been studied in people with metabolic syndrome—a combination of large waist circumference, high cholesterol and blood sugar, hypertension, and low HDL cholesterol. Research has shown that metabolic syndrome is linked to inflammation that could cause a decline in cognitive function.

Losing weight, then, might be a way for some people to boost their brain health.

“Clinical studies...suggest the importance of diet and exercise to help manage symptoms of depression and anxiety, and even prevent or attenuate neurodegenerative diseases such as Alzheimer’s and Parkinson’s,” said Baier.

Related: Study Finds 15 Health and Lifestyle Factors That Could Increase Risk of Early Dementia

How Different Weight Loss Strategies Can Affect the Brain

In so far as they can help a person lose weight, it’s possible that weight loss surgery, weight loss medications, and lifestyle changes can all have some effect on a person’s brain health.

Weight Loss Surgery

The February JAMA Network Open study is one of the most recent to draw a connection between weight loss surgery and better cognition. In particular, researchers looked at 133 adults in the Netherlands with severe obesity who completed bariatric surgery.

Two years later, about 43% of participants’ cognition scores were improved. Additionally, study authors noted lower inflammatory markers and fewer depressive symptoms among participants, as well as greater thickness of their temporal cortexes.

Other research has found similar results—a 2014 study tested the brain function of 17 women with obesity before and six months after a weight loss surgery called RYBG (Roux-en-Y Gastric Bypass). The same tests were also run once on a control group of 16 women without obesity.

Before their weight loss surgeries, the group with obesity had higher rates of metabolism in certain areas of their brains. But following surgery, their brain metabolism was comparable to that of the control group. The women also performed better on a test measuring for executive function after their weight loss procedures.

Weight loss surgery can have positive impacts on overall health and cognitive function, but the procedure does come with some risks. This can include bleeding, blood clots, infection, diarrhea, and more. It’s best to consult with your physician about the potential side effects before undergoing any weight loss procedure.

Related: How Is Obesity Treated?

GLP-1 Medications

Ozempic, Wegovy, and similar drugs are great tools for improving metabolic health, Baier said. Because of this, they might be able to improve brain metabolism and, by extension, brain health, she said.

But experts are trying to figure out how these glucagon-like peptide-1 (GLP-1) drugs actually interact with the brain.

Research has shown that gliptins, a type of diabetes medication, increase GLP-1 levels and can improve cognitive decline in people with type 2 diabetes. The idea is that because Ozempic mimics this GLP-1 hormone, it might be able to do the same. In fact, Novo Nordisk, the makers of Ozempic and Wegovy, are currently conducting a clinical trial that will determine if the medication can have a “positive effect on early Alzheimer’s disease.”

Other similar weight loss medications have been linked to better brain health, too.

An August 2023 study found associative learning impairments caused by obesity can be restored with liraglutide, an anti-obesity medication also known as Saxenda or Victoza. After just one dose, researchers said participants with obesity showed no impairment compared to a group of healthy-weight participants.

However, it’s imperative to be cautious when using these medications, said Chris Allen, MD, pediatric neurologist and sleep medicine physician at Covenant Healthcare and senior science advisor at Aeroflow Sleep.

GLP-1 drugs can lead to gastrointestinal side effects such as nausea and vomiting, while Ozempic and Wegovy, in particular, have been linked to more severe side effects such as pancreatitis.

And though more recent studies have not found any connection between these medications and suicidal ideation, it’s important to ensure the drugs don’t make brain health worse in any way.

“Potential side effects and long-term impacts on neurological functions should be thoroughly evaluated,” Allen told Health. “Consultation with a healthcare professional is crucial before considering these drugs.”

Related: What Is 'Food Noise'? How Drugs Like Ozempic and Wegovy Quiet Obsessive Thoughts About Food

Lifestyle Changes

While surgery can provide the most dramatic weight loss results, lifestyle changes are also very beneficial.

Implementing a well-balanced diet, exercising regularly, focusing on quality sleep hygiene, and eliminating stress have been shown to cause weight loss. And these types of lifestyle changes have been associated with inflammation reduction, and therefore, with a lower risk of developing neurodegenerative and other diseases. In particular, exercise might be able to improve blood flow in the brain, boosting cognition.

Though lifestyle changes tend to come with fewer risks, you should check with your doctor before starting any new weight loss program. This is especially true if you’re currently being treated for any neurological or psychological disease.

Related: How To Build a Great Weight Loss Grocery List

Can Weight Loss Always Boost Cognition?

Though research suggests weight loss could contribute to cognitive improvements, it’s certainly not a guarantee.

“Cognitive function is influenced by a multitude of factors, including genetics, lifestyle, and overall health,” said Allen.

Even among factors that are in your control, weight management is just one way to protect against cognitive decline. Others include keeping your mind active, engaging with friends and social activities, and lowering stress.

And if a person is interested in losing weight to try to improve their brain health, that too isn’t “one-size-fits-all,” Baier said. Factors such as medical and family history, age, gender, or personal goals can all influence which method of weight loss is best for you, she added.

“Weight loss should be viewed as part of a holistic approach to enhancing cognitive well-being, complemented by other healthy habits and practices,” said Allen.

Related: Hobbies Like Gardening, Fishing Can Boost Your Brain Health

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