Bariatric surgery outcomes in obese adults with cognitive impairments: A systematic review

Obesity is highly prevalent among individuals with cognitive impairments, yet bariatric surgery is often underutilized in this population due to concerns regarding adherence and safety. The aim of this review is to evaluate the outcomes of bariatric surgery in obese adults with cognitive impairments, focusing on weight loss, cognitive function, general health, and postoperative risks. A systematic review of 11 studies was conducted, including case reports, cohort studies, and pilot trials that investigated bariatric surgery outcomes in adults with intellectual disabilities, neurodevelopmental disorders, or acquired cognitive dysfunction. Outcomes included excess weight loss (EWL), cognitive changes, comorbidity resolution, and postoperative complications. Most studies reported significant weight loss, although slightly lower than in neurotypical populations (EWL ranging from 31.1% to 90%). Cognitive improvements were observed in domains such as memory and executive function within weeks after surgery. Bariatric surgery also led to notable improvements in comorbidities such as diabetes and hypertension. However, risks included nutritional deficiencies and poor adherence, particularly in patients with low preoperative cognitive function. Strong caregiver support and structured follow-up programs were key predictors of long-term success. Bariatric surgery can be a safe and effective intervention for adults with cognitive impairments when tailored support systems are implemented. Cognitive screening and personalized postoperative care are essential to optimize outcomes.