Adipositas - Ursachen, Folgeerkrankungen, Therapie 2010; 04(03): 131-137
DOI: 10.1055/s-0037-1618710
Psychische Aspekte der Adipositas
Schattauer GmbH

Ist es doch die Willenskraft? Exekutivfunktionen bei Adipositas

Is it all about willpower? Executive functioning in obesity
A. Müller
1   Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen
,
E. Pauli
2   Neurologische Klinik, Universitätsklinikum Erlangen
,
M. de Zwaan
1   Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2017 (online)

Zusammenfassung

Das Konzept der Exekutivfunktionen umfasst mentale Prozesse höherer Ordnung, deren Zusammenspiel zielgerichtetes Verhalten und flexibles, angemessenes Reagieren auf neue Situationen und damit Selbstkontrolle gewährleistet. Exekutivfunktionen sind immer dann relevant, wenn mehrere Handlungsalternativen hinsichtlich ihrer Konsequenzen miteinander verglichen und Hypothesen über die Folgen des eigenen Handelns gegeneinander abgewogen werden müssen. Die bisherige Studienlage zeigt, dass exekutive Funktionen bei extrem übergewichtigen Patienten beeinträchtigt sind. Wahrscheinlich tragen reduzierte Exekutivfunktionen bzw. eine verringerte Selbstkontrolle zu den Problemen bei der Steuerung des Essverhaltens bei adipösen Patienten bei. Ungeklärt ist, ob extremes Übergewicht eine Ursache oder ein Resultat exekutiver Dysfunktion darstellt. Es besteht Forschungsbedarf, um die Zusammenhänge zwischen Adipositas und defizitären Exekutivfunktionen besser verstehen zu können. Zudem ist noch ungewiss, inwiefern eine nachhaltige, klinisch signifikante Gewichtsreduktion zur Verbesserung neurokognitiver Funktionen führt.

Summary

The concept of executive functioning includes higher-order cognitive abilities that are necessary to engage in goal-directed behaviour, respond in an adaptive manner in novel situations, and for self-control. Executive functions are relevant when alternative behaviours must be compared with each other and prioritized on the basis of their consequences. Research has provided evidence for an association between obesity and impaired executive functioning. Deficits in executive functioning and reduced self-control probably contribute to uncontrolled eating behaviour in obese patients. It is difficult to determine whether obesity is a cause or a result of executive dysfunction. Further research is needed to identify etiological mechanisms and underlying physiological processes that contribute to the association between obesity and impaired executive functioning. Furthermore, it remains unknown whether extreme weight loss would reverse cognitive deficits.

 
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