INTRODUCTION: Obesity has become a global public health issue, which impacts general health and the brain. Associations between obesity and white matter microstructure measured using diffusion tensor imaging have been under reviewed, despite a relatively large number of individual studies. Our objective was to determine the association between obesity and white matter microstructure in a large general population sample. METHODS: We analyzed location of brain white matter changes in obesity using the Anisotropic Effect Size Seed-based d Mapping (AES-SDM) method in a voxel-based meta-analysis, with validation in a region of interest (ROI) effect size meta-analysis. Our sample included 21 742 individuals from 51 studies. RESULTS: The voxel-based spatial meta-analysis demonstrated reduced fractional anisotropy (FA) with obesity in the genu and splenium of the corpus callosum, middle cerebellar peduncles, anterior thalamic radiation, cortico-spinal projections, and cerebellum. The ROI effect size meta-analysis replicated associations between obesity and lower FA in the genu and splenium of the corpus callosum, middle cerebellar peduncles. Effect size of obesity related brain changes was small to medium. DISCUSSION: Our findings demonstrate obesity related brain white matter changes are localized rather than diffuse. Better understanding the brain correlates of obesity could help identify risk factors, and targets for prevention or treatment of brain changes.

Department of Clinical Neuroscience Center for Psychiatric Research and Education Karolinska Institutet Stockholm Sweden

Department of Medical Neuroscience Dalhousie University Halifax NS Canada

Department of Psychiatry Dalhousie University Halifax NS Canada

Department of Psychosis Studies Institute of Psychiatry Psychology and Neuroscience King's College London London United Kingdom

Institut d'Investigacions Biomèdiques August Pi i Sunyer University of Barcelona Barcelona Spain

Mental Health Research Networking Center Madrid Spain

National Institute of Mental Health Prague Czechia

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