Cognitive and Behavioral Findings in Prader-Willi Syndrome and Early-Onset Morbid Obesity      

Jennifer Miller¹, John Kranzler², Ann Hatfield¹, O. Thomas Mueller³, Douglas W. Theriaque⁴ , Anthony P. Goldstone¹, Jonathan J. Shuster^4,5, Daniel J. Driscoll^1,6

¹ Department of Pediatrics, University of Florida, College of Medicine, Gainesville, FL ² Department of Educational Psychology, University of Florida, Gainesville, FL ³ All Children’s Hospital, St. Petersburg, FL ⁴ General Clinical Research Center, University of Florida, Gainesville, FL ⁵ Department of Statistics, University of Florida, Gainesville, FL ⁶ Center for Mammalian Genetics, University of Florida, College of Medicine, Gainesville, FL

Introduction

Childhood obesity is a major health problem throughout the world, with increasing prevalence, severity, and appearance at younger ages.  Prader-Willi syndrome is an excellent model to assess the causes and effects of early-onset morbid obesity (EMO), since it has a characteristic age of onset of obesity in addition to a well-described learning difficulties and behavioral problems. The early-onset morbid obesity is the most significant health problem and the primary cause of morbidity and mortality in individuals with PWS. We performed a comprehensive cognitive, achievement, and behavioral evaluation on 3 groups of individuals (PWS, EMO, and controls) to determine if children with early-onset morbid obesity had cognitive and behavioral problems associated solely with obesity.

Methods

We studied individuals with early-onset morbid obesity (EMO) of unknown etiology (n= 17; 8 males, 9 females), individuals with Prader-Willi syndrome (PWS) as a known cause of early-onset obesity (n=19; 13 males, 6 females), and the normal weight siblings from each of these groups (n=24; 11  males, 13 females) to determine if early-onset obesity is related to cognitive dysfunction and behavioral problems.  We used the Woodcock-Johnson Test of Cognitive Ability and Academic Achievement- Third Edition to assess general intellectual ability and achievement, and the Behavioral Assessment System for Children to obtain information regarding behavioral symptoms.