Upon his visit to Tam Anh General Hospital, TP HCM, Toan presented with grade two obesity, weighing 92 kg and standing 1.68 m tall. His body fat percentage was approximately 50%, with visceral fat levels two to three times the safe threshold. He also suffered from dyslipidemia, elevated cholesterol, and diabetes.

A neurologist examined Toan, ruling out other causes of memory impairment such as depression, prolonged insomnia, traumatic brain injury, encephalitis, or early-onset Alzheimer's disease. A subsequent brain MRI scan revealed an increased white matter signal, indicating damage to the brain's white matter.

White matter serves as the brain's "transmission" system, connecting various regions and facilitating information processing, memory, concentration, and motor coordination. Damage to these nerve fibers weakens signal transmission, leading to reduced memory, slow information processing, and difficulty concentrating. Severe cases can manifest as motor disorders, reduced sensation, blurred vision, or poor motor coordination.

Doctor Hoang advises Toan on weight loss. Photo: Tam Anh General Hospital

Doctor Lam Van Hoang, Head of the Department of Endocrinology - Diabetes, explained that white matter damage often stems from reduced circulation in small blood vessels, which harms nerve fibers. Factors such as high blood pressure, high blood sugar (due to diabetes), a high-fat diet, and smoking can increase the number of white matter spots or lesions in the brain. Obesity can also induce chronic inflammation and metabolic disorders, contributing to reduced gray matter volume and white matter damage.

"Obesity, high blood pressure, and metabolic disorders can elevate the risk of early memory decline," stated Doctor Hoang. He added that adipose tissue functions not merely as an energy storage site but also as an endocrine organ, secreting inflammatory substances. Chronic inflammation, insulin resistance, and prolonged small blood vessel damage can reduce cerebral blood flow, impacting nerve cell activity and promoting early progressive cognitive decline.

Initial symptoms of white matter damage are often easily overlooked because they mimic common life stressors, including reduced concentration, forgetfulness, slow reactions, or decreased work efficiency.

Toan underwent multidisciplinary obesity treatment, which included weight loss medication, a personalized nutrition plan, increased physical activity for at least 150 minutes each week, and adequate sleep for seven to eight hours each night. Additionally, he engaged in cognitive training activities such as reading, playing Rubik's Cube, learning a foreign language, or a musical instrument.

Doctors advised him to incorporate more antioxidant and flavonoid-rich foods, such as berries, and to use supportive products containing ginkgo biloba extract as prescribed to enhance cognitive function.

After two months of consistent treatment, he lost 7 kg, his concentration improved, and he experienced less forgetfulness. Toan is currently aiming to reduce his weight to below 70 kg.

Duc Hanh

*Patient's name has been changed