Obesity is a global public health problem with alarming proportions worldwide, being a transversal problem to all age groups. In Portugal, it is estimated that the prevalence of obesity is approximately 20% in the adult population, and that one in three Portuguese children is overweight. Although there are predisposing innate conditions, it is above all a direct consequence of dietary errors and a sedentary lifestyle.

Obesity is not just an aesthetic issue. It is a complex medical condition that affects multiple systems, including the brain and the rest of the nervous system. In addition to being a well-established cardiovascular risk factor in the development of neurological disease of vascular origin, the evolution in scientific knowledge has revealed a complex and multifactorial relationship between obesity and neurological diseases, which is still the subject of study.

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Several physiopathological factors are identified as potential contributors. One of the main mechanisms through which obesity affects the brain is the promotion of a state of chronic inflammation, which can trigger harmful neuroinflammatory responses, contributing to the progression of neurodegenerative diseases such as Alzheimer's, Parkinson's and multiple sclerosis.

Insulin resistance, a common feature of obesity, not only increases the risk of type 2 diabetes mellitus, but also plays a crucial role in the pathogenesis of neurological diseases. The metabolic dysfunction associated with insulin resistance can lead to imbalances in brain metabolism and the accumulation of toxic proteins, characteristic of Alzheimer's disease. There is evidence that the risk of Alzheimer's disease in obese individuals is twice as high compared to individuals with normal weight.

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In addition to the metabolic aspects, obesity negatively influences the functioning of the central nervous system through sleep disorders, such as obstructive sleep apnea, which are associated with an increased risk of cognitive decline and dementia. Chronic sleep deprivation interferes with memory consolidation processes and can aggravate the symptoms of pre-existing neurological diseases.

It is important to emphasize that the relationship between obesity and neurological diseases is bidirectional. That is, not only does obesity increase the risk of developing neurological diseases, but on the other hand, certain neurological conditions can also contribute to obesity, either by decreasing physical activity, by limiting mobility, or as a consequence of side effects of medications, among others.

In view of this worrying panorama, it is imperative to adopt integrated and holistic approaches to prevent and treat both obesity and neurological diseases. This includes interventions that promote the adoption of healthy lifestyles, such as a balanced diet and regular physical activity, in addition to the treatment of underlying medical conditions.

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