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Multiple sclerosis (MS) is a neurological autoimmune, inflammatory degenerative disease leading to physical, emotional and cognitive disability among young adults (Ben-Zacharia & Del-Bene, 2008; Tullman, 2013). The prevalence of MS is half a million people in the United States and 2.5 million people worldwide (Kurtzke, 2000). Although, MS is highly prevalent in Whites, Blacks and Hispanics have a worsened form of the illness (Kurtzke, 2000). Aside from ethnicity/race and genetics, which are non-modifiable risk factors for MS, recent studies showed an association between modifiable factors such as obesity and risk of MS in adolescents and young adults (Langer-Gould, Brara, Beaber, & Koebnick, 2013). Although body mass index (BMI) is a modifiable risk factor, 70% of patients with MS are obese or overweight (Khurana et al., 2009). In the general population, obesity is a leading preventable cause of death and concomitant cardiovascular diseases producing a significant public concern. Moreover, obesity has been shown to trigger morphometric brain changes leading to cognitive impairment in otherwise healthy adults (Gunstad et al., 2008).

Cognitive impairment is a serious complication of MS. Cognitive dysfunction occurs in 65% of people with MS, which lessens their ability to maintain their vocational and societal roles (Rahn, Slusher, & Kaplin, 2012). Although the correlation between BMI, cognition and brain volume is not well studied in patients with MS, there is sufficient data showing an association between brain atrophy and cognitive deficits. Brain volume loss in MS, specifically subcortical and cortical atrophy, elucidate more variance in neuropsychological dysfunction than overall lesion burden (Benedict, Carone, & Bakshi, 2004; De Stefano et al., 2014; Hoffmann, Tittgemeyer, & von Cramon, 2007). Optimal cognitive functioning is essential to effectively negotiate the environment and societal responsibilities, thus medical comorbidities such as obesity that can impede brain health, may negatively affect cognitive performance (Vance, Larsen, Eagerton, & Wright, 2011). Furthermore, preventing brain volume loss and minimizing cognitive decline have important clinical implications in MS.