1. Childhood attention-deficit/hyperactivity disorder (ADHD) was associated with a greater body mass index (BMI) and obesity rate in adulthood when compared to controls; these associations remained after adjustment for socioeconomic status, substance abuse, and other mental health disorders.
2. While those with ADHD that remitted prior to adulthood had increased BMI and obesity when compared to controls, adults with persistent ADHD showed no significant difference.
Evidence Rating Level: 1 (Excellent)
Study Rundown: As previous studies were limited by their retrospective nature, this prospective study was designed to investigate the long-term effects of ADHD on BMI and obesity rates. During follow-up at 41 years old, those with childhood ADHD had a significantly greater BMI and rate of obesity than controls. These differences were hypothesized to be inherent to ADHD-associated impulsivity, subsequently leading to poor eating behaviors. Additionally, certain front-striatal dopaminergic neuronal circuits have been implicated in both ADHD and obesity, lending credibility to potential concurrent dysfunction in affected patients. While BMI rates were higher for those with remitted ADHD when compared to controls, those with persistent-ADHD did not show a significant difference. Limitations to the study included its homogenous sample population and reliance on self-reported data. The strong association between ADHD and obesity prompts consideration for close long-term monitoring.
Study Author, F. Xavier Castellanos, M.D., talks to 2 Minute Medicine: Center for Neurodevelopmental Disorders, NYU Langone Medical Center Child Study Center, Nathan Kline Institute for Psychiatric Research
“One of the reasons for the correlation between the diagnosis of ADHD in childhood and increased risk of obesity later in life is a lack of impulse control and poor planning skills, symptoms often associated with ADHD. This could lead to poor eating habits and food choices. Inability to maintain a regular eating pattern also could be a cause… I would say that the papers that have emerged from this study of men who were hyperactive children followed prospectively is confirming that ADHD casts a long shadow. Boys who are diagnosed with ADHD should be monitored for long-term risk of obesity.”
In-Depth [prospective cohort]: 207 white, middle-class, medically healthy boys with childhood ADHD and 178 demographically matched boys without childhood ADHD participated in a 33-year, prospective study to investigate the potential association between childhood ADHD and adult BMI. At age 41, 111 subjects each from the case and control groups responded to a self-reported height and weight survey. Men with childhood ADHD had a significantly higher BMI and obesity rate than those without childhood ADHD (BMI 30.1 + 6.3 vs. 27.6 ± 3.9, p < 0.001; obesity rate 41.4% vs. 21.6%, p = 0.001). Men with remitted-ADHD, but not those with persistent-ADHD, showed an increase in BMI when compared to controls.
By Neha Joshi and Leah H. Carr
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