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Childhood ADHD often leads to obesity as adults

Teresa Tanoos's picture
New study shows boys with ADHD often grow up to be obese as adults

Children with ADHD are at increased risk of obesity as adults, according to a long-term study released today.

The study, published in Pediatrics, finds that boys who had attention deficit hyperactivity disorder as children are twice as likely to be overweight or obese when they are adults, compared to those who never had ADHD. Researchers for the study believe their results would also be true for females with ADHD.

This finding may surprise parents whose children have been diagnosed with ADHD. That’s because the most popular medications used to treat the disorder (e.g. Ritalin, Adderall, Dexedrine, etc.) tend to suppress appetite, said study co-author Dr. F. Xavier Castellanos, a professor of child and adolescent psychiatry at New York University.

“It’s not uncommon for kids treated with ADHD medications to be fairly thin,” Castellanos said. Accordingly, their parents tend to try to get these thinner kids to eat more food, especially if the child with ADHD is a boy because, as Castellanos puts it, such parents are often concerned that their thinner son won’t grow as tall, so they “sometimes will encourage their boys to eat more.”

According to the new study, however, encouraging children with ADHD to eat more often leads to weight problems down the road due to poor eating habits they learned as children when their parents would typically give them more fattening foods, including fried and fast food, in an effort to get as much food into their thinner bodies as possible.

Castellanos says such parents need to be alert to the tendency to overfeed their ADHD children.

“If anything, you have to pay attention to how many times they’re having fast food, how many times they’re having fried food, whether they’re getting meals supersized," Castellanos said.

The study comes at a time when rates of ADHD are increasing. In a recent report published yesterday from the Centers for Disease Control and Prevention (CDC), researchers found that ADHD is the most common mental health issue in children ages 3-17. That equates to nearly 7 percent of kids receiving a diagnosis of ADHD – and that doesn’t include all the kids (or adults) who frequently go undiagnosed. Click here to read an article by emaxhealth.com regarding yesterday's report about rising rates of ADHD and other mental disorders in children .

In this new study, researchers followed 222 boys, 111 of whom had ADHD, with the other 111 not having ADHD. The researchers followed the boys for an average of 33 years in an effort to gain a better understanding of how the disorder affects the brain. All of the boys who had ADHD were from middle-class, white families and were diagnosed between the ages of 6 and 12.

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When some of these boys returned decades later for brain scans, many of whom were now 40-something adults who had ADHD as children, they had gained so much weight that they barely fit into the fMRI machine, according to Castellanos.

All 222 of the boys in the study who were now “men” were then measure to determine their body-mass index (BMI). As a result, the researchers discovered that the men with ADHD as children were significantly heavier than those without the disorder. Specifically, the average BMI for the ADHD participants was 30.1, compared to 27.6 for those who never had ADHD. And the obesity rate among the men with ADHD as children was 41.4 percent, compared to only 21.6 percent among those without the disorder.

According to the CDC, an adult with a BMI of 25 or higher is considered overweight.

Some of the common problems associated with ADHD may be to blame for the link between obesity and ADHD. For example, symptoms of ADHD include lack of impulse control, difficulty paying attention to details, and poor planning skills – all of which could lead to poor eating habits, such as making unhealthy food choices, not paying attention to what foods are eaten, and having an irregular eating pattern that persists into adulthood, Castellanos said.

Although the study was only of men, Castellanos said that he suspects the results would also hold true for women.

The new study “shows exactly what I would have expected,” child psychiatrist Dr. James McGough, director of the UCLA ADHD clinic, told NBC News.

“People with ADHD have a terrible time delaying gratification. They’re very impulsive and they don’t think about consequences. Their problems with organization may make it more difficult to stay on a regular eating schedule which leaves them more likely to binge eat,” he said.

Obesity expert, Dana Rofey, an assistant professor of pediatric psychiatry and psychology at the University of Pittsburgh Medical Center agrees, saying that “sneak eating and aberrant eating patterns” are common among many of her young, male patients with ADHD.

“Once they start eating, they don’t stop,” said Rofey, who is also weight management director at the Children’s Hospital of Pittsburgh. She hopes the study will prompt parents to help their sons with ADHD develop healthful eating habits before they become a problem.

“That may mean tracking food intake or using a pedometer to keep track of activity,” Rofey said. “You want to encourage your child to do more outside with their friends, instead of spending hours texting or looking up their friends on Facebook.”

SOURCE: Pediatrics, Obesity in Men With Childhood ADHD: A 33-Year Controlled, Prospective, Follow-up Study (doi: 10.1542/peds.2012-0540); Centers for Disease Control and Prevention, In US, 20% Of Children Have A Mental Disorder, May 19, 2013.