Attention-Deficit/Hyperactivity Disorder (ADHD) and Obesity: Update 2016

Abstract

While psychiatric comorbidities of attention-deficit/hyperactivity disorder (ADHD) have been extensively explored, less attention has been paid to somatic conditions possibly associated with this disorder. However, mounting evidence in the last decade pointed to a possible significant association between ADHD and certain somatic conditions, including obesity. This papers provides an update of a previous systematic review on the relationship between obesity and ADHD (Cortese and Vincenzi, Curr Top Behav Neurosci 9:199–218, 2012), focusing on pertinent peer-reviewed empirical papers published since 2012. We conducted a systematic search in PubMed, Ovid, and Web of Knowledge databases (search dates: from January 1st, 2012, to July 16th, 2016). We retained a total of 41 studies, providing information on the prevalence of obesity in individuals with ADHD, focusing on the rates of ADHD in individuals with obesity, or reporting data useful to gain insight into possible mechanisms underlying the putative association between ADHD and obesity. Overall, over the past 4 years, an increasing number of studies have assessed the prevalence of obesity in individuals with ADHD or the rates of ADHD in patients with obesity. Although findings are mixed across individual studies, meta-analytic evidence shows a significant association between ADHD and obesity, regardless of possible confounding factors such as psychiatric comorbidities. An increasing number of studies have also addressed possible mechanisms underlying the link between ADHD and obesity, highlighting the role, among others, of abnormal eating patterns, sedentary lifestyle, and possible common genetic alterations. Importantly, recent longitudinal studies support a causal role of ADHD in contributing to weight gain. The next generation of studies in the field should explore if and to which extent the treatment of comorbid ADHD in individuals with obesity may lead to long-term weight loss, ultimately improving their overall well-being and quality of life.

Association between psychological problems and overweight and obesity in school children

“…We did not find a significant relationship between ADHD problems and obesity as has been found in recent years by other authors (Cortese & Tessari, 2017;Khalife et al, 2014;Dahlgren and Björk, 2014;Griffits et al, 2011;Perez-Bonaventura et al, 2015). Several aspects could explain this lack of association; for instance, our study did not use specific tests for ADHD while other studies used ADHD patients or had a longitudinal design to explore the risk of one disorder on the other.…”

“…In addition to emotional problems, behavioral and neurodevelopmental disorders have also been shown to have a relationship with obesity, or have been considered predictors of weight gain (Dahlgren & Björk 2014;Khalife et al 2014;Korczak, Lipman, Morrison, Duku, & Szatmari, 2014;Mallan et al, 2017;Wentz, Björk, & Dahlgren et al, 2017). Among these disorders, meta-analytic evidence shows a significant association between ADHD and obesity, regardless of possible confounding factors such as other psychiatric comorbidities (Cortese & Tessari, 2017). This relationship has been found already in the preschool age by Perez-Bonaventura, Granero, & Ezpeleta (2015), who showed that a higher BMI at the age of 3 years was predictive of hyperactivity and ADHD symptoms at the age of 4 years.…”

“…This relationship has been found already in the preschool age by Perez-Bonaventura, Granero, & Ezpeleta (2015), who showed that a higher BMI at the age of 3 years was predictive of hyperactivity and ADHD symptoms at the age of 4 years. Several mechanisms may explain this association, highlighting the role, among others, of abnormal eating patterns secondary to food cue disorders and difficulties in inhibitory control over food, sedentary lifestyle and possible common genetic alterations (Van Den Akker, Stewart, Antoniou, Palmberg, & Jansen, 2014;Cortese & Tessari, 2017).…”

Thyroid Hormone Status in Overweight Children with Attention Deficit/Hyperactivity Disorder

“…Other studies have reported slightly increased TSH levels in ADHD [1-4]. However, all previous studies had not been adjusted to weight status, although it is well known that overweight is related to both ADHD [11-13, 15] and increased thyroid hormones [16-18]. This might explain the reported indirect associations in these studies.…”

“…Additionally, several studies reported a higher prevalence of overweight in children with ADHD [11-15]. Interestingly, overweight and obesity in childhood are associated with slightly increased concentrations of TSH and free triiodothyronine (fT3) [16-18].…”