Childhood obesity and attention deficit/hyperactivity disorder: A newly described comorbidity in obese hospitalized children

Agranat-Meged, Anat; Deitcher, Chane; Goldzweig, Gil; Leibenson, Lilach; Stein, Magda; Galili-Weisstub, Esti

doi:10.1002/eat.20096

Cited by 185 publications

(169 citation statements)

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“…2 To date, the comorbidity between ADHD and obesity has been overlooked. 6 As it is often assumed that a low level of physical activity is involved in the etiology of obesity, one might think that ADHD (or at least the hyperkinetic component of this disorder) may be underrepresented in obese patients. 7 However, preliminary evidence surprisingly suggests a potential relationship between ADHD and obesity in clinical samples of obese adults and children seeking treatment.…”

Section: Introductionmentioning

confidence: 99%

“…In their sample, significantly more subjects than expected had a BMI X90th percentile (19.6%) and X97th percentile (7.2%). In a sample of 26 children hospitalized for the treatment of their obesity, Agranat-Meged et al 6 found that over one-half (57.7%) had ADHD according to DSM-IV criteria. From a slightly different perspective, in a sample of 108 women with seasonal affective disorder, Levitan et al 9 found a significant correlation between attentional problems in childhood and maximum lifetime BMI (r ¼ 0.35, P ¼ 0.001, N ¼ 96), after excluding subjects with extreme obesity (BMI440kg/m 2 ), which may represent a genetically distinct subgroup.…”

Section: Introductionmentioning

confidence: 99%

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Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

et al. 2006

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Objective: Preliminary evidence suggests a comorbidity between attention-deficit/hyperactivity disorder (ADHD) and obesity. This study was carried out to identify the clinical characteristics of obese adolescents with a higher probability of ADHD and advance the understanding of the potential factors underlying the comorbidity between obesity and ADHD. We evaluated the association between ADHD symptoms and bulimic behaviors, depressive and anxiety symptoms, degree of obesity, pubertal stage, age and gender in a clinical sample of obese adolescents. Design: Cross-sectional study. Subjects: Ninety-nine severely obese adolescents aged 12-17 years. Measurements: Subjects filled out the Bulimic Investigatory Test, Edinburgh, the Beck Depression Inventory and the State-Trait Anxiety Inventory for Children. Their parents completed the Conners Parent Rating Scale, which assesses ADHD symptoms. The degree of overweight was expressed as body mass index-z score. Puberty development was clinically assessed on the basis of Tanner stages. Results: Bulimic behaviors were significantly associated with ADHD symptoms after controlling for depressive and anxiety symptoms. The degree of overweight, pubertal stage, age and gender were not significantly associated with ADHD symptoms. Conclusion: Obese adolescents with bulimic behaviors may have a higher probability to present with ADHD symptoms independently from associated depressive or anxiety symptoms. The degree of overweight, pubertal stage, age and gender might not be useful for detecting obese adolescents with ADHD symptoms. Therefore, we suggest systematic screening for ADHD in obese adolescents with bulimic behaviors. Further studies are needed to understand which specific dimension of ADHD primarily accounts for the association with bulimic behaviors. Future research should also investigate the causal link between bulimic behaviors and ADHD and explore potential common neurobiological alterations. This may lead to a better understanding of the effectiveness of stimulants for the treatment of bulimic behaviors in obese subjects.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

et al. 2006

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“…This is the more surprising in light of mounting evidence for a significant comorbidity between obesity and ADHD [4,24]. We assume that especially for ADHD, relying on the information of a child or an adolescent leads to an underestimation of the prevalence.…”

Section: Discussionmentioning

confidence: 98%

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

Vlierberghe

Braet

Goossens

et al. 2008

Eur Child Adolesc Psychiatry

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Background: This study aimed firstly to investigate whether youngsters referred for overweight treatment differ from non-referred overweight youngsters on the prevalence of psychiatric disorders and psychological symptoms. Secondly, the potentially moderating role of age, gender, socio-economic status and degree of overweight in the association of referral status and mental disorder in overweight youth was explored. Methods: Participants were 155 overweight youngsters enrolled in an obesity treatment programme (mean age = 13.76; mean BMI = 33.99) and 73 non-referred overweight youngsters (mean age = 13.74; mean BMI = 27.35). The Structured Clinical Interview for DSM-IV-Childhood version and the Child version of the Eating Disorder Examination were administered and participants filled out the Children’s Depression Inventory, the Spence Children’s Anxiety Scale and the Youth Self Report. Parents were asked to complete the Child Behavior Checklist. Results: In the referred group 37.50% and in the non-referred group 23.29% of the participants met criteria for at least one mental disorder. In both groups, anxiety disorders were most prominent. Overall, a higher prevalence of mental disorders was found in the referred group. Referred youth displayed significantly more ‘full blown’ eating disorders and binge eating than non-referred youngsters and exhibited a significantly greater severity of self- and parent-reported internalizing symptoms. Referral was also associated with a significantly higher degree of overweight and significantly lower SES. After controlling for these pre-existing differences in degree of overweight and SES, only the greater severity of parent-reported internalizing symptoms in referred youth remained significant. Older age was generally predictive for the presence of mental disorders and in the non-referred group SES was positively associated with psychiatric disorder. Conclusions: A substantial proportion of overweight youngsters suffer from mental disorders. Referral status and age are associated with the presence of psychopathology. However, differences between referred and non-referred youngsters are not as pronounced as expected on the basis of earlier research in the field

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“…16 When considering the other aspect of impulsivity, insufficient response inhibition, it was found that obese children and women are less able to inhibit their response to infrequent stop signals, when the dominant task was to respond as fast as possible. 12,17 Interestingly, obese children show comorbidity with attention deficit/hyperactivity disorder, which is indicative of less impulse control, 18 and vice versa, attention deficit/hyperactivity disorder children have higher weights and higher incidences of obesity than norm groups. 19 The association between impulsivity and obesity might suggest that impulsivity causes overeating, especially in the current food abundant environment and as argued above, frequent overeating in turn leads to body weight increase.…”

Section: Introductionmentioning

confidence: 99%

The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket

et al. 2009

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Objective: It has been shown repeatedly that impulsivity, obesity and food intake are related; obese people are more impulsive than lean people and impulsive people eat more than less impulsive people. The relation between impulsivity and food intake might be state dependent; hunger motivates food seeking behaviour and food consumption, especially of high caloric food. Difficulties to overrule automatic behavioural tendencies might make impulsive people more susceptible to the effects of hunger on food selection. Therefore, they are expected to increase their intake more than low impulsive people when feeling hungry. Study 1: Fifty-seven female participants were randomly assigned to a hunger or sated condition. Response inhibition (a measure of impulsivity) and food intake were measured. Results show that impulsive participants ate significantly more, but only when feeling hungry. Study 2: Ninety-four undergraduate students participated. Hunger, response inhibition and the purchase of food in a virtual supermarket were measured. The same interaction was found: impulsive participants bought most calories, especially from snack food, but only when feeling hungry. Conclusion: Hunger and impulsivity interact in their influence on consumption. These data suggest that reducing hunger during calorie restricting diets is important for successful weight loss, particularly for the impulsive dieters.

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Childhood obesity and attention deficit/hyperactivity disorder: A newly described comorbidity in obese hospitalized children

Abstract: AD/HD shows a high comorbidity among obese hospitalized children. The characteristic difficulty in regulation found in AD/HD may be a risk factor for the development of abnormal eating behaviors leading to obesity. We suggest that obese children should be screened routinely for AD/HD.

Cited by 185 publications

References 10 publications

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket

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