Half of the children with overweight or obesity and attention‐deficit/hyperactivity disorder reach normal weight with stimulants

Abstract

Aim: Treatment of childhood obesity is often insufficient and may be aggravated by high co-occurrence of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate whether children with overweight or obesity normalised in weight when receiving stimulant treatment for ADHD.Methods: Growth data of 118 children were obtained from medical records at outpatient paediatric and children's psychiatric services in the Gothenburg area, Sweden. The children were diagnosed with ADHD and were between 6 and 17 years at the start of stimulant treatment. The pre-treatment data act as an internal control where every child is their own control. Results: At the start of treatment, 74 children had normal weight and 44 had either overweight or obesity. During the year with stimulants, the mean (SD) body mass index (BMI) in standard deviation score (SDS) decreased significantly: −0.72 (0.66) compared with 0.17 (0.43) during the year before treatment (p < 0.01). After one year with treatment, 43% of those with overweight or obesity had reached normal weight. Conclusions: Stimulant treatment for ADHD yields significant weight loss. In children with overweight or obesity and ADHD, this is an important finding showing additional benefit in terms of weight management. K E Y W O R D S attention deficit hyperactivity disorder, body mass index, central stimulants, children, obesity Key Notes• The conventional treatment of obesity is often not enough for children with co-occurring attention-deficit/hyperactivity disorder (ADHD).• After one year with stimulant medication for ADHD, 43% of those with overweight or obesity had reached normal weight.• Improved regulation of appetite due to increased behaviour control and reduced impulsivity may contribute to the beneficial effect on weight.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Obesity, yet another symptom of a neurodevelopmental disorder

“…Many children with ADHD benefit from stimulants. From a clinical viewpoint, overweight is common in ADHD, and in this study from Gothenburg, the mean reduction in BMI after at least one year of stimulant treatment was 0.72 SD and 19 out of 44 overweight or obese children transitioned into normal weight during the period 2 . However, one year is a relatively short follow‐up time for this finding and for making conclusions regarding long‐term outcome.…”

“…The paper by Karin Fast et al 2 in this issue of Acta Paediatrica highlights not only the role of pharmacological treatment of overweight in patients with ADHD but also important organisational and conceptual obstacles to a more patient‐centred approach.…”

“…Commentaries in this Editorial will not focus only on the study results and the title: ‘Half of the children with overweight or obesity and attention deficit hyperactivity disorder reach normal weight with stimulants’ 2 . Keywords in this viewpoint are attrition, symptoms, co‐morbidities, efficacy, teamwork and ethics.…”

The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease

“…Based on their significance in univariate analysis, models were specified to control for race (White vs. other) and metformin use (yes/no). Patients taking a stimulant drug only ( n = 13) were not included in analyses examining a change in BMI over time given their association with weight loss (vs. weight gain) 19 . The significance level was set at 0.05 and SAS version 9.4 (SAS Institute Inc.) was used for analyses.…”

Issue highlights October 2021

“…After one year of treatment with stimulant drugs for ADHD, 43% of children who were overweight or obese had reached normal weight. The finding comes from a Swedish study carried out by Fast et al in Gothenburg 1 . Improved appetite regulation, increased behavioural control and decreased impulsivity are believed to have been some of the factors behind the weight loss.…”