Obesity in Men With Childhood ADHD: A 33-Year Controlled, Prospective, Follow-up Study

Cortese, Samuele; Olazagasti, María A. Ramos; Klein, Rachel G.; Proal, Erika; Mannuzza, Salvatore

doi:10.1542/peds.2012-0540

Cited by 98 publications

(92 citation statements)

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“…The findings are consistent with and may partially explain observed associations of childhood ADHD with adult obesity. 2,8,9 The associations of stimulants with BMI growth trajectories were robust to the metric used, with evidence of dose-response relations for both age at first stimulant order and stimulant use duration, and after adjustment for many relevant , race/ethnicity (separate terms for black, Hispanic, and other), race/ethnicity*age, race/ethnicity*age 2 , medical assistance, medical assistance*age, medical assistance*age 2 , medical assistance*age 3 , and community type (borough, census tract). b Diag-NoMeds indicates children who only had encounters with ADHD diagnoses without a record of stimulants for treatment; Meds-NoDiag indicates children who only had orders for stimulants without a record of ADHD diagnosis; Diag +meds indicates children who had both encounters of diagnoses for ADHD as well as orders for stimulants.…”

Section: Discussionmentioning

confidence: 99%

“…1 As a likely consequence of this, stimulants, the most common therapy for ADHD, 2 are the second most commonly prescribed medications among children. 3 National data reveal that the prevalence of stimulant use has increased rapidly over the past 30 years.…”

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confidence: 99%

“…Cross-sectional studies in children have reported an association between ADHD and obesity, [5][6][7] and childhood ADHD may be a risk factor for adult obesity. 2,8,9 The risk of obesity associated with ADHD may be reduced or eliminated among children who have received stimulants as treatment for ADHD. 6,7,10 However, the independent contributions of ADHD and the medications used to treat it have not been fully elucidated.…”

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Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

2014

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Childhood attention-deficit/ hyperactivity disorder has been associated with both childhood and adult obesity, whereas treatment with stimulants has been associated with delayed child growth. No longitudinal studies with details about dates of diagnosis, treatment, and duration of stimulant use have been published. WHAT THIS STUDY ADDS:Using electronic health record data, this was the first study to evaluate the independent associations of attention-deficit/hyperactivity disorder diagnosis, stimulant treatment, age at first stimulant use, and duration of stimulant use on longitudinal BMI trajectories throughout childhood and adolescence.abstract BACKGROUND: Childhood attention-deficit/hyperactivity disorder (ADHD) has been associated with childhood and adult obesity, and stimulant use with delayed childhood growth, but the independent influences are unclear. No longitudinal studies have examined associations of ADHD diagnosis and stimulant use on BMI trajectories throughout childhood and adolescence. METHODS:We used longitudinal electronic health record data from the Geisinger Health System on 163 820 children ages 3 to 18 years in Pennsylvania. Random effects linear regression models were used to model BMI trajectories with increasing age in relation to ADHD diagnosis, age at first stimulant use, and stimulant use duration, while controlling for confounding variables.RESULTS: Mean (SD) age at first BMI was 8.9 (5.0) years, and children provided a mean (SD) of 3.2 (2.4) annual BMI measurements. On average, BMI trajectories showed a curvilinear relation with age. There were consistent associations of unmedicated ADHD with higher BMIs during childhood compared with those without ADHD or stimulants. Younger age at first stimulant use and longer duration of stimulant use were each associated with slower BMI growth earlier in childhood but a more rapid rebound to higher BMIs in late adolescence. CONCLUSIONS:The study provides the first longitudinal evidence that ADHD during childhood not treated with stimulants was associated with higher childhood BMIs. In contrast, ADHD treated with stimulants was associated with slower early BMI growth but a rebound later in adolescence to levels above children without a history of ADHD or stimulant use. The findings have important clinical and neurobiological implications. Pediatrics 2014;133:668-676

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Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

2014

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“…el 60% persiste con síntomas durante la edad adulta. 34 La primera asociación TDAH-obesidad se reportó en 2002 35 y un estudio en adultos con diagnóstico retrospectivo de TDAH en la infancia confirmó esta asociación.…”

Section: Trastorno Por Déficit De Atención E Hiperactividad (Tdah)unclassified

“…35 El vínculo TDAH-obesidad sugiere una regulación genética que está mediada por una asociación entre una mutación del gen que codifica la proteína MC4-R, presente en pacientes con TDAH y que se localiza en el exón único 18q del cromosoma 22, cuyo déficit se ha asociado también con las vías neuronales que regulan el hambre y la saciedad. [37][38][39] El mecanismo neurobiológico de esta asociación es la disfunción en el control inhibitorio, que altera el funciona-miento ejecutivo generando distraibilidad, desorganización e incumplimiento en hábitos de vida saludables.…”

Section: Trastorno Por Déficit De Atención E Hiperactividad (Tdah)unclassified

La salud mental en el paciente con obesidad en protocolo para cirugía bariátrica

Esquivias-Zavala

Reséndiz-Barragán

García³

et al. 2016

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BackgroundThe association between obesity and psychopathology is well known. However, the presence of psychopathology in patients with morbid obesity who attend bariatric surgery and its impact in weight loss has been less studied. ObjectiveTo perform a theme update about the general context of psychiatric disorders associated with morbid obesity, and to assess the impact of such disorders in patients undergoing bariatric surgery. Method EBSCO ResearchDatabase and PubMed databases were consulted. Articles published between 2011 and today were selected. Key words related to the topic of study were used. ResultsThe studies reviewed showed five psychopathological clinical entities with high prevalence in patients who attend bariatric surgery: Depression and anxiety, attention deficit hyperactivity disorder, disorders of eating behavior, substance abuse, and some dimensions of personality. The presence of these disorders was associated to a poor post-surgical weight loss. Discussion and conclusionBinge eating disorder and substance abuse impact on weight loss after bariatric surgery is controversial. The evaluation of obese patients who attend bariatric surgery must emphasize, according with reported disorders prevalence, the identification of depression, anxiety and attention deficit hyperactivity disorder.Key words: Mental health, morbid obesity, bariatric surgery, weight loss, psychopathology, depressive disorder. RESUMEN AntecedentesLa asociación entre obesidad y psicopatología es bien conocida; sin embargo, la presencia de esta última en los pacientes con obesidad mórbida sometidos a cirugía bariátrica y su impacto en la pérdida de peso ha sido menos estudiado. ObjetivoRealizar una actualización sobre el panorama general de los trastornos psiquiátricos asociados con la obesidad mórbida, y el impacto de éstos sobre la pérdida de peso en pacientes bariátricos. MétodoSe consultaron las bases de datos EBSCO Research Database y PubMed. Se seleccionaron los artículos publicados de 2011 a la fecha. Fueron utilizadas palabras clave relacionadas con el tema de estudio. ResultadosLos estudios revisados mostraron cinco entidades clínicas psicopatológicas con alta prevalencia en pacientes que se encuentran en protocolo de cirugía bariátrica: Depresión y ansiedad, trastorno por déficit de atención e hiperactividad, trastornos de la conducta alimentaria, abuso de sustancias y algunas dimensiones de la personalidad. La presencia de estas condiciones se asoció a una menor pérdida de peso posterior al procedimiento quirúrgico. Discusión y conclusiónEl impacto del trastorno por atracón y por abuso de sustancias en la pérdida de peso, posterior a la cirugía bariátrica, es controversial. La evaluación del paciente con obesidad candidato a cirugía bariá-trica debe enfatizar, de acuerdo con la prevalencia de los trastornos reportados, la identificación de trastornos depresivos-ansiosos y del trastorno por déficit de atención e hiperactividad.Palabras clave: Salud mental, obesidad mórbida, cirugía bariátri-ca, pérdida de pes...

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A multisite view of psychosocial risks in patients presenting for bariatric surgery

Rofey

Zeller

Brode

et al. 2015

Obesity

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, and the TeenView Writing Group in cooperation with the Teen-LABS ConsortiumObjective: The psychosocial health of adolescents with severe obesity (BMI 120% for age and gender) has only recently been the focus of empirical work. Methods: This multisite study-an ancillary to a prospective longitudinal observational study documenting health in adolescents having weight loss surgery (WLS)-presents preoperative/baseline data from 141 WLS adolescents and 83 nonsurgical comparisons (NSComps). Self-report data from adolescent and caregiver dyads characterize adolescent psychopathology and potential correlates. Results: One in three adolescents reported internalizing symptoms, and one in five endorsed externalizing symptoms in the clinical range. Generalized linear model analysis demonstrated that increased risk of psychopathology for adolescents with severe obesity was associated with family dysfunction, eating pathology, family composition, and seeking behavioral intervention (versus WLS), whereas better quality of life (QOL) was associated with lower psychopathology. Conclusions: While psychopathology rates are comparable to national samples, there is a subgroup of youth who present for behavioral weight loss services and are at greater risk for psychopathology relative to national adolescent base rates. Adolescents who achieve candidacy for WLS may be a highly selective population of youth with severe obesity and may have lower base rates of psychopathology compared to NSComps.

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Obesity in Men With Childhood ADHD: A 33-Year Controlled, Prospective, Follow-up Study

Cited by 98 publications

References 38 publications

Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

La salud mental en el paciente con obesidad en protocolo para cirugía bariátrica

A multisite view of psychosocial risks in patients presenting for bariatric surgery

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