Boyhood ADHD tied to adult obesity

Boyhood ADHD tied to adult obesity
Boyhood ADHD tied to adult obesity

HealthDay News -- Men who had attention-deficit/hyperactivity disorder (ADHD) during childhood are at increased risk for obesity as adults, study results indicate.

Compared with those without the disorder, men with ADHD in childhood had a significantly higher BMI (20.1 vs. 27.6; P=0.001) and rates of obesity (41.4% vs. 21.6%; P=0.001) at age 41 years, Samuele Cortese, MD, PhD, of NYU Langone Medical Center in New York City and colleagues reported in Pediatrics.

The associations persisted after the researchers adjusted for socioeconomic status and lifetime mental disorders.

"The long-term risk for obesity should be considered when man-aging children with ADHD," the researchers wrote.

Cortese and colleagues assessed data from men with childhood ADHD who were participating in a long-term cohort. They  examined BMI and obesity in adult men with and without ADHD, as well as those with persistent and with remitted ADHD, those with remitted or persistent ADHD and those without ADHD, among 111 white men who had childhood ADHD and 111 age-, gender-, social class- and geographic residence-matched controls who did not have ADHD.

Participants with ADHD were enrolled based on school referral for behavioral problems and were aged 6 to 12 years (mean age 8.3 years). Follow-up was conducted at mean ages 18.4 years, 25 years and 41.2 years.

At final follow up, the researchers collected data on ADHD status, substance and mental disorders, BMI from self-reported height and weight, parental socioeconomic status and participants' socioeconomic status in adulthood. DSM-4 symptom criteria were used to define participants with ongoing ADHD.

Participants without childhood ADHD had higher parental and current socioeconomic status (P=0.03 and P<0.001, respectively), and lower rates of non-alcohol substance use disorders and nicotine dependence (P=0.02 and P<0.001, respectively). Lifetime mood and anxiety disorders were similar in booth groups.

The researchers found that men with childhood ADHD had significantly higher BMI (30.1 vs. 27.6 kg/m²) and obesity rates (41.4% versus 21.6%) than men without childhood ADHD. Even after adjusting for socioeconomic status and lifetime mental disorders, group differences remained significant.

BMI and obesity rates did not differ significantly in men with persistent (24 men) or remitted (87 men) ADHD. Men with remitted, but not persistent ADHD had significantly higher BMI and obesity rates (P<0.001 for both) than those without childhood ADHD, after adjusting for other factors.

The researchers proposed two hypotheses for explaining the higher risk for obesity with ADHD. The first, includes "deficient inhibitory control and delay aversion," and "expressions of the impulsivity intrinsic to ADHD," which could lead to "poor planning and difficulty in monitoring eating behaviors."

In the second hypothesis, they suggested "inattention and deficits in executive functions" could make it difficult to adhere to regular eating patterns and behaviors.

Study limitations included missing weight and height for some of the cohort, as well as missing evaluation of participants' physical activity, sedentary time, and sleep problems. There was also a limited number of participants with persistent ADHD, the researchers noted. 

References

  1. Cortese S et al. Pediatrics. 2013; 131(6): e1731-e1738; doi: 10.1542/peds.2012-0540.
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