An obese boy aged 11 years with attention-deficit hyperactivity disorder (ADHD) eats constantly. He is in psychotherapy, and his mother has asked about putting him on an ADHD medication that will also suppress his appetite. Does such a therapy exist? — FRANCINE SMITH, PHD, APRN, BC, Worcester, Mass.

Children with ADHD may experience low self-esteem, significant problems in school, and problems with interpersonal relationships among friends and family. Proper treatment can help facilitate the psychosocial and educational development in most children with ADHD. One part of the treatment plan is the use of stimulant medications, which have the side effect of loss of appetite.

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These drugs are recommended as part of a multimodal treatment plan that also includes educational and behavior interventions along with parental involvement (J Am Acad Child Adolesc Psychiatry. 2007;46:894-921, accessed March 15, 2011). There are no recommendations to use this class of drugs for the primary purpose of suppressing appetite. Rather, addressing the root cause, which can be biological or psychological, for this patient’s excessive eating needs to be further explored and managed.

Childhood obesity has risen significantly over recent decades and poses a serious health threat. Fast-food establishments offer tasty and relatively inexpensive food that is lacking in nutrients. Processed foods not only contribute to excessive calorie intake but can also leave one feeling less full. Diet composition may have an effect on one’s satiety. “Close to nature” foods tend to have more fiber and water content and provide properties that can leave one feeling satiated with fewer calories (Katz DL. Nutrition in Clinical Practice, 2nd ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:377-390).

Helping our patients to establish healthy lifestyles, including regular activity and a healthy diet, can help prevent the multitude of problems associated with obesity. — Eileen F. Campbell, MSN, CRNP, associate program director, family health nurse practitioner program, University of Pennsylvania School of Nursing, Philadelphia (150-2)