An increasing body of research, starting with a study by Oregon psychiatrist Jules R. Altfas reported in 2002, indicates a link between attention deficit/hyperactivity disorder and obesity in both adults and children. Fortunately, treatment for ADHD helps some individuals decrease their weight. Research continues into the ADHD-obesity link and its possible causes.
Adults
Oregon psychiatrist Jules Altfas was directing a weight-loss clinic when he noticed some obese patients trying yet failing to lose weight. He evaluated these 215 patients and diagnosed 27.4 percent of them with ADHD---a much higher rate than the estimated 4.4 percent rate for ADHD in adults reported by the National Institute for Mental Health. In 2009, behavioral medicine professor Sherry L. Pagoto at the University of Massachusetts Medical School and colleagues reported on their study of the prevalence of obesity among individuals with and without ADHD. In the study, which involved nearly 7,000 subjects, they found that 29.4 percent of those with ADHD were obese, compared with 21.6 percent of those without ADHD.
Children
At roughly the same time researchers began to realize obese adults could have ADHD, pediatric researchers found that obese children could have ADHD. German psychiatrists K. Holtkamp and colleagues studied 97 male patients with ADHD, ages 8-14, and reported in 2005 that about 7 percent were obese and 20 percent were overweight. As a result, parents and professionals disregarding the possibility of ADHD in obese children began to rethink their premises.
Speculation
French physician Samuele Cortese and colleagues analyzed studies of subjects with both ADHD and obesity and speculated that obese individuals with ADHD may eat more impulsively than those without ADHD. In addition, overeating may be a way to relieve frustration for the untreated person with ADHD, who is struggling and failing to meet societal expectations. Dr. Pagoto at the University of Massachusetts Medical School explains how ADHD may cause obesity: "ADHD has been characterized as a problem of behavioral disinhibition affecting memory, motivation, and self-regulation of affect. As a result, an individual with ADHD might fail to plan meals ahead of time, frequently skip meals due to distractions, and/or lose sight of intentions to moderate food intake."
Role of Stigma
Obese individuals with ADHD may face social stigma related to both conditions. A study by Rebecca M. Puhl and Chelsea A. Heuer of the Rudd Center for Food Policy and Obesity at Yale University reported in 2009 that more than half of physicians surveyed said obese patients were awkward and ugly. A third said obese patients were sloppy, weak and lazy. Obese people with untreated ADHD must deal with negative views toward obese people in general as well as unfavorable reactions of others to their own ADHD behaviors---such as losing items, forgetting appointments and blurting out unwelcome comments.
Treatment
ADHD is treated with stimulants or with atomoxetine, a nonstimulant medication. Research is ongoing, but some studies indicate that treatment for ADHD symptoms helps some obese individuals lose weight. For example, Canadian physicians L.D. Levy and colleagues at the National Disorders Clinic reported in 2009 that adults treated for their ADHD were less prone to use food to resolve boredom and also controlled their food portions better. Further research should pave their way to helping obese children and adults with ADHD resolve these problems.
References
- "BMC Psychiatry"; "Prevalence of Attention Deficit/Hyperactivity Disorder Among Adults in Obesity Treatment"; Jules R. Altfas, 2002
- "International Journal of Obesity"; "Overweight and Obesity in Children with Attention-Deficit/Hyperactivity Disorder"; K. Holtkamp, et al.; 2004
- "Critical Reviews in Food Science and Nutrition"; "Attention Deficit/Hyperactivity Disorder (ADHD) and Obesity: A Systematic Review of the Literature"; Samuele Cortese, et al.; 2008
