One of the most common pediatric psychiatric disorders is attention-deficit/hyperactivity disorder (ADHD), and the most common therapy for ADHD is stimulant medication. In the past few decades, concerns have been raised about a possible link between ADHD and the rapid increase in obesity rates among children.
In the April 2014 Pediatrics study, “Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory,” (published online March 17), researchers studied electronic health record data from the Geisinger Health System on 163,820 children aged 3 to 18 years of age in Pennsylvania.
Models were used to determine BMI trajectories in relation to ADHD diagnosis, age when first using stimulants, and duration of stimulant use. Researchers found that children with untreated ADHD or ADHD treated without stimulants had faster BMI growth than those without ADHD. Conversely, children who had ADHD treated with stimulants demonstrated slower BMI growth early in childhood, but they rebounded later in adolescence to higher BMIs -- higher than children without a history of ADHD or stimulant use. The earlier stimulants were started and the longer they were used, the stronger were these effects.
Study authors concluded their findings support the idea that children with ADHD are at an increased risk for obesity. However, they concluded that stimulant use and the impressive rebound in BMI growth later in childhood and adolescence -- rather than ADHD itself -- was most responsible for these observations. Clinicians should be aware of the obesity risk of ADHD and particularly stimulant use. Further research is needed to develop appropriate obesity prevention interventions for children with ADHD.
Editor’s Note: A related study, “Attention-Deficit/Hyperactivity Disorder in Young Children: Predictors of Diagnostic Stability,” will also be published online on March 17 in Pediatrics.