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ADHD makes people fat? ADHD's Cameo in the Obesity Epidemic

Posted May 21 2013 1:38pm
Adult males diagnosed with attention-deficit/hyperactivity disorder (ADHD) in childhood face nearly twice the odds of becoming obese according to a new study published online at Pediatrics.  Witness the latest chapter of ADHD, the Diagnosis Eating Away at America
The prospective study included 207 white men diagnosed with ADHD at an average age of 8 and a comparison group of 178 men not diagnosed with childhood ADHD, who were matched for race, age, residence and social class. The average age at follow up was 41 years old. The study was designed to compare Body Mass Index (BMI) and obesity rates in grown men with and without childhood ADHD...Results showed that, on average, men with childhood ADHD had significantly higher BMI (30.1 vs. 27.6) and obesity rates (41.1 percent vs. 21.6 percent) than men without childhood ADHD. via Science Daily
Now this isn't the first study to link ADHD to obesity and it certainly won't be the last but it's an improvement as my friend Tara Haelle over at Scientific American almost single-handedly pointed out much to the delight of those of us who like our news sprinkled with context and nuance
The previous studies, however, were retrospective (relying on participants’ recall), did not focus exclusively on ADHD (included other conduct disorders) or compared only men suffering from adult ADHD with those having remitted childhood ADHD, rather than to controls without ADHD. This prospective study is the most long-term and the first to focus exclusively on adult obesity rates in men with childhood ADHD compared with those who did not have the condition as children. Its findings therefore contribute to the growing evidence base for an association between obesity and childhood ADHD. Childhood ADHD Linked to Adult Obesity, Scientific American 
Why might men with childhood ADHD be prone to obesity?

One theory favors ADHD culprits like poor impulse control and decision-making that have continued to dog these men into adulthood. Others speculate about a more physiological mechanism, maybe one related to, cue the anti-pharma camp, the use of ADHD meds in childhood that ironically are known to suppress appetite and might somehow mess up appetite control or satiety.

In any event, obesity should savor its fifteen minutes this week but it better be prepared to share the spotlight with the other ne'er do wells hanging with ADHD.  Drug and alcohol use, depression, anxiety, low career aspirations, lower income, criminal arrests, bad grades, bad marriages...It's only a matter of time before the increasingly popular disorder gets a larger role in the obesity literature earning mentions in the same breath as diabetes and heart disease. Oh my.

Thank goodness the researchers cared enough about the perilous health implications of childhood ADHD that they set out to uncover its vicious life-long carnage on America's waistlines. Not quite. Initially they weren't worried at all about expanding girths but potential brain anomalies associated with ADHD.  It was only after several study participants couldn't squeeze into the brain scanner that the obesity hypothesis popped to mind. Thanks to Time Healthland's Bonnie Rochman for breaking this curious detail.

All this talk of eating and squeezing not to mention MRIs calls to mind the decided lack of behavior in this study about a disorder involving a multitude of behavioral symptoms. Although the participants reported their own height and weight it's anyone's guess if or how men with childhood ADHD behaved in real life, that is, when they weren't being asked personal questions and subjected to claustrophobia-inducing spaces. Did they eat more? Eat more trans fats and high-fructose? Exercise less? And if they did, why? Who knows. It's ever so much fun and impressive to labor over high tech brain contraptions even if some underpaid research assistant has to rearrange a few pounds of flesh from time to time.

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