Skip to main content

Advertisement

SpringerLink
Log in

The Co-occurrence of Pediatric Obesity and ADHD: an Understanding of Shared Pathophysiology and Implications for Collaborative Management

  • Childhood Obesity (A Kelly and C Fox, Section Editor)
  • Published:
Current Obesity Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To describe what is known about the association between obesity and attention-deficit hyperactivity disorder (ADHD) in children along with the co-occurring conditions of sleep dysfunction, loss of control/binge eating disorder (LOC-ED/BED), and anxiety.

Recent Findings

Obesity and ADHD share common brain pathways (hypothalamic, executive, and reward centers) with pathophysiology in these areas manifesting in partial or complete expression of these diseases. Sleep dysfunction, LOC-ED/BED, and anxiety share similar pathways and are associated with this disease dyad.

Summary

The association of obesity and ADHD with sleep dysfunction, LOC-ED/BED, and anxiety is discussed. An algorithm outlining decision pathways for patients with obesity and with and without ADHD is presented. Future research exploring the complex pathophysiology of both obesity and ADHD as well as co-occurring conditions is needed to develop clinical guidelines and ultimately assist in providing the best evidence-based care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Sayal K, Prasad V, Daley D, Ford T, Coghill D. ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. 2018;5:175–86. https://doi.org/10.1016/S2215-0366(17)30167-0.

    Article  PubMed  Google Scholar 

  2. Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 2016;22(7 Suppl):s176–85.

    PubMed  Google Scholar 

  3. Kim J, Lee GH, Sung SM, Jung DS, Pak K. Prevalence of attention deficit hyperactivity disorder symptoms in narcolepsy: a systematic review. Sleep Med. 2020;65:84–8. https://doi.org/10.1016/j.sleep.2019.07.022.

    Article  PubMed  Google Scholar 

  4. Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92(2):251–65. https://doi.org/10.1016/j.mayocp.2016.09.017.

    Article  PubMed  Google Scholar 

  5. Ranum BM, Wichstrøm L, Pallesen S, Falch-Madsen J, Halse M, Steinsbekk S. Association between objectively measured sleep duration and symptoms of psychiatric disorders in middle childhood. JAMA Netw Open. 2019;2(12):e1918281. Published 2019 Dec 2. https://doi.org/10.1001/jamanetworkopen.2019.18281.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sciberras E, Efron D, Patel P, Mulraney M, Lee KJ, Mihalopoulos C, et al. Does the treatment of anxiety in children with attention-deficit/hyperactivity disorder (ADHD) using cognitive behavioral therapy improve child and family outcomes? Protocol for a randomized controlled trial. BMC Psychiatry. 2019;19(1):359. https://doi.org/10.1186/s12888-019-2276-3.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sharma V, Coleman S, Nixon J, Sharples L, Hamilton-Shield J, Rutter H, et al. A systematic review and meta-analysis estimating the population prevalence of comorbidities in children and adolescents aged 5 to 18 years. Obes Rev. 2019;20(10):1341–9. https://doi.org/10.1111/obr.12904.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Obesity. World Health Organization. https://www.who.int/health-topics/obesity#tab=tab_1 Updated 2020. Accessed Jun 30, 2020.

  9. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al. CDC growth charts: United States. Adv Data. 2000;314:1–27.

    Google Scholar 

  10. Gulati AK, Kaplan DW, Daniels SR. Clinical tracking of severely obese children: a new growth chart. Pediatrics. 2012;130(6):1136–40.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kelly AS, Barlow SE, Rao G, Inge TH, Hayman LL, Steinberger J, et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation. 2013;128(15):1689–712. https://doi.org/10.1161/CIR.0b013e3182a5cfb3.

    Article  PubMed  Google Scholar 

  12. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: Author.

  13. Visser SN, Zablotsky B, Holbrook JR, Danielson ML, Bitsko RH. Diagnostic experiences of children with attention-deficit/hyperactivity disorder. Natl Health Stat Rep. 2015;81:1–7.

    Google Scholar 

  14. Molina BSG, Hinshaw SP, Swanson JM, Arnold LE, Vitiello B, Jensen PS, et al. The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry. 2009;48(5):484–500. https://doi.org/10.1097/CHI.0b013e31819c23d0.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65. https://doi.org/10.1111/jcpp.12381.

    Article  PubMed  Google Scholar 

  16. Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 2015;135(4):e994–1001. https://doi.org/10.1542/peds.2014-3482.

    Article  PubMed  Google Scholar 

  17. Wolraich ML, McKeown RE, Visser SN, Bard D, Cuffe S, Neas B, et al. The prevalence of ADHD: its diagnosis and treatment in four school districts across two states. J Atten Disord. 2014;18(7):563–75. https://doi.org/10.1177/1087054712453169.

    Article  PubMed  Google Scholar 

  18. Rowland AS, Skipper BJ, Umbach DM, Rabiner DL, Campbell RA, Naftel AJ, et al. The prevalence of ADHD in a population-based sample. J Atten Disord. 2015;19(9):741–54. https://doi.org/10.1177/1087054713513799.

    Article  PubMed  Google Scholar 

  19. •• Cortese S. The association between ADHD and obesity: intriguing, progressively more investigated, but still puzzling. Brain Sci. 2019;9(10):256. https://doi.org/10.3390/brainsci9100256Most recent review of literature describing the association between obesity and ADHD.

    Article  PubMed Central  Google Scholar 

  20. Cortese S, Moreira-Maia CR, St Fleur D, Morcillo-Peñalver C, Rohde LA, Faraone SV. Association between ADHD and obesity: a systematic review and meta-analysis. Am J Psychiatry. 2016;173(1):34–43. https://doi.org/10.1176/appi.ajp.2015.15020266.

    Article  PubMed  Google Scholar 

  21. Nigg JT, Johnstone JM, Musser ED, Long HG, Willoughby MT, Shannon J. Attention-deficit/hyperactivity disorder (ADHD) and being overweight/obesity: New data and meta-analysis. Clin Psychol Rev. 2016;43:67–79. https://doi.org/10.1016/j.cpr.2015.11.005.

    Article  PubMed  Google Scholar 

  22. Khalife N, Kantomaa M, Glover V, Tammelin T, Laitinen J, Ebeling H, et al. Childhood attention-deficit/hyperactivity disorder symptoms are risk factors for obesity and physical inactivity in adolescence. J Am Acad Child Adolesc Psychiatry. 2014;53(4):425–36. https://doi.org/10.1016/j.jaac.2014.01.009.

    Article  PubMed  Google Scholar 

  23. Aguirre Castaneda RL, Kumar S, Voigt RG, Leibson CL, Barbaresi WJ, Weaver AL, et al. Childhood attention-deficit/hyperactivity disorder, sex, and obesity: a longitudinal population-based study. Mayo Clin Proc. 2016;3:61. https://doi.org/10.1016/j.mayocp.2015.09.017.

    Article  Google Scholar 

  24. Bowling AB, Tiemeier HW, Jaddoe VWV, Barker ED, Jansen PW. ADHD symptoms and body composition changes in childhood: a longitudinal study evaluating directionality of associations. Pediatr Obes. 2018:567–75. https://doi.org/10.1111/ijpo.12288.

  25. Seymour KE, Reinblatt SP, Benson L, Carnell S. Overlapping neurobehavioral circuits in ADHD, obesity, and binge eating: evidence from neuroimaging research. CNS Spectr. 2015;20(4):401–11. https://doi.org/10.1017/S1092852915000383.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Martins-Silva T, Vaz JDS, Hutz MH, Salatino-Oliveira A, Genro JP, Hartwig FP, et al. Assessing causality in the association between attention-deficit/hyperactivity disorder and obesity: a Mendelian randomization study. Int J Obes. 2019;43(12):2500–8. https://doi.org/10.1038/s41366-019-0346-8.

    Article  Google Scholar 

  27. Cortese S, Angriman M, Comencini E, Vincenzi B, Maffeis C. Association between inflammatory cytokines and ADHD symptoms in children and adolescents with obesity: a pilot study. Psychiatry Res. 2019;278:7–11. https://doi.org/10.1016/j.psychres.2019.05.030.

    Article  CAS  PubMed  Google Scholar 

  28. Nousen EK, Franco JG, Sullivan EL. Unraveling the mechanisms responsible for the comorbidity between metabolic syndrome and mental health disorders. Neuroendocrinology. 2013;98(4):254–66. https://doi.org/10.1159/000355632.

    Article  CAS  PubMed  Google Scholar 

  29. •• Berthoud HR, Münzberg H, Morrison CD. Blaming the brain for obesity: integration of hedonic and homeostatic mechanisms. Gastroenterology. 2017;152(7):1728–38. https://doi.org/10.1053/j.gastro.2016.12.050New conceptual framework of human energy regulation addressing how hedonic controls interact with homeostatic controls to regulate body weight in a flexible and adaptive manner that takes environmental conditions into account.

    Article  PubMed  Google Scholar 

  30. Schwartz MW, Seeley RJ, Zeltser LM, Drewnowski A, Ravussin E, Redman LM, et al. Obesity pathogenesis: an endocrine society scientific statement. Endocr Rev. 2017;4:267–96. https://doi.org/10.1210/er.2017-00111.

    Article  Google Scholar 

  31. Roh E, Kim MS. Brain regulation of energy metabolism. Endocrinol Metab (Seoul). 2016;31(4):519–24. https://doi.org/10.3803/EnM.2016.31.4.519.

    Article  CAS  Google Scholar 

  32. Verbeken S, Braet C, Goossens L, van der Oord S. Executive function training with game elements for obese children: a novel treatment to enhance self-regulatory abilities for weight-control. Behav Res Ther. 2013;51(6):290–9. https://doi.org/10.1016/j.brat.2013.02.006.

    Article  PubMed  Google Scholar 

  33. Davis C, Levitan RD, Muglia P, Bewell C, Kennedy JL. Decision-making deficits and overeating: a risk model for obesity. Obes Res. 2004;12(6):929–35. https://doi.org/10.1038/oby.2004.113.

    Article  PubMed  Google Scholar 

  34. Yang Y, Shields GS, Guo C, Liu Y. Executive function performance in obesity and overweight individuals: a meta-analysis and review. Neurosci Biobehav Rev. 2018;84:225–44. https://doi.org/10.1016/j.neubiorev.2017.11.020.

    Article  PubMed  Google Scholar 

  35. Laurent JS, Watts R, Adise S, Allgaier N, Chaarani B, Garavan H, et al. Associations among body mass index, cortical thickness, and executive function in children. JAMA Pediatr. 2019;174(2):170–7. https://doi.org/10.1001/jamapediatrics.2019.4708.

    Article  PubMed Central  Google Scholar 

  36. Heinitz S, Reinhardt M, Piaggi P, Weise CM, Diaz E, Stinson EJ, et al. Neuromodulation directed at the prefrontal cortex of subjects with obesity reduces snack food intake and hunger in a randomized trial. Am J Clin Nutr. 2017;106(6):1347–57. https://doi.org/10.3945/ajcn.117.158089.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Münzberg H, Qualls-Creekmore E, Yu S, Morrison CD, Berthoud HR. Hedonics act in unison with the homeostatic system to unconsciously control body weight. Front Nutr. 2016;3:6. https://doi.org/10.3389/fnut.2016.00006.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Brooks SJ, Cedernaes J, Schiöth HB. Increased prefrontal and parahippocampal activation with reduced dorsolateral prefrontal and insular cortex activation to food images in obesity: a meta-analysis of fMRI studies. PLoS One. 2013;8(4):e60393. https://doi.org/10.1371/journal.pone.0060393.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Bruce AS, Holsen LM, Chambers RJ, Martin LE, Brooks WM, Zarcone JR, et al. Obese children show hyperactivation to food pictures in brain networks linked to motivation, reward and cognitive control. Int J Obes. 2010;34(10):1494–500. https://doi.org/10.1038/ijo.2010.84.

    Article  CAS  Google Scholar 

  40. Stice E, Figlewicz DP, Gosnell BA, Levine AS, Pratt WE. The contribution of brain reward circuits to the obesity epidemic. Neurosci Biobehav Rev. 2013;37(9 Pt A):2047–58. https://doi.org/10.1016/j.neubiorev.2012.12.001.

    Article  PubMed  Google Scholar 

  41. Blum K, Thanos PK, Gold MS. Dopamine and glucose, obesity, and reward deficiency syndrome. Front Psychol. 2014;5:919. Published 2014 Sep 17. https://doi.org/10.3389/fpsyg.2014.00919.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Zhang Y, Liu J, Yao J, Ji G, Qian L, Wang J, et al. Obesity: pathophysiology and intervention. Nutrients. 2014;6(11):5153–83. https://doi.org/10.3390/nu6115153.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Timper K, Brüning JC. Hypothalamic circuits regulating appetite and energy homeostasis: pathways to obesity. Dis Model Mech. 2017;10(6):679–89. https://doi.org/10.1242/dmm.026609.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Cortese S. The neurobiology and genetics of attention-deficit/hyperactivity disorder (ADHD): what every clinician should know. Eur J Paediatr Neurol. 2012;16(5):422–33. https://doi.org/10.1016/j.ejpn.2012.01.009.

    Article  PubMed  Google Scholar 

  45. •• Koss KJ, Gunnar MR. Annual research review: early adversity, the hypothalamic-pituitary-adrenocortical axis, and child psychopathology. J Child Psychol Psychiatry. 2018;59(4):327–46. https://doi.org/10.1111/jcpp.12784Review of neurobiology of hypothalamic-pituitary-adrenocortical (HPA) axis and relationship between early adversity-HPA axis activity and HPA axis activity-psychopathology. Also, discusses the role of regulatory mechanisms and sensitive periods in development.

    Article  PubMed  Google Scholar 

  46. Koss KJ, Mliner SB, Donzella B, Gunnar MR. Early adversity, hypocortisolism, and behavior problems at school entry: a study of internationally adopted children. Psychoneuroendocrinology. 2016;66:31–8. https://doi.org/10.1016/j.psyneuen.2015.12.018.

    Article  PubMed  Google Scholar 

  47. Cherkasova MV, Hechtman L. Neuroimaging in attention-deficit hyperactivity disorder: beyond the frontostriatal circuitry. Can J Psychiatr. 2009;54(10):651–64. https://doi.org/10.1177/070674370905401002.

    Article  Google Scholar 

  48. Giedd JN, Rapoport JL. Structural MRI of pediatric brain development: what have we learned and where are we going? Neuron. 2010;67(5):728–34. https://doi.org/10.1016/j.neuron.2010.08.040.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Shaw P, Lerch J, Greenstein D, Sharp W, Clasen L, Evans A, et al. Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2006;63(5):540–9. https://doi.org/10.1001/archpsyc.63.5.540.

    Article  PubMed  Google Scholar 

  50. Sowell ER, Thompson PM, Welcome SE, Henkenius AL, Toga AW, Peterson BS. Cortical abnormalities in children and adolescents with attention-deficit hyperactivity disorder. Lancet. 2003;362(9397):1699–707. https://doi.org/10.1016/S0140-6736(03)14842-8.

    Article  PubMed  Google Scholar 

  51. Shaw P, Gilliam M, Liverpool M, Weddle C, Malek M, Sharp W, et al. Cortical development in typically developing children with symptoms of hyperactivity and impulsivity: support for a dimensional view of attention deficit hyperactivity disorder. Am J Psychiatry. 2011;168(2):143–51. https://doi.org/10.1176/appi.ajp.2010.10030385.

    Article  PubMed  Google Scholar 

  52. Plessen KJ, Bansal R, Zhu H, Whiteman R, Amat J, Quackenbush GA, et al. Hippocampus and amygdala morphology in attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2006;63(7):795–807. https://doi.org/10.1001/archpsyc.63.7.795.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Ivanov I, Bansal R, Hao X, Zhu H, Kellendonk C, Miller L, et al. Morphological abnormalities of the thalamus in youths with attention deficit hyperactivity disorder. Am J Psychiatry. 2010;167(4):397–408. https://doi.org/10.1176/appi.ajp.2009.09030398.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Dickstein SG, Bannon K, Castellanos FX, Milham MP. The neural correlates of attention deficit hyperactivity disorder: an ALE meta-analysis. J Child Psychol Psychiatry. 2006;47(10):1051–62. https://doi.org/10.1111/j.1469-7610.2006.01671.x.

    Article  PubMed  Google Scholar 

  55. Shaw P, Eckstrand K, Sharp W, Blumenthal J, Lerch JP, Greenstein D, et al. Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proc Natl Acad Sci U S A. 2007;104(49):19649–54. https://doi.org/10.1073/pnas.0707741104.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Mackie S, Shaw P, Lenroot R, Pierson R, Greenstein DK, Nugent TF 3rd, et al. Cerebellar development and clinical outcome in attention deficit hyperactivity disorder. Am J Psychiatry. 2007;164(4):647–55. https://doi.org/10.1176/ajp.2007.164.4.647.

    Article  PubMed  Google Scholar 

  57. Clerkin SM, Schulz KP, Berwid OG, Fan J, Newcorn JH, Tang CY, et al. Thalamo-cortical activation and connectivity during response preparation in adults with persistent and remitted ADHD. Am J Psychiatry. 2013;170(9):1011–9. https://doi.org/10.1176/appi.ajp.2013.12070880.

    Article  PubMed  Google Scholar 

  58. Shaw P, Malek M, Watson B, Greenstein D, de Rossi P, Sharp W. Trajectories of cerebral cortical development in childhood and adolescence and adult attention-deficit/hyperactivity disorder. Biol Psychiatry. 2013;74(8):599–606. https://doi.org/10.1016/j.biopsych.2013.04.007.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Francx W, Oldehinkel M, Oosterlaan J, Heslenfeld D, Hartman CA, Hoekstra PJ, et al. The executive control network and symptomatic improvement in attention-deficit/hyperactivity disorder. Cortex. 2015;73:62–72. https://doi.org/10.1016/j.cortex.2015.08.012.

    Article  PubMed  Google Scholar 

  60. Halperin JM, Trampush JW, Miller CJ, Marks DJ, Newcorn JH. Neuropsychological outcome in adolescents/young adults with childhood ADHD: profiles of persisters, remitters and controls. J Child Psychol Psychiatry. 2008;49(9):958–66. https://doi.org/10.1111/j.1469-7610.2008.01926.x.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Rajendran K, Rindskopf D, O'Neill S, Marks DJ, Nomura Y, Halperin JM. Neuropsychological functioning and severity of ADHD in early childhood: a four-year cross-lagged study. J Abnorm Psychol. 2013;122(4):1179–88. https://doi.org/10.1037/a0034237.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Del Campo N, Chamberlain SR, Sahakian BJ, Robbins TW. The roles of dopamine and noradrenaline in the pathophysiology and treatment of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2011;69(12):e145–57. https://doi.org/10.1016/j.biopsych.2011.02.036.

    Article  CAS  PubMed  Google Scholar 

  63. Prince J. Catecholamine dysfunction in attention-deficit/hyperactivity disorder: an update. J Clin Psychopharmacol. 2008;28(3 Suppl 2):S39–45. https://doi.org/10.1097/JCP.0b013e318174f92a.

    Article  CAS  PubMed  Google Scholar 

  64. Patte KA, Davis CA, Levitan RD, Kaplan AS, Carter-Major J, Kennedy JL. A behavioral genetic model of the mechanisms underlying the link between obesity and symptoms of ADHD. J Atten Disord. 2016;1087054715618793:1425–36. https://doi.org/10.1177/1087054715618793.

    Article  Google Scholar 

  65. Lundahl A, Nelson TD. Attention deficit hyperactivity disorder symptomatology and pediatric obesity: psychopathology or sleep deprivation? J Health Psychol. 2016 Jun;21(6):1055–65. https://doi.org/10.1177/1359105314544991.

    Article  PubMed  Google Scholar 

  66. Hakim F, Kheirandish-Gozal L, Gozal D. Obesity and altered sleep: a pathway to metabolic derangements in children? Semin Pediatr Neurol. 2015;22(2):77–85. https://doi.org/10.1016/j.spen.2015.04.006.

    Article  PubMed  PubMed Central  Google Scholar 

  67. • Fang CT, Chen VC, Ma HT, Chao HH, Ho MC, Gossop M. Attentional bias, "cool" and "hot" executive functions in obese patients: roles of body mass index, binge eating, and eating style. J Clin Psychopharmacol. 2019;39(2):145–52. https://doi.org/10.1097/JCP.0000000000001016Study examined "cool" (inhibitory control and mental flexibility) and "hot" (affective decision making) executive functions (EFs) in relation to body mass index, binge-eating tendency, and eating styles.

    Article  PubMed  Google Scholar 

  68. Lindberg L, Hagman E, Danielsson P, Marcus C, Persson M. Anxiety and depression in children and adolescents with obesity: a nationwide study in Sweden. BMC Med. 2020;18(1):30. https://doi.org/10.1186/s12916-020-1498-z.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Chihara Y, Akamizu T, Azuma M, Murase K, Harada Y, Tanizawa K, et al. Among metabolic factors, significance of fasting and postprandial increases in acyl and desacyl ghrelin and the acyl/desacyl ratio in obstructive sleep apnea before and after treatment. J Clin Sleep Med. 2015;11(8):895–905. https://doi.org/10.5664/jcsm.4942.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Gileles-Hillel A, Kheirandish-Gozal L, Gozal D. Biological plausibility linking sleep apnoea and metabolic dysfunction. Nat Rev Endocrinol. 2016;12(5):290–8. https://doi.org/10.1038/nrendo.2016.22.

    Article  CAS  PubMed  Google Scholar 

  71. Tankersley CG, O'Donnell C, Daood MJ, Watchko JF, Mitzner W, Schwartz A, et al. Leptin attenuates respiratory complications associated with the obese phenotype. J Appl Physiol (1985). 1998;85(6):2261–9. https://doi.org/10.1152/jappl.1998.85.6.2261.

    Article  CAS  Google Scholar 

  72. Aygun AD, Gungor S, Ustundag B, Gurgoze MK, Sen Y. Proinflammatory cytokines and leptin are increased in serum of prepubertal obese children. Mediat Inflamm. 2005;2005(3):180–3. https://doi.org/10.1155/MI.2005.180.

    Article  CAS  Google Scholar 

  73. Halbower AC, Mahone EM. Neuropsychological morbidity linked to childhood sleep-disordered breathing. Sleep Med Rev. 2006;10(2):97–107. https://doi.org/10.1016/j.smrv.2005.10.002.

    Article  PubMed  Google Scholar 

  74. Vgontzas AN, Bixler EO, Chrousos GP. Obesity-related sleepiness and fatigue: the role of the stress system and cytokines. Ann N Y Acad Sci. 2006;1083:329–44.

    Article  CAS  PubMed  Google Scholar 

  75. Turkoglu S, Cetin FH. The relationship between chronotype and obesity in children and adolescent with attention deficit hyperactivity disorder. Chronobiol Int. 2019;36:1138–47.

    Article  PubMed  Google Scholar 

  76. Matherne CE, Tanofsky-Kraff M, Altschul AM, Shank LM, Schvey NA, Brady SM, et al. A preliminary examination of loss of control eating disorder (LOC-ED) in middle childhood. Eat Behav. 2015;18:57–61. https://doi.org/10.1016/j.eatbeh.2015.04.001.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Kalarchian MA, Marcus MD. Psychiatric comorbidity of childhood obesity. Int Rev Psychiatry. 2012;24(3):241–6. https://doi.org/10.3109/09540261.2012.678818.

    Article  PubMed  Google Scholar 

  78. Furlong TM, Jayaweera HK, Balleine BW, Corbit LH. Binge-like consumption of a palatable food accelerates habitual control of behavior and is dependent on activation of the dorsolateral striatum. J Neurosci. 2014;14:5012–22. https://doi.org/10.1523/JNEUROSCI.3707-13.2014.

    Article  CAS  Google Scholar 

  79. • Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. Am Psychol. 2020;75(2):274–89. https://doi.org/10.1037/amp0000538Overview of recent evidence examining links between weight stigma and weight-related behaviors and health including health consequences and implications for treatment.

    Article  PubMed  Google Scholar 

  80. Dias-Ferreira E, Sousa JC, Melo I, Morgado P, Mesquita AR, Cerqueira JJ, et al. Chronic stress causes frontostriatal reorganization and affects decision-making. Science. 2009;325(5940):621–5. https://doi.org/10.1126/science.1171203.

    Article  CAS  PubMed  Google Scholar 

  81. •• Stern A, Agnew-Blais JC, Danese A, Fisher HL, Matthews T, Polanczyk GV, et al. Associations between ADHD and emotional problems from childhood to young adulthood: a longitudinal genetically sensitive study. J Child Psychol Psychiatry. 2020. https://doi.org/10.1111/jcpp.13217Review of developmental associations between ADHD and childhood emotional problems; examined the genetic and environmental contributions.

  82. Overgaard KR, Aase H, Torgersen S, Zeiner P. Co-occurrence of ADHD and anxiety in preschool children. J Atten Disord. 2016;20(7):573–80. https://doi.org/10.1177/1087054712463063.

    Article  PubMed  Google Scholar 

  83. Jarrett MA, Wolff JC, Davis TE 3rd, Cowart MJ, Ollendick TH. Characteristics of children with ADHD and anxiety. J Atten Disord. 2016;20(7):636–44. https://doi.org/10.1177/1087054712452914.

    Article  PubMed  Google Scholar 

  84. Özcan Ö, Arslan M, Güngör S, Yüksel T, Selimoğlu MA. Plasma leptin, adiponectin, neuropeptide Y levels in drug naive children with ADHD. J Atten Disord. 2018;22(9):896–900. https://doi.org/10.1177/1087054715587095.

    Article  PubMed  Google Scholar 

  85. • Barker ED, Ing A, Biondo F, Jia T, Pingault JB, Du Rietz E, et al. Do ADHD-impulsivity and BMI have shared polygenic and neural correlates? Mol Psychiatry. 2019. https://doi.org/10.1038/s41380-019-0444-yExamined the neural and polygenic correlates between obesity and ADHD; found a common neural substrate that may account for shared genetic underpinnings of ADHD and obesity along with the manifestation of their (observable) phenotypic association.

  86. Hanc T, Dmitrzak-Weglarz M, Borkowska A, Wolanczyk T, Pytlinska N, Rybakowski F, et al. Overweight in boys with ADHD is related to candidate genes and not to deficits in cognitive functions. J Atten Disord. 2018;22:1158–72.

    Article  PubMed  Google Scholar 

  87. Albayrak Ö, Pütter C, Volckmar AL, Cichon S, Hoffmann P, Nöthen MM, et al. Psychiatric GWAS Consortium: ADHD Subgroup. Common obesity risk alleles in childhood attention-deficit/hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet. 2013;162B(4):295–305. https://doi.org/10.1002/ajmg.b.32144.

    Article  CAS  PubMed  Google Scholar 

  88. Chervin RD, Dillon JE, Bassetti C, Ganoczy DA, Pituch KJ. Symptoms of sleep disorders, inattention, and hyperactivity in children. Sleep. 1997;20(12):1185–92. https://doi.org/10.1093/sleep/20.12.1185.

    Article  CAS  PubMed  Google Scholar 

  89. Guerdjikova AI, Blom TJ, Mori N, Matthews A, Cummings T, Casuto LL, et al. Lisdexamfetamine in pediatric binge eating disorder: a retrospective chart review. Clin Neuropharmacol. 2019;42(6):214–6. https://doi.org/10.1097/WNF.0000000000000367.

    Article  CAS  PubMed  Google Scholar 

  90. Fleck DE, Eliassen JC, Guerdjikova AI, Mori N, Williams S, Blom TJ, et al. Effect of lisdexamfetamine on emotional network brain dysfunction in binge eating disorder. Psychiatry Res Neuroimaging. 2019;286:53–9. https://doi.org/10.1016/j.pscychresns.2019.03.003.

    Article  PubMed  Google Scholar 

  91. Guerdjikova AI, Mori N, Casuto LS, McElroy SL. Novel pharmacologic treatment in acute binge eating disorder - role of lisdexamfetamine. Neuropsychiatr Dis Treat. 2016;12:833–41. https://doi.org/10.2147/NDT.S80881.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  92. Srivastava G, O'Hara V, Browne N. Use of lisdexamfetamine to treat obesity in an adolescent with severe obesity and binge eating. Children (Basel). 2019;6(2):22. https://doi.org/10.3390/children6020022.

    Article  Google Scholar 

  93. Sheinbein DH, Stein RI, Hayes JF, Brown ML, Balantekin KN, Conlon RPK, et al. Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach. Pediatr Obes. 2019;14(8):e12518. https://doi.org/10.1111/ijpo.12518.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Eiraldi RB, Mautone JA, Power TJ. Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am. 2012;21(1):145-x. https://doi.org/10.1016/j.chc.2011.08.012.

    Article  Google Scholar 

  95. Wolraich ML, Hagan JF Jr, Allan C, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents [published correction appears in Pediatrics. 2020 Mar;145(3):]. Pediatrics. 2019;144(4):e20192528. https://doi.org/10.1542/peds.2019-2528.

Download references

Author information

Authors and Affiliations

  1. WOW for Wellness Clinic, Penobscot Community Health Care, 6 Telcom Drive, Bangor, ME, 04401, USA

    Valerie M. O’Hara

  2. Northern Light Health, Eastern Maine Medical Center, Department of Pediatrics, 489 State St, Bangor, ME, 04401, USA

    Jennifer L. Curran

  3. 25 Andrews Avenue, Falmouth, ME, 04105, USA

    Nancy T. Browne

Authors
  1. Valerie M. O’Hara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer L. Curran
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nancy T. Browne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nancy T. Browne.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Childhood Obesity

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

O’Hara, V.M., Curran, J.L. & Browne, N.T. The Co-occurrence of Pediatric Obesity and ADHD: an Understanding of Shared Pathophysiology and Implications for Collaborative Management. Curr Obes Rep 9, 451–461 (2020). https://doi.org/10.1007/s13679-020-00410-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13679-020-00410-0

Keywords

Search

Navigation