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Obesity and ADHD: Clinical and Neurobiological Implications

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Behavioral Neuroscience of Attention Deficit Hyperactivity Disorder and Its Treatment

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 9))

Abstract

Although quite overlooked, increasing evidence points to a significant association between attention-deficit/hyperactivity disorder (ADHD) and obesity. Here, we present an updated systematic review and a critical discussion of studies on the relationship between ADHD and obesity, with a particular emphasis on the possible behavioral, neurobiological, and genetics underlying mechanisms. Available empirically based studies indicate that the prevalence of ADHD in clinical samples of patients seeking treatment for their obesity is higher than that in the general population. Moreover, although still limited, current evidence shows that individuals with ADHD have higher-than-average body mass index z-scores and/or significantly higher obesity rates compared with subjects without ADHD. Three mechanisms underlying the association between ADHD and obesity have been proposed: (1) obesity and/or factors associated with it (such as sleep-disordered breathing and deficits in arousal/alertness) manifest as ADHD-like symptoms; (2) ADHD and obesity share common genetics and neurobiological dysfunctions, involving the dopaminergic and, possibly, other systems (e.g., brain-derived neurotropic factor, melanocortin-4-receptor); and (3) impulsivity and inattention of ADHD contribute to weight gain via dysregulated eating patterns. With regards to the possible clinical implications, we suggest that it is noteworthy to screen for ADHD in patients with obesity and to look for abnormal eating behaviors as possible contributing factors of obesity in patients with ADHD. If further studies confirm a causal relationship between ADHD and obesity, appropriate treatment of ADHD may improve eating patterns and, as a consequence, weight status of individuals with both obesity and ADHD.

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Abbreviations

ADD:

Attention-deficit disorder

BDNF:

Brain-derived neurotropic factor

BMI-SDS:

Body mass index standard deviations scores

CAPA:

Child and Adolescent Psychiatric Assessment

CI:

Confidence interval

CPRS-R:S:

Conners Parent Rating Scale-Revised:Short version

DRD2:

Dopamine D2 receptor

DRD4:

Dopamine D4 receptor

EDS:

Excessive daytime sleepiness

MC4-R:

Melanocortin-4-receptor

NSCH:

National Survey of Children’s Health

OR:

Odds ratio

SAD:

Seasonal affective disorder

SDSC:

Sleep Disturbance Scale for Children

WURS-25:

Wender Utah Rating Scale-25

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Acknowledgment

Dr. Cortese is supported by a grant from European Union “International outgoing fellowship, Marie Curie actions, FP7 Program, # PIOF-GA-2009-253103.”

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Authors and Affiliations

  1. Institute for Pediatric Neuroscience, New York University Child Study Center, New York, NY, USA

    Samuele Cortese

  2. 215, Lexington Ave, 14th Floor, New York, 10016, NY, USA

    Samuele Cortese

  3. Ellern Mede Centre, London, UK

    Brenda Vincenzi

  4. 31 Totteridge Common, London, N20 8LR, UK

    Brenda Vincenzi

Authors
  1. Samuele Cortese
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  2. Brenda Vincenzi
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Correspondence to Samuele Cortese .

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Editors and Affiliations

  1. , Dept of Neurosci, Physiol & Pharmacol, University College London, Gower Street, London, WC1E6BT, United Kingdom

    Clare Stanford

  2. , Human Development & Applied Psychology, The Ontario Institute for Studies in Edu, Bloor Street West 252, Toronto, M5S1V6, Canada

    Rosemary Tannock

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Cortese, S., Vincenzi, B. (2011). Obesity and ADHD: Clinical and Neurobiological Implications. In: Stanford, C., Tannock, R. (eds) Behavioral Neuroscience of Attention Deficit Hyperactivity Disorder and Its Treatment. Current Topics in Behavioral Neurosciences, vol 9. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2011_154

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