Current Psychiatry Reports

, Volume 12, Issue 5, pp 389–395

Attention-deficit/Hyperactivity Disorder: Associations with Overeating and Obesity

Article

Abstract

In the past decade, we have become increasingly aware of strong associations between overweight/obesity and symptoms of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults. This review addresses the prevalence of the comorbidity and discusses some of the mechanisms that could account for their relationship. It is suggested that the inattentive and impulsive behaviors that characterize ADHD could contribute to overeating in our current food environment, with its emphasis on fast food consumption and its many food temptations. It is also proposed—based on the compelling evidence that foods high in fat, sugar, and salt are as addictive as some drugs of abuse—that excessive food consumption could be a form of self-medication. This view conforms with the well-established evidence that drug use and abuse are substantially higher among those with ADHD than among the general population.

Keywords

ADHD Obesity Addiction Impulsivity 

References

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

  1. 1.
    Barkley RA, Fischer M, Smallish L, et al.: The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol 2002, 111:279–289.CrossRefPubMedGoogle Scholar
  2. 2.
    Walshaw PD, Alloy LB, Sabb FW: Executive function in pediatric bipolar disorder and attention-deficit hyperactivity disorder: in search of distinct phenotypic profiles. Neuropsychol Rev 2010, 20:103–120.CrossRefPubMedGoogle Scholar
  3. 3.
    Faraone SV: The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder. Eur Child Adolesc Psychiatry 2005, 14:1–10.CrossRefPubMedGoogle Scholar
  4. 4.
    Thapar A, Langley K, O’Donovan M, et al.: Refining the attention deficit hyperactivity disorder phenotype for molecular genetic studies. Mol Psychiatry 2006, 11:714–720.CrossRefPubMedGoogle Scholar
  5. 5.
    Fuemmeler BF, Kollins SH, McClernon FJ: Attention deficit hyperactivity disorder symptoms predict nicotine dependence and progression to regular smoking from adolescence to young adulthood. J Pediatr Psychol 2007, 32:1203–1213.CrossRefPubMedGoogle Scholar
  6. 6.
    Golden SM: Does childhood use of stimulant medication as a treatment for ADHD affect the likelihood of future drug abuse and dependence? A literature review. J Child Adolesc Subst Abuse 2009, 18:243–258.CrossRefGoogle Scholar
  7. 7.
    Biederman J, Petty CR, Wilens TE, et al.:. Familial risk analyses of attention deficit hyperactivity disorder and substance use disorders. Am J Psychiatry 2008, 165:107–115.CrossRefPubMedGoogle Scholar
  8. 8.
    Agranat-Meged AN, Deitcher C, Goldzweig G, et al.: Childhood obesity and attention deficit/hyperactivity disorder: a newly described comorbidity in obese hospitalized children. Int J Eat Disord 2005, 37:357–359.CrossRefPubMedGoogle Scholar
  9. 9.
    Altfas JR: Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment. BMC Psychiatry 2002, 2:1–8.CrossRefGoogle Scholar
  10. 10.
    Fleming J, Levy L: Eating disorders in women with AD/HD. In Gender Issues and AD/HD: Research, Diagnosis, and Treatment. Edited by Quinn PO, Nadeau KG. Silver Springs, MD: Advantage Books; 2002:411–426.Google Scholar
  11. 11.
    •• Pagoto SL, Curtin C, Lemon SC, et al.: Association between adult attention deficit/hyperactivity disorder and obesity in the US population. Obesity 2009, 17:539–544. Data from a large sample of US residents indicated that adult ADHD was associated with about a 1.5 OR of being overweight and a 1.8 OR of being obese. This was the first population-based study to examine these relationships.CrossRefPubMedGoogle Scholar
  12. 12.
    Holtkamp K, Konrad K, Muller B, et al.: Overweight and obesity in children with attention-deficit/hyperactivity disorder. Int J Obes 2004, 28:685–689.CrossRefGoogle Scholar
  13. 13.
    •• Waring ME, Lapane KL: Overweight in children and adolescents in relations to attention-deficit/hyperactivity disorder: results from a national sample. Pediatrics 2008, 122:e1–e6. Data from a large, nationally representative sample in the United States found that among unmedicated children and adolescents with ADHD, there was a 1.5 times the odds risk of being overweight. Their medicated counterparts had 1.6 times the odds of being underweight compared with aged-matched healthy controls.CrossRefPubMedGoogle Scholar
  14. 14.
    Ptacek R, Kuzelova H, Pacit I, et al.: ADHD and growth: anthropometric changes in medicated and non-medicated ADHD boys. Med Sci Monit 2009, 15:CR595–CR599.PubMedGoogle Scholar
  15. 15.
    Riverin M, Tremblay A: Obesity and ADHD. Int J Obes 2009, 33:945.CrossRefGoogle Scholar
  16. 16.
    Chen AY, Kim SE, Houtrow AJ, et al.: Prevalence of obesity among children with chronic conditions. Obesity 2009, 18:210–213.CrossRefPubMedGoogle Scholar
  17. 17.
    Claridge G, Davis C: Personality and Psychological Disorders. London: Arnold; 2003.Google Scholar
  18. 18.
    •• Cortese S, Angriman M, Maffeis C, et al.: Attention deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature. Crit Rev Food Sci Nutr 2008, 48:524–537. This paper provides an early review of the links between obesity and ADHD and speculates on possible mechanisms to account for this association. The review is limited to studies in which individuals received a formal diagnosis of ADHD.CrossRefPubMedGoogle Scholar
  19. 19.
    Bray GA, Nielsen SJ, Popkin BM: Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr 2004, 79:537–543.PubMedGoogle Scholar
  20. 20.
    Bray GA: Fructose: should we worry? Int J Obes 2008, 32:S127–S131.CrossRefGoogle Scholar
  21. 21.
    Nederkoorn C, Guerrieri R, Havermans RC, et al.: The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket. Int J Obes 2009, 33:905–912.CrossRefGoogle Scholar
  22. 22.
    •• Avena NM, Rada P, Hoebel BG: Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neursci Biobehav Rev 2008, 32:20–39. This paper presents compelling evidence from controlled laboratory animal research for the argument that sugar is a potentially addictive substance.CrossRefGoogle Scholar
  23. 23.
    Ifland JR, Preuss HG, Marcus MT, et al.: Refined food addiction: a classic substance use disorder. Med Hypotheses 2009, 72:518–526.CrossRefPubMedGoogle Scholar
  24. 24.
    Avena NM, Rada P, Hoebel BG: Sugar and fat bingeing have notable differences in addictive-like behavior. J Nutr 2009, 139:623–628.CrossRefPubMedGoogle Scholar
  25. 25.
    Grigson PS: Like drugs for chocolate: separate rewards modulated by common mechanisms. Physiol Behav 2002, 76:389–395.CrossRefPubMedGoogle Scholar
  26. 26.
    Spring B, Schneider K, Smith M, et al.: Abuse potential of carbohydrates for overweight carbohydrate cravers. Psychopharmacology 2008, 197:637–647.CrossRefPubMedGoogle Scholar
  27. 27.
    •• Davis C, Carter JC: Compulsive overeating as an addiction disorder: a review of theory and evidence. Appetite 2009, 53:1–8. This paper presents compelling evidence that some forms of overeating (eg, binge eating) can be conceptualized as an addiction disorder. This argument has significance for the well-established links between obesity and ADHD.CrossRefPubMedGoogle Scholar
  28. 28.
    Gearhardt AN, Corbin WR, Brownell KD: Food addiction. An examination of the diagnostic criteria for dependence. J Addict Med 2009, 3:1–7.CrossRefGoogle Scholar
  29. 29.
    Cassin SE, von Ranson KM: Is binge eating experienced as an addiction? Appetite 2007, 49:687–690.CrossRefPubMedGoogle Scholar
  30. 30.
    Davis C, Levitan RD, Smith M, et al.: Associations among overeating, overweight, and attention deficit/hyperactivity disorder: a structural equation modeling approach. Eat Behav 2006, 7:266–274.CrossRefPubMedGoogle Scholar
  31. 31.
    Cortese S, Bernardina BD, Mouren M-C: Attention-deficit/hyperactivity disorder (ADHD) and binge eating. Nutr Rev 2007, 65:404–411.CrossRefPubMedGoogle Scholar
  32. 32.
    Limosin F, Romo L, Batel P, et al.: Association between dopamine receptor D3 gene BalI polymorphism and cognitive impulsiveness in alcohol-dependent men. Eur Psychiatry 2005, 20:304–306.CrossRefPubMedGoogle Scholar
  33. 33.
    Ondo WG, Lai DJ: Predictors of impulsivity and reward seeking behavior with dopamine agonists. Parkinsonism Relat Disord 2008, 14:28–32.CrossRefPubMedGoogle Scholar
  34. 34.
    Verdejo-Garcia A, Bechara A, Recknor EC, et al.: Negative emotion-driven impulsivity predicts substance dependence problems. Drug Alcohol Depend 2007, 91:213–219.CrossRefPubMedGoogle Scholar
  35. 35.
    •• Davis C, Patte K, Levitan RD, et al.: A psychogenetic study of associations between the symptoms of binge eating disorder and those of attention deficit (hyperactivity) disorder. J Psychiatr Res 2009, 43:687–696. This study demonstrated that symptoms of ADHD were strongly associated with obesity in a nonclinical community sample of adult men and women.CrossRefPubMedGoogle Scholar
  36. 36.
    Duckworth AL, Tsukayama E, Geier AB: Self-controlled children stay leaner in the transition to adolescence. Appetite 2010, 54:304–308.CrossRefPubMedGoogle Scholar
  37. 37.
    • Davis C, Patte K, Curtis C, Reid C: Immediate pleasures and future consequences: a neuropsychological study of binge eating and obesity. Appetite 2010, 54:208–213. Decision-making deficits and a diminished ability to delay gratification were found in obese women—with and without BED—compared with an age-matched group of normal weight women.CrossRefPubMedGoogle Scholar
  38. 38.
    Dawe S, Loxton, N: The role of impulsivity in the development of substance use and eating disorders. Neurosci Biobehav Rev 2004, 28:343–351.CrossRefPubMedGoogle Scholar
  39. 39.
    Drechsler R, Rizzo P, Steinhausen HC: Decision-making on an explicit risk-taking task in preadolescents with attention-deficit/hyperactivity disorder. J Neural Transm 2008, 115:201–209.CrossRefPubMedGoogle Scholar
  40. 40.
    Verbeken S, Braet C, Claus L, et al.: Childhood obesity and impulsivity: an investigation with performance-based measures. Behav Change 2009, 26:153–167.CrossRefGoogle Scholar
  41. 41.
    Nederkoorn C, Jansen E, Mulkens S, et al.: Impulsivity predicts treatment outcome in obese children. Behav Res Ther 2006, 45:1071–1075.CrossRefPubMedGoogle Scholar
  42. 42.
    Pauli-Pott U, Albayrak O, Hebebrand J, et al.: Does inhibitory control capacity in overweight and obese children and adolescents predict success in a weight-reduction program? Eur Child Adolesc Psychiatry 2010, 19:135–141.CrossRefPubMedGoogle Scholar
  43. 43.
    Thapar A, O’Donovan M, Owen MJ: The genetics of attention deficit hyperactivity disorder. Hum Mol Genet 2005, 14:R275–R282.CrossRefPubMedGoogle Scholar
  44. 44.
    Wermter A-K, Laucht M, Schimmelmann BG, et al.: From nature versus nurture, via nature and nurture, to gene x environment interaction in mental disorders. Eur Child Adolesc Psychiatry 2010, 19:199–210.CrossRefPubMedGoogle Scholar
  45. 45.
    Thapur A, Langley K, Asherson P, Gill M: Gene-environment interplay in attention-deficit hyperactivity disorder and the importance of a developmental perspective. Br J Psychiatry 2007, 190:1–3.CrossRefGoogle Scholar
  46. 46.
    Grant TM, Huggins JE, Sampson PD, et al.: Alcohol use before and during pregnancy in western Washington, 1989–2004: implications for the prevention of fetal alcohol spectrum disorders. Am J Obstet Gynecol 2009, 278:e1–e8.Google Scholar
  47. 47.
    Golden J: “An argument that goes back to the womb”: the demedicalization of fetal alcohol syndrome, 1973–1992. J Soc Hist 1999, 33:269–298.CrossRefGoogle Scholar
  48. 48.
    Greenbaum RL, Stevens SA, Nash K, et al.: Social cognitive and emotional processing abilities of children with fetal alcohol spectrum disorders: a comparison with attention deficit hyperactivity disorder. Alcohol Clin Exp Res 2009, 33:1656–1670.CrossRefPubMedGoogle Scholar
  49. 49.
    Kooistra L, Crawford S, Gibbard B, et al.: Differentiating attention deficits in children with fetal alcohol spectrum disorder or attention-deficit-hyperactivity disorder. Dev Med Child Neurol 2010, 52:205–211.CrossRefPubMedGoogle Scholar
  50. 50.
    Rodriguez A, Miettunen J, Henrikson TB, et al.: Maternal adiposity prior to pregnancy is associated with ADHD symptoms offspring: evidence from three prospective pregnancy cohorts. Int J Obes 2008, 32:550–557.CrossRefGoogle Scholar
  51. 51.
    • Rodriguez A: Maternal pre-pregnancy obesity and risk for inattention and negative emotionality in children. J Child Psychol Psychiatry 2010, 51:134–143. Prepregnancy overweight/obesity was associated with a twofold increase in inattention symptoms in kindergarten children even after controlling for parental ADHD symptoms.CrossRefPubMedGoogle Scholar
  52. 52.
    •• Levy LD, Fleming JP, Klar D: Treatment of refractory obesity in severely obese adults following management of newly diagnosed attention deficit hyperactivity disorder. Int J Obes 2009, 33:326–334. This paper concludes that treatment of ADHD with psychomotor stimulant medication is associated with significant long-term weight loss in severely obese adults with a lengthy history of weight loss failure.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.York UniversityTorontoCanada

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