European Child & Adolescent Psychiatry

, Volume 28, Issue 11, pp 1507–1516 | Cite as

Body dissatisfaction and weight control behaviour in children with ADHD: a population-based study

  • Matthew BissetEmail author
  • Nicole Rinehart
  • Emma Sciberras
Original Contribution


Although attention-deficit/hyperactivity disorder (ADHD) is associated with eating disorders (EDs), it is unclear when ED risk emerges in children with ADHD. We compared differences in body dissatisfaction and weight control behaviour in children with/without ADHD aged 12–13 years concurrently, and when aged 8–9 and 10–11 years, to determine when risk emerges. We also examined differences by ADHD medication status at each age. This study uses waves 1–5 from the Longitudinal Study of Australian Children (n = 2323–2972). ADHD (7.7%) was defined at age 12–13 years by both parent- and teacher-reported SDQ Hyperactivity–Inattention scores > 90th percentile, parent-reported ADHD diagnosis and/or ADHD medication treatment. Children reported body dissatisfaction and weight control behaviour at 8–9, 10–11 and 12–13 years. Children with ADHD had greater odds of body dissatisfaction at ages 8–9 and 12–13 years. Comorbidities drove this relationship at 8–9 but not at 12–13 years [adjusted odds ratio (AOR): 1.6; 95 % CI 1.1–2.4; p = 0.01]. At 12–13 years, children with ADHD had greater odds of both trying to lose and gain weight, regardless of BMI status. Comorbidities drove the risk of trying to lose weight in ADHD but not of trying to gain weight (AOR 2.3; 95% CI 1.1–4.6; p = 0.03), which is likely accounted for by ADHD medication treatment. ADHD moderately increases body dissatisfaction risk in children aged 8–9 and 12–13 years. Clinicians should monitor this and weight control behaviour throughout mid-late childhood, particularly in children with comorbid conditions and those taking ADHD medication, to reduce the likelihood of later ED onset.


Attention-deficit/hyperactivity disorder Eating disorder Body dissatisfaction Weight control Children 



Adjusted odds ratio


Confidence interval


Eating disorder


Longitudinal Study of Australian Children


Odds ratio


Strengths and Difficulties Questionnaire



Mr Bisset’s position is funded by a Deakin University Postgraduate Research Scholarship (2017–2018). Associate Professor Sciberras’ position is funded by a National Health and Medical Research Council (NHMRC) Early Career Fellowship in Population Health 1037159 (2012–2015) and an NHMRC Career Development Fellowship 1110688 (2016–2019). We thank all families participating in the LSAC study. This paper uses unit record data from Growing Up in Australia, the Longitudinal Study of Australian Children. The study is conducted in partnership between the Department of Social Services (DSS), the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). The findings and views reported in this paper are those of the authors and should not be attributed to DSS, AIFS or the ABS.

Compliance with ethical standards

Conflict of Interest:

The authors have no financial relationships or conflicts of interest relevant to this article to disclose.

Ethical standards

This study was approved by The Australian Institute of Family Studies (AIFS) ethics committee. Informed consent was obtained from all individual participants prior to inclusion in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Supplementary material

787_2019_1314_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 22 kb)


  1. 1.
    Curtin C, Pagoto SL, Mick E (2013) The association between ADHD and eating disorders/pathology in adolescents: a systematic review. Open J Epidemiol 3:193–202. CrossRefGoogle Scholar
  2. 2.
    Bleck J, DeBate R, Levin BL, Baldwin J (2016) Underlying mechanisms and trajectory of comorbid ADHD and eating disorders: proposing an innovative systems framework for informing research. Int J Ment Health Addict 14:449–458. CrossRefGoogle Scholar
  3. 3.
    Nazar BP, Bernardes C, Peachey G et al (2016) The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Int J Eat Disord 49:1045–1057. CrossRefPubMedGoogle Scholar
  4. 4.
    Levin RL, Rawana JS (2016) Attention-deficit/hyperactivity disorder and eating disorders across the lifespan: a systematic review of the literature. Clin Psychol Rev 50:22–36. CrossRefPubMedGoogle Scholar
  5. 5.
    Kaisari P, Dourish CT, Higgs S (2017) Attention deficit hyperactivity disorder (ADHD) and disordered eating behaviour: a systematic review and a framework for future research. Clin Psychol Rev 53:109–121. CrossRefPubMedGoogle Scholar
  6. 6.
    Yilmaz Z, Javaras KN, Baker JH et al (2017) Association between childhood to adolescent attention deficit/hyperactivity disorder symptom trajectories and late adolescent disordered eating. J Adolesc Heal 61:140–146. CrossRefGoogle Scholar
  7. 7.
    Güngör S, Celiloğlu ÖS, Raif SG et al (2016) Malnutrition and obesity in children with ADHD. J Atten Disord 20:647–652. CrossRefPubMedGoogle Scholar
  8. 8.
    Chamay-Weber C, Narring F, Michaud PA (2005) Partial eating disorders among adolescents: a review. J Adolesc Heal 37:417–427CrossRefGoogle Scholar
  9. 9.
    Vall E, Wade TD (2015) Predictors of treatment outcome in individuals with eating disorders: a systematic review and meta-analysis. Int J Eat Disord 48:946–971CrossRefGoogle Scholar
  10. 10.
    Kazdin AE, Fitzsimmons-Craft EE, Wilfley DE (2017) Addressing critical gaps in the treatment of eating disorders. Int J Eat Disord 50:170–189CrossRefGoogle Scholar
  11. 11.
    Stice E (2002) Risk and maintenance factors for eating pathology: a meta-analytic review. Psychol Bull 128:825–848CrossRefGoogle Scholar
  12. 12.
    Stice E, Shaw HE (2002) Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. J Psychosom Res 53:985–993CrossRefGoogle Scholar
  13. 13.
    Polivy J, Herman CP (2002) Causes of eating disorders. Annu Rev Psychol 53:187–213CrossRefGoogle Scholar
  14. 14.
    Davison KK, Markey CN, Birch LL (2003) A longitudinal examination of patterns in girls’ weight concerns and body dissatisfaction from ages 5–9 years. Int J Eat Disord 33:320–332CrossRefGoogle Scholar
  15. 15.
    Neumark-Sztainer D, Story M, Resnick MD et al (1995) Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study. Arch Pediatr Adolesc Med 149:1330–1335. CrossRefPubMedGoogle Scholar
  16. 16.
    Mikami AY, Hinshaw SP, Lee KA, Chang J (2008) Eating pathology among adolescent girls with attention-deficit/hyperactivity disorder. J Abnorm Psychol 117:225–235. CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Mikami AY, Hinshaw SP, Arnold LE et al (2010) Bulimia nervosa symptoms in the multimodal treatment study of children with ADHD. Int J Eat Disord 43:248–259. CrossRefPubMedGoogle Scholar
  18. 18.
    Bleck J, DeBate RD (2013) Exploring the co-morbidity of attention-deficit/hyperactivity disorder with eating disorders and disordered eating behaviors in a nationally representative community-based sample. Eat Behav 14:390–393CrossRefGoogle Scholar
  19. 19.
    Gowey MA, Stromberg SE, Lim CS, Janicke DM (2017) The moderating role of body dissatisfaction in the relationship between ADHD symptoms and disordered eating in pediatric overweight and obesity. Child Heal Care 46:15–33CrossRefGoogle Scholar
  20. 20.
    Cortese S, Vincenzi B (2012) Obesity and ADHD: clinical and neurobiological implications. Curr Top Behav Neurosci 9:199–218. CrossRefPubMedGoogle Scholar
  21. 21.
    Råstam M, Täljemark J, Tajnia A et al (2013) Eating problems and overlap with ADHD and autism spectrum disorders in a nationwide twin study of 9- and 12-year-old children. Sci World J 2013:315429. CrossRefGoogle Scholar
  22. 22.
    Davis C, Fattore L, Kaplan AS et al (2012) The suppression of appetite and food consumption by methylphenidate: the moderating effects of gender and weight status in healthy adults. Int J Neuropsychopharmacol 15:181–187CrossRefGoogle Scholar
  23. 23.
    Reinblatt SP, Leoutsakos JMS, Mahone EM et al (2015) Association between binge eating and attention-deficit/hyperactivity disorder in two pediatric community mental health clinics. Int J Eat Disord 48:505–511. CrossRefPubMedGoogle Scholar
  24. 24.
    Biederman J, Ball SW, Monuteaux MC et al (2007) Are girls with ADHD at risk for eating disorders? Results from a controlled, 5-year prospective study. J Dev Behav Pediatr 28:302–307. CrossRefPubMedGoogle Scholar
  25. 25.
    Yoshimasu K, Barbaresi WJ, Colligan RC et al (2012) Childhood ADHD is strongly associated with a broad range of psychiatric disorders during adolescence: a population-based birth cohort study. J Child Psychol Psychiatry 53:1036–1043. CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Cortese S, Isnard P, Frelut ML et al (2007) Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents. Int J Obes 31:340–346. CrossRefGoogle Scholar
  27. 27.
    Kim EJ, Kwon HJ, Ha M et al (2014) Relationship among attention-deficit hyperactivity disorder, dietary behaviours and obesity. Child Care Health Dev 40:698–705. CrossRefPubMedGoogle Scholar
  28. 28.
    Lawrence D, Johnson S, Hafekost J et al (2015) The mental health of children and adolescents: report on the second Australian child and adolescent survey of mental health and wellbeing. ACT, CanberraGoogle Scholar
  29. 29.
    Gray M, Sanson A (2005) Growing up in Australia: the Longitudinal Study of Australian Children. Fam Matters 72:4–9Google Scholar
  30. 30.
    Soloff C, Lawrence D, Johnstone R (2005) LSAC technical paper no. 1: sample design. Aust Aust Inst Fam Stud, MelbourneGoogle Scholar
  31. 31.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, ArlingtonCrossRefGoogle Scholar
  32. 32.
    Concannon P, Tang Y (2005) Management of attention deficit hyperactivity disorder: a parental perspective. J Paediatr Child Health 41:625–630CrossRefGoogle Scholar
  33. 33.
    Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345. CrossRefPubMedGoogle Scholar
  34. 34.
    Sciberras E, Ukoumunne OC, Efron D (2011) Predictors of parent-reported attention-deficit/hyperactivity disorder in children aged 6–7 years: a national longitudinal study. J Abnorm Child Psychol 39:1025–1034CrossRefGoogle Scholar
  35. 35.
    Sciberras E, Lucas N, Efron D et al (2013) Health care costs associated with parent-reported ADHD: a longitudinal Australian population–based study. J Atten Disord 21:1063–1072CrossRefGoogle Scholar
  36. 36.
    Collins ME (1991) Body figure perceptions and preferences among preadolescent children. Int J Eat Disord 10:199–208CrossRefGoogle Scholar
  37. 37.
    Daraganova G (2017) Body image of pre-adolescents. In: Garvis S, Pendergast D (eds) Health and wellbeing in childhood, 2nd ed. Cambridge University Press, Cambridge, pp 177–194CrossRefGoogle Scholar
  38. 38.
    Stock S, Miranda C, Evans S et al (2007) Healthy buddies: a novel, peer-led health promotion program for the prevention of obesity and eating disorders in children in elementary school. Pediatrics 120:e1059–e1068CrossRefGoogle Scholar
  39. 39.
    Franklin J, Denyer G, Steinbeck KS et al (2006) Obesity and risk of low self-esteem: a statewide survey of Australian children. Pediatrics 118:2481–2487CrossRefGoogle Scholar
  40. 40.
    Ogden CL, Kuczmarski RJ, Flegal KM et al (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109:45–60. CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Sung V, Hiscock H, Sciberras E, Efron D (2008) Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family. Arch Pediatr Adolesc Med 162:336–342CrossRefGoogle Scholar
  42. 42.
    Quach J, Hiscock H, Canterford L, Wake M (2009) Outcomes of child sleep problems over the school-transition period: Australian population longitudinal study. Pediatrics 123:1287–1292CrossRefGoogle Scholar
  43. 43.
    Lycett K, Mensah FK, Hiscock H, Sciberras E (2014) A prospective study of sleep problems in children with ADHD. Sleep Med 15:1354–1361CrossRefGoogle Scholar
  44. 44.
    StataCorp (2015) Stata statistical software: release 14. StataCorp LP, College StationGoogle Scholar
  45. 45.
    Reinblatt SP, Mahone EM, Tanofsky-Kraff M et al (2015) Pediatric loss of control eating syndrome: association with attention-deficit/hyperactivity disorder and impulsivity. Int J Eat Disord 48:580–588CrossRefGoogle Scholar
  46. 46.
    Sonneville KR, Calzo JP, Horton NJ et al (2015) Childhood hyperactivity/inattention and eating disturbances predict binge eating in adolescence. Psychol Med 45:2511–2520. CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Benard V, Cottencin O, Guardia D et al (2015) The impact of discontinuing methylphenidate on weight and eating behavior. Int J Eat Disord 48:345–348CrossRefGoogle Scholar
  48. 48.
    Ranstam J (2016) Multiple p values and Bonferroni correction. Osteoarthr Cartil 24:763–764. CrossRefPubMedGoogle Scholar
  49. 49.
    Barmine M, Schvey NA, Ress R, Tanofsky-Kraff M (2017) Assessment of Children and Adolescents: Special Considerations. In: Wade T (ed) Encyclopedia of Feeding and Eating Disorders. Springer, Singapore, pp 18–24CrossRefGoogle Scholar
  50. 50.
    Gordon-Lipkin E, Marvin AR, Law JK, Lipkin PH (2018) Anxiety and mood disorder in children with autism spectrum disorder and ADHD. Pediatrics 141:e20171377CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Psychology, Faculty of Health, Deakin Child Study CentreDeakin UniversityBurwoodAustralia
  2. 2.Murdoch Children’s Research InstituteParkvilleAustralia
  3. 3.Department of PaediatricsThe University of MelbourneParkvilleAustralia

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