Association Between ADHD and Obesity: A Systematic Review and Meta-Analysis
Publication: American Journal of Psychiatry
Abstract
Objective:
Impulsivity and inattention related to attention deficit hyperactivity disorder (ADHD) may increase food intake and, consequently, weight gain. However, findings on the association between obesity/overweight and ADHD are mixed. The authors conducted a meta-analysis to estimate this association.
Method:
A broad range of databases was searched through Aug. 31, 2014. Unpublished studies were also obtained. Study quality was rated with the Newcastle-Ottawa Scale. Random-effects models were used.
Results:
Forty-two studies that included a total of 728,136 individuals (48,161 ADHD subjects; 679,975 comparison subjects) were retained. A significant association between obesity and ADHD was found for both children (odds ratio=1.20, 95% CI=1.05–1.37) and adults (odds ratio=1.55, 95% CI=1.32–1.81). The pooled prevalence of obesity was increased by about 70% in adults with ADHD (28.2%, 95% CI=22.8–34.4) compared with those without ADHD (16.4%, 95% CI=13.4–19.9), and by about 40% in children with ADHD (10.3%, 95% CI=7.9–13.3) compared with those without ADHD (7.4%, 95% CI=5.4–10.1). The significant association between ADHD and obesity remained when limited to studies 1) reporting odds ratios adjusted for possible confounding factors; 2) diagnosing ADHD by direct interview; and 3) using directly measured height and weight. Gender, study setting, study country, and study quality did not moderate the association between obesity and ADHD. ADHD was also significantly associated with overweight. Individuals medicated for ADHD were not at higher risk of obesity.
Conclusions:
This study provides meta-analytic evidence for a significant association between ADHD and obesity/overweight. Further research should address possible underlying mechanisms and the long-term effects of ADHD treatments on weight in individuals with both ADHD and obesity.
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History
Received: 28 February 2015
Revision received: 23 May 2015
Accepted: 2 July 2015
Published online: 28 August 2015
Published in print: January 01, 2016
Authors
Competing Interests
Dr. Cortese has received royalties from Aargon Healthcare Italy for online educational activity. Dr. Moreira-Maia has received research support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); has served as a speaker to and developed educational material for Novartis; has received travel awards from the Health Technology Assessment Institute and Universidade Federal do Rio Grande do Sul; and has received travel and registration support for the World Congress on ADHD from the World Federation of ADHD. Dr. Rohde has served as a speaker, adviser, or consultant for Eli Lilly, Janssen-Cilag, Novartis, and Shire; receives authorship royalties from ArtMed and Oxford University Press; received travel awards from Shire; and receives research support from Brazilian government institutions including CNPq, Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, and CAPES. The ADHD and Juvenile Bipolar Disorder Outpatient Programs, for which Dr. Rohde serves as chair, has received unrestricted educational and research support from Eli Lilly, Janssen-Cilag, Novartis, and Shire. Dr. Faraone has received income, travel expenses, or research support from or served on advisory boards or participated in CME programs for Akili Interactive Labs, Alcobra, CogCubed, Eli Lilly, Impax, Ironshore, Janssen, McNeil, NeuroLifeSciences, Neurovance, Novartis, Otsuka, Pfizer, Shire, and VAYA Pharma; he has received research support from NIH and the K.G. Jebsen Centre for Research on Neuropsychiatric Disorders; and he receives book royalties from Elsevier, Guilford Press, and Oxford University Press. Dr. Faraone’s institution is seeking a patent for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. Drs. Morcillo-Peñalver and St. Fleur report no financial relationships with commercial interests.
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