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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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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DOI: https://doi.org/10.1007/7854_2011_154
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