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Association between ADHD and obesity: a systematic review and meta-analysis

Association between ADHD and obesity: a systematic review and meta-analysis
Association between ADHD and obesity: a systematic review and meta-analysis
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 Unpublished studies were also obtained.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.
1535-7228
34-43
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Moreira-Maia, C.R.
769dcb3a-9bd6-4a5c-82a4-d3b5557c76af
St Fleur, D.
7c40224b-6b24-4818-b276-8b4d564763e6
Morcillo-Penalver, C.
512b8f1b-1d74-4d45-9899-0d4a27cd6f72
Rohde, L.A.
714f1c84-c464-45b8-8dad-4b5b2c714176
Faraone, S.V.
023439f0-0461-4037-9b79-27e0c25a9488
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Moreira-Maia, C.R.
769dcb3a-9bd6-4a5c-82a4-d3b5557c76af
St Fleur, D.
7c40224b-6b24-4818-b276-8b4d564763e6
Morcillo-Penalver, C.
512b8f1b-1d74-4d45-9899-0d4a27cd6f72
Rohde, L.A.
714f1c84-c464-45b8-8dad-4b5b2c714176
Faraone, S.V.
023439f0-0461-4037-9b79-27e0c25a9488

Cortese, Samuele, Moreira-Maia, C.R., St Fleur, D., Morcillo-Penalver, C., Rohde, L.A. and Faraone, S.V. (2016) Association between ADHD and obesity: a systematic review and meta-analysis. American Journal of Psychiatry, 173 (1), 34-43. (doi:10.1176/appi.ajp.2015.15020266).

Record type: Article

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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More information

Accepted/In Press date: 2015
e-pub ahead of print date: 28 August 2015
Published date: January 2016
Organisations: Clinical Neuroscience

Identifiers

Local EPrints ID: 380058
URI: http://eprints.soton.ac.uk/id/eprint/380058
ISSN: 1535-7228
PURE UUID: 0f965249-cdfc-4f7f-b95c-444297d2ad22
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

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Date deposited: 19 Aug 2015 14:09
Last modified: 15 Mar 2024 03:52

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Contributors

Author: Samuele Cortese ORCID iD
Author: C.R. Moreira-Maia
Author: D. St Fleur
Author: C. Morcillo-Penalver
Author: L.A. Rohde
Author: S.V. Faraone

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