It’s no secret that attention deficit hyperactivity disorder stimulants may suppress the appetite. According to the Cleveland Clinic, possible side effects include decreased appetite (which affects approximately 80 percent of people taking stimulants) and weight loss.
However, what about the flip side of the coin — are there possible associations between ADHD stimulants and weight gain?
The Many Variables Behind ADHD and Weight Gain
First, it’s important to understand that the very nature of ADHD may lead to weight fluctuations. April Bowling, assistant professor of health sciences at Merrimack College in North Andover, Massachusetts, says that people with ADHD “have consistently been found to have an increased risk of being overweight or obese.” She notes that adults with the disorder have about one-and-a-half times the obesity risk compared to adults who don’t have ADHD.
[Read: ADHD and Eating Disorders: What You Should Know.]
As for children, one study found that girls with the disorder were more likely to experience more pronounced weight gain around the ages of 10 to 12. In fact, those girls had “a fourfold risk of being obese,” according to the study. The researchers also found that about “one-third of the ADHD population experiences motor issues in terms of developmental coordination disorder,” drawing parallels between the commonly held view that high motor proficiency is associated with a lower body mass index, or BMI. The study explained that “children with DCD are less physically active,” which may make them overweight. The study also touches on the fact that sleep difficulties — which children with ADHD often have — are linked to weight gain. Not only might lack of sleep mean more time spent eating, but it could increase fatigue the following day, making people less inclined to engage in the physical activity necessary to manage weight.
Do Stimulants Play a Role?
Another study published that same year in Pediatrics turned its attention toward ADHD stimulants, concluding that childhood ADHD “not treated with stimulants was associated with higher childhood BMIs.” It also found that ADHD treated with stimulants was linked to a “slower early BMI growth but a rebound later in adolescence to levels above children without a history of ADHD or stimulant use.”
Bowling was also involved in a study on the topic, published in Obesity in August. She says that children with ADHD who were taking stimulants had a lower BMI in the fifth grade, which was most likely due to temporary growth reductions that doctors know the medications can cause. However, her study found that this was followed by those children “catching up and gaining body mass index more quickly than kids who weren’t taking stimulants or who didn’t have ADHD at all.” Compared to typically developing kids without ADHD, she says, kids taking ADHD stimulant medication experienced a significantly greater BMI increase between fifth and eighth grades.
“This tells us that doctors and parents can’t assume that treating with stimulants in childhood means that the elevated risk of obesity that comes with an ADHD diagnosis will go away,” Bowling says. She explains that even when adjusting for the severity of ADHD symptoms before medication, this BMI change persisted, once again reinforcing the need to examine stimulant use among children. “We need a lot more studies to investigate the different ways the increased risk of obesity in ADHD could be occurring,” she says, adding that assessing hormones, metabolic changes, sleep patterns and overall lifestyle are some areas worth more in-depth exploration.
[See: 8 Things You Didn’t Know About Counseling.]
Teaching Healthy Lifestyle Habits
Dr. Daniel Coury, professor of pediatrics at Ohio State University and a developmental-behavioral pediatrician at Nationwide Children’s Hospital in Columbus, Ohio, agrees that looking at the whole picture is helpful when assessing ADHD and weight gain. For example, he points to impulsivity and poor inhibitory control as possible reasons why someone with the disorder many eat more frequently and therefore put on weight. “The family’s lifestyle also plays a role,” Coury says. “A child’s diet falls back on the parents who buy the food in the house.” He explains that young children often don’t have any choice but to eat what parents provide, so eating habits may revolve around whether there are cookies in the house or if there are healthier options, such as fruits and vegetables. Even when children are old enough to purchase food on their own, he explains that it may be challenging to deviate from what they grew up with, making junk food options a likely choice.
Another expert, Dr. Mark Bertin, a developmental pediatrician in Pleasantville, New York, and the author of “Mindful Parenting for ADHD,” says that children easily pick up on their surroundings. In a Psychology Today article, he writes that children learn by observation, emphasizing the need for parents to teach better eating habits. “Our children watch, and learn,” he writes, encouraging parents to serve themselves on smaller plates, pause between bites and not eat directly from a bag. Bertin also suggests refraining from having “overly enticing items on the shelf” (like junk foods), and to routinely enjoy family dinners together to reinforce healthy choices. “Eating is only one of many facets of ordinary life influenced by ADHD, yet typically flies under the radar,” he notes.
However, finding the ideal balance can be challenging for parents.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
Bowling says parents are often overwhelmed with trying to obtain treatment and academic support for their child with ADHD and may feel as though they have to “pick their battles.” She explains that some parents may have to focus on managing social and academic behaviors and feel as though they are “more important than diet and exercise.” That’s when a clinician and support organizations come into play, she says. “Parents should realize that healthy eating and physical activity can directly impact their child’s behavioral health as well as academic success, and be supported as they try to help their children live healthier lives.”
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Can Giving Kids Stimulants for ADHD Make Them Heavier Later in Life? originally appeared on usnews.com
