ADHD Stimulants Tied to Children’s Future Obesity Risk
Attention deficit hyperactivity disorder (ADHD) is a mental disorder that is often diagnosed in young children. The symptoms, which include poor concentration, difficulty controlling behavior and hyperactivity, tend to be treated with stimulants. Even though stimulants can be very effective for some children, a new study reported that children taking these stimulants have a greater risk of obesity during their teenage years.
"The reason we think it is more likely to be the drugs than the diagnosis is because the earlier the drugs were started and the longer the drugs were used, the stronger the effects," said study author Dr. Brian Schwartz, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, MD. "If you agree with the reports that stimulants may be over-prescribed, then this is another important cost of that over-treatment -- kids who have dramatic changes in their growth trajectories during and after the treatment."
For this study, the researchers examined medical records on more than 160,000 children taken from a large Pennsylvania health maintenance organization. The children were between the ages of three and 18, and were tracked for up to 12 years. Around eight percent of the children in the study were diagnosed with ADHD. About seven percent of these children were given stimulants to treat their condition.
The researchers also had data on the children's body mass index (BMI), which is a measurement of obesity that takes into account one's weight in relation to height. There were roughly three annual BMI measurements taken throughout the study. The researchers reported that for 10-year-old children with ADHD who were not on stimulants, their BMIs were larger than fellow classmates who did not have ADHD. When the team examined children with ADHD who took stimulants, they found a very interesting pattern.
When ADHD children started taking stimulants such as Ritalin and Concerta, their BMIs were about one to two points lower than children who did not have ADHD at the age of ten. The researchers stated that this finding was not shocking because stimulants have been tied to lowering appetite. However, by the age of 15 to 18, the researchers found that the children who used to take stimulants had BMIs that were one to two points higher than children who never took these drugs.
"As an average effect size, this is large," Schwartz said reported by HealthDay. "In contrast, in the untreated ADHD children, the effects are relatively small."
The researchers stated that obesity might be linked to the actual mental condition since children with ADHD who did not take stimulants also gained more weight than children without the condition. This study also suggests that stimulant drugs could increase the risk of obesity as well in children with ADHD.
"There's a lot of reward that we get from eating -- especially things that are bad for us," Dr. Tonya Froehlich, a developmental-behavioral pediatrician at Cincinnati Children's Hospital Medical Center in Ohio said. "If you have issues regulating reward and also regulating your delay of gratification, which we see a lot with ADHD, it makes sense that would also be linked to eating the wrong things at the wrong times and gaining more weight."
Schwarts added according to TIME, "We certainly need to be more cautious about use of these medications in children. Obesity has lifelong risks. If this is a consequence of stimulant use, and since there is evidence that we might be overprescribing stimulants, we might be contributing to the childhood- and adult-obesity epidemics."
The study was published in Pediatrics.