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Overweight and obesity in children with Attention-Deficit/Hyperactivity Disorder

International Journal of Obesity volume 28, pages 685–689 (2004)Cite this article

Abstract

OBJECTIVE: Epidemiological studies suggest that adiposity in children may be associated with a reduced level of physical activity. Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are physically hyperactive as of early childhood and have been shown to exhibit higher levels of motor activity than normal. The aim of our study was to assess if the prevalence of overweight and obesity is lower in a population of boys with ADHD in comparison with the German healthy male reference population of the same age.

DESIGN: Patients were investigated from 1999 until 2001 upon referral to the inpatient and outpatient unit of the Department of Child and Adolescent Psychiatry of the University of Aachen.

SUBJECTS: A total of 97 male patients (mean age 10±2 y) with a diagnosis of ADHD according the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), who were free of potentially orexigenic medication and who had no further comorbid diagnosis apart from conduct disorder.

MEASUREMENTS: BMI standard deviation scores (BMI-SDS) were calculated and compared to age-adapted reference value of the German population.

RESULTS: Patients' mean BMI–SDS was significantly higher than the age-adapted reference values of the German population (P=0.038). Our sample included significantly more subjects than expected with a BMI ≥90th percentile (19.6%, P<0.001) and ≥97th percentile (7.2%, P=0.007).

CONCLUSION: Surprisingly, being ‘hyperactive’ in the sense of the DSM-IV diagnosis of ADHD does not prevent the development or persistence of overweight and obesity in children. The examination of these children might be a helpful approach in the investigation of the relationship between obesity and its contributing psychological and behavioural factors.

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References

  1. Muller MJ, Grund A, Krause H, Siewers M, Bosy-Westphal A, Rieckert H . Determinants of fat mass in prepubertal children. Br J Nutr 2002; 88: 545–554.

    Article  CAS  Google Scholar 

  2. Maffeis C, Talamini G, Tato L . Influence of diet, physical activity and parents' obesity on children's adiposity: a four-year longitudinal study. Int J Obes Relat Metab Disord 1998; 22: 758–764.

    Article  CAS  Google Scholar 

  3. Treuth MS, Figueroa-Colon R, Hunter GR, Weinsier RL, Butte NF, Goran MI . Energy expenditure and physical fitness in overweight vs non-overweight prepubertal girls. Int J Obes Relat Metab Disord 1998; 22: 440–447.

    Article  CAS  Google Scholar 

  4. Bandini LG, Schoeller DA, Dietz WH . Energy expenditure in obese and nonobese adolescents. Pediatr Res 1990; 27: 198–203.

    Article  CAS  Google Scholar 

  5. Moore LL, Gao D, Bradlee ML, Cupples LA, Sundarajan-Ramamurti A, Proctor MH, Hood MY, Singer MR, Ellison RC . Does early physical activity predict body fat change throughout childhood? Prev Med 2003; 37: 10–17.

    Article  Google Scholar 

  6. Lazzer S, Boirie Y, Bitar A, Montaurier C, Vernet J, Meyer M, Vermorel M . Assessment of energy expenditure associated with physical activities in free-living obese and nonobese adolescents. Am J Clin Nutr 2003; 78: 471–479.

    Article  CAS  Google Scholar 

  7. Trost SG, Sirard JR, Dowda M, Pfeiffer KA, Pate RR . Physical activity in overweight and nonoverweight preschool children. Int J Obes Relat Metab Disord 2003; 27: 834–839.

    Article  CAS  Google Scholar 

  8. Krebs NF, Jacobson MS . American Academy of Pediatrics Committee on Nutrition. Prevention of pediatric overweight and obesity. Pediatrics 2003; 112: 424–430.

    Article  Google Scholar 

  9. Hill JO, Wyatt HR, Reed GW, Peters JC . Obesity and the environment: where do we go from here? Science 2003; 299: 853–855.

    Article  CAS  Google Scholar 

  10. Epstein LH, Valoski A, Wing RR, McCurley J . Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol 1994; 13/5: 373–383.

    Article  Google Scholar 

  11. Parsons TJ, Power C, Logan S, Summerbell CD . Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord Suppl 1999; 23/8: 1–107.

    Google Scholar 

  12. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association: Washington, DC; 1994.

  13. Barley RA, Jackson T . Hyperkinesis autonomic nervous system activity and stimulant drug effects. J Child Psychol Psychiat 1977; 18: 247–258.

    Google Scholar 

  14. Kendall P, Brophy C . Activity and attentional correlates of teacher ratings of hyperactivity. J Pediatr Psychol 1981; 6: 451–458.

    Article  CAS  Google Scholar 

  15. Porrino LJ, Rapoport JL, Behar D, Sceery W, Ismond DR, Bunney Jr WE . A naturalistic assessment of the motor activity of hyperactive boys. I. Comparison with normal controls. Arch Gen Psychiatry 1983; 40/6: 681–687.

    Article  Google Scholar 

  16. Herpertz SC, Wenning B, Mueller B, Qunaibi M, Sass H, Herpertz-Dahlmann B . Psychophysiological responses in ADHD boys with and without conduct disorder: implications for adult antisocial behavior. J Am Acad Child Adolesc Psychiatry 2001; 40/10: 1222–1230.

    Article  Google Scholar 

  17. Doepfner M, Lehmkuhl G . Diagnostic system for mental disorders in child and adolescence according to ICD-10 and DSM-IV (DISYPS-KJ). Huber: Bern, Switzerland; 1998.

    Google Scholar 

  18. Conners CK . Rating scales for use in drug studies with children. Psychopharmacol Bull 1973; 9: 24–84.

    Google Scholar 

  19. Tewes U, Rossmann P, Schallberger U . Wechsler intelligence test for children, HAWIK-III, 3rd edn. Huber: Bern, Switzerland; 1999.

    Google Scholar 

  20. Unnewehr S, Schneider S, Margraf J . Diagnostic interview for psychiatric disorders in childhood and adolescence. Springer: Berlin, Germany; 1995.

    Google Scholar 

  21. Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, von Hippel A, Jaeger U, Johnsen D, Korte W, Menner K, Müller G, Müller JM, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen H-U, Zabransky S, Zellner K, Ziegler A, Hebebrand J . Percentiles of body mass index in children and adolescents evaluated from different regional German studies. Monatsschr Kinderheilk 2001; 149: 807–818.

    Article  Google Scholar 

  22. Poskitt EM . Defining childhood obesity: the relative body mass index (BMI). European Childhood Obesity group. Acta Paediatr 1995; 84: 961–963.

    Article  CAS  Google Scholar 

  23. Wabitsch M, Kunze D . D 4 adipositas. In: Reinhardt D (ed). Leitlinien Kinderheilkunde und Jugendmedizin. Urban Fischer: München; 2002. pp 1–36.

    Google Scholar 

  24. Robinson TN, Hammer LD, Killen JD, Kraemer HC, Wilson DM, Hayward C, Taylor CB . Does television viewing increase obesity and reduce physical activity? Cross-sectional and longitudinal analyses among adolescent girls. Pediatrics 1993; 91/2: 273–280.

    Google Scholar 

  25. Schertz M, Adesman AR, Alfieri NE, Bienkowski RS . Predictors of weight loss in children with attention deficit hyperactivity disorder treated with stimulant medication. Pediatrics 1996; 98: 763–769.

    CAS  PubMed  Google Scholar 

  26. Henninghausen K, Rischmuller B, Heseker H, Remschmidt H, Hebebrand J . Low body mass indices in adolescents with obsessive-compulsive disorder. Acta Psychiatr Scand 1999; 99/4: 267–273.

    Article  Google Scholar 

  27. Hebebrand J, Henninghausen K, Nau S, Himmelmann GW, Schulz E, Schafer H, Remschmidt H . Low body weight in male children and adolescents with schizoid personality disorder or Asperger's disorder. Acta Psychiatr Scand 1997; 96/1: 64–67.

    Article  Google Scholar 

  28. Pine DS, Cohen P, Brook J, Coplan JD . Psychiatric symptoms in adolescence as predictors of obesity in early adulthood: a longitudinal study. Am J Public Health 1997; 87/8: 1303–1310.

    Article  Google Scholar 

  29. Altfas JR . Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment. BMC Psychiatry 2002; 13/2: 9.

    Article  Google Scholar 

  30. Agranat AN Oral representation at the 50th Anniversary Meeting of the American Academy of Child and Adolescent Psychiatry in October 2003.

  31. Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ . Obesity and psychiatric disorder: developmental trajectories. Pediatrics 2003; 111: 851–859.

    Article  Google Scholar 

  32. Lumeng JC, Gannon K, Cabral HJ, Frank DA, Zuckerman B . Association between clinically meaningful behavior problems and overweight in children. Pediatrics 2003; 112: 1138–1145.

    Article  Google Scholar 

  33. Biederman J, Faraone SV . Current concepts on the neurobiology of Attention-Deficit/Hyperactivity. J Atten Disord Suppl 2002; 6/1: 7–16.

    Article  Google Scholar 

  34. Salamone JD, Correa M, Mingote S, Weber SM . Nucleus accumbens dopamine and the regulation of effort in food-seeking behavior: implications for studies of natural motivation, psychiatry, and drug abuse. J Pharmacol Exp Ther 2003; 305/1: 1–8.

    Article  Google Scholar 

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Acknowledgements

We thank the patients for their participation. This research was supported by the German Federal Ministry for Education and Research (NeuroNet Marburg, NGFN; 01 GS 0168 and 01 GS 0118).

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry and Psychotherapy, Technical University of Aachen, Germany

    K Holtkamp, K Konrad, B Müller & B Herpertz-Dahlmann

  2. Department of Medical Statistics, Aachen University, Germany

    N Heussen

  3. Department of Psychiatry and Psychotherapy, University of Rostock, Germany

    S Herpertz

  4. Department of Child and Adolescent Psychiatry and Psychotherapy, University of Marburg, Germany

    J Hebebrand

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  1. K Holtkamp
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  2. K Konrad
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  6. B Herpertz-Dahlmann
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Correspondence to K Holtkamp.

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Holtkamp, K., Konrad, K., Müller, B. et al. Overweight and obesity in children with Attention-Deficit/Hyperactivity Disorder. Int J Obes 28, 685–689 (2004). https://doi.org/10.1038/sj.ijo.0802623

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