Screen obese children for ADHD, report advises

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The problems some children with attention deficit hyperactivity disorder have in regulating their behavior may lead to abnormal eating patterns, and obesity, according to a team of Israeli researchers.

Thus, “obese children should be screened routinely for ADHD," the authors write in the International Journal of Eating Disorders.

As many as 10 percent of all school-aged children are estimated to have ADHD. Studies have shown this disorder is often accompanied by various psychiatric disturbances including conduct, anxiety and substance abuse disorders. Until now, however, researchers had not investigated any associations between ADHD in children and Eating disorders or behaviors.

To investigate, Dr. Anat N. Agranat-Meged, of Hadassah Mount Scopus Hospital in Jerusalem and colleagues evaluated 26 children, aged 8 to 17 years, who were hospitalized while being treated for obesity.

They found that nearly 60 percent of the children had symptoms of ADHD, “significantly higher than the proportion in the general population for the same school age group.”

Further, although six of the 15 children identified were previously diagnosed with ADHD, nine were diagnosed for the first time during the study, Agranat-Meged and colleagues note. “For the majority of patients the diagnosis of ADHD was missed,” they point out.

Commenting on the study, Dr. Russell Barkley noted that half of all cases of ADHD are not diagnosed or treated. While most of those with the disorder “are not morbidly obese,” he told Reuters Health, they “may be at higher risk (for obesity) given their impulsiveness, lack of self-control” and their lowered likelihood of engaging in regular physical activity.

Barkley, a research professor at the State University of New York (SUNY) Upstate Medical University in Syracuse, is currently involved in an area of research similar to Agranat-Meged’s. Barkley’s preliminary findings are also showing an association between obesity and ADHD in young adults, particularly in girls, he said.

In light of the “striking” prevalence of ADHD found among the obese children in the current study, Agranat-Meged and colleagues recommend that every obese child be screened for attention deficit hyperactivity disorder.

“It has become routine to screen ADHD patients for known comorbid disorders,” the investigators conclude. “Our results suggest ADHD patients should be screened for their eating behavior as well.”

SOURCE: International Journal of Eating Disorders, May 2005.

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