I didn’t expect this research result—a study published today in the medical journal Pediatrics found that children with ADHD, and especially those treated with stimulant medications, are more likely to become obese.

But wait—the stimulant medications used to treat ADHD usually cause weight loss, not obesity.  In fact, we often have to take young children off ADHD medications if they are losing too much weight.  So I was very surprised to find out that these same skinny little school-aged kids with ADHD are growing into obese adolescents.

It seems like the ADHD itself would be the likely culprit for this obesity—people with ADHD seek stimulation, and food is a great stimulant.  I’ve seen patients with ADHD mindlessly eating as a form of self-stimulation.  Eventually, these eating habits lead to obesity.  But this isn’t exactly what the research showed.

This study looked at the body mass index (BMI) of 160,000 children ages 3-18 years.  Children with ADHD that were not on stimulant medications had higher BMIs compared to children without ADHD.  Children with ADHD who were on stimulant medications had lower BMIs as younger children, but eventually experienced a “BMI rebound,” and grew into adolescents with higher BMIs compared to their counterparts without ADHD and those with ADHD who were not treated with stimulant medications.

The authors conclude:

“The findings suggest that stimulant use, rather than ADHD itself, is most strongly associated with growth trajectories in childhood, early BMI rebound, and later obesity. Stimulants appear to slow the rate of BMI growth in early to midchildhood and then to accelerate growth rates in later childhood, generally after discontinuation of the medication.” (Schwartz, B. et al.)

In other words, children with ADHD are at increased risk of obesity.  Stimulant medications seem to make the obesity worse.

What does this mean for parents of kids with ADHD?

  1. If your child is currently taking stimulant medications, don’t stop his or her treatment based only on this research.  The decision to start or stop medication should be based on many factors, and merits a discussion with your pediatrician.
  2. Remember that non-pharmacologic treatments for ADHD are effective, such as neurofeedback and cognitive therapy.  These treatments have no known association with weight gain. (Here’s my article, “Treating ADHD without meds.”)
  3. Talk to your pediatrician about non-stimulant ADHD medications.  In this study, the “BMI rebound” effect that resulted in overweight adolescents was only seen in those patients who were taking stimulant medications.  There are many non-stimulant medications on the market, and you may wish to discuss these options with your pediatrician.  But do consider that stimulant medications are highly studied and highly effective for the treatment of ADHD.  In short, stimulants work very well.  (Here’s my article, “Why do stimulants work for the treatment of ADHD?”)
  4. Remember that any treatment plan for ADHD should include behavioral interventions.  In other words, no-fun-parenting.  Are you parenting a child with ADHD?  Here are six tricks to make your life easier.