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Obesity and ADHD

International Journal of Obesity volume 33, page 945 (2009)Cite this article

There is growing evidence demonstrating that there is a link between the proneness to obesity and the attention deficit hyperactivity disorder (ADHD).1 In the March Issue of this Journal, Levy et al.2 reported data providing significant support to this association. Indeed, they showed that severely obese, weight loss refractory individuals diagnosed as having ADHD became successful weight losers after a treatment of ADHD pharmacotherapy. They concluded that this effect was likely attributable to the positive effects of this treatment on relevant behaviors, including self-directedness, persistence and novelty-seeking behaviors. This interpretation is interesting and relevant. However, beyond this explanation, our physiological vision of the biological effects of cognitive effort leads us to either extend this interpretation and/or to propose an alternative explanation. Indeed, recent data support the relevance to consider mental work and its related cognitive effort as a potential mediator of this relationship. In this regard, we have recently demonstrated that mental work substantially increases ad libitum energy intake, plasma glucose instability and cortisolemia.3 Furthermore, hyperphagia and glycemic instability were found to be greater in individuals for whom the intensity of cognitive effort was greater.4 As patients characterized by ADHD are susceptible to commit more cognitive effort to take in charge standard mental tasks, it is likely that knowledge-based work accentuates for them the proneness to hyperphagia and the consequent long-term weight gain. This seems to be concordant with recent data documenting the effects of methylphenidate on energy intake and carbohydrate needs. For instance, Volkow et al.5 showed that after consuming methylphenidate, the brain required about 50% lesser increase in glucose to accomplish a task at the same level of performance. It has also been demonstrated that this medication reduces energy and dietary fat intake in adults.6 The reduction in energy intake could be the result of an increase in the level of dopamine, which is caused by the use of methylphenidate. As methylphenidate was part of the pharmacotherapy used in the Levy et al. study, these observations suggest that the drug probably not only influenced weight loss-related behaviors but also directly affected energy balance, particularly energy intake and its related metabolic variations. Beyond this hypothesis, the results reported by Levy et al. maybe also provide an indirect demonstration that the growing relative importance of mental work in our daily activities could represent another factor potentially explaining the obesity epidemic.

The authors declare no conflict of interest.

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References

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Authors and Affiliations

  1. Department of Nutrition and Food Sciences, Laval University, Québec, Canada

    M Riverin

  2. Division of Kinesiology, Laval University, Québec, Canada

    A Tremblay

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  1. M Riverin
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  2. A Tremblay
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Correspondence to A Tremblay.

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Riverin, M., Tremblay, A. Obesity and ADHD. Int J Obes 33, 945 (2009). https://doi.org/10.1038/ijo.2009.125

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