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Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents

Pediatric Research (2023)Cite this article

Abstract

Aim

Attention-deficit hyperactivity disorder (ADHD) and disordered eating (DE) are both highly prevalent among adolescents, but their relationship is understudied. This study examines their possible association in a nationally representative sample of adolescents.

Methods

Participants in the Israeli Youth Health and Nutrition Survey (2015–2016), a cross-sectional, school-based study, completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. An affirmative reply to at least two SCOFF items was considered a DE case. Multivariable logistic regression evaluated the ADHD-DE association and the associations between ADHD and individual SCOFF items, controlling for age, sex, socioeconomic status, and body mass index.

Results

Of 4616 participants (12–18 years, 50.2% male), 654 reported an ADHD diagnosis. DE prevalence among ADHD adolescents was significantly higher than the non-ADHD group (50.2% vs. 43.9%, p = 0.003). Controlling for potential covariates, the association between ADHD and DE remained significant (OR = 1.409; 95% CI: 1.170–1.697), as did associations between ADHD and three SCOFF items. No difference in DE prevalence was found between stimulant-treated (n = 287) and untreated (n = 326) adolescents with ADHD.

Conclusion

Adolescents with ADHD are more likely to experience DE. As DE can herald an imminent eating disorder, early identification is crucial. Further studies are needed to determine the ADHD-DE relationship’s causality.

Impact

  • Disordered eating (DE) and attention-deficit hyperactivity disorder (ADHD) are common among adolescents, and significantly affect health and well-being.

  • This study examined the association between ADHD and DE in adolescents using the SCOFF questionnaire. Following adjustment for sociodemographic variables and BMI z-score, ADHD was associated with a 41% increased odds for DE.

  • This study established the association between ADHD and DE, using a well-known questionnaire, in a large, nationally representative sample of adolescents. Monitoring eating behaviors and attitudes among adolescents with ADHD should be a priority, to minimize the risk of developing an eating disorder and its harmful consequences.

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Data availability

Data will be provided upon request and in accordance with the decision of the ICDC’s Publications Committee.

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Acknowledgements

The authors would like to acknowledge the diligent work of our study staff that was involved in conducting the survey, and/or collecting data at schools across the country, and to thank all study participants for their valuable contribution.

Author contributors:

C.N.H was involved in designing the study, interpreted the data, and drafted the manuscript; C.D. was involved in designing the study, performed the statistical analyses and interpreted the data; A.H.S helped with interpretation of the data and manuscript writing; R.D. supervised and performed the statistical analyses; M.B. was involved in designing and supervision of the survey; T.S. conceptualized, designed, and supervised the study, interpreted the data, was involved in the initial manuscript drafting and revised the manuscript critically for important intellectual content.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel

    Chen Namimi-Halevi, Chen Dor, Rita Dichtiar, Michal Bromberg & Tali Sinai

  2. School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel

    Aliza H. Stark & Tali Sinai

  3. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Michal Bromberg

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Correspondence to Tali Sinai.

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According to the Ministry of Education guidelines, all parents received written information regarding the survey and only students, whose parents did not oppose in writing the participation of their children, were included in the study. The students reserved the right to refuse participation in any part of the survey.

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Namimi-Halevi, C., Dor, C., Stark, A.H. et al. Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents. Pediatr Res (2023). https://doi.org/10.1038/s41390-023-02925-3

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