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Obesity and ADHD: What's the connection?

Obesity is a common, serious, and costly problem in America today. The CDC reports that 36% of adults and 17% of children in the U.S. are obese.  Among Hispanic and Black youth, obesity rates are even higher when compared to Whites. The medical costs alone for people who are obese are close to $150 billion annually.[1]  Research in the areas of obesity and ADHD shows increasing evidence pointing to a significant association between the two conditions. 

Overweight and obese are terms used to identify ranges of weight that have been shown to be associated with serious health conditions and problems.

For adults with ADHD, the challenges of healthy weight management appear to be greater than for those without ADHD.  For example, one study found that adults with ADHD are 1.58 times more likely to be overweight and 1.81 times more likely to be obese than adults who do not have ADHD.[2]

Children with ADHD also appear to have higher rates of overweight and obesity than their peers without the disorder. However, whether or not a child's ADHD is being treated is also an important factor. Data from the 2003-2004 National Survey of Children's Health found that children whose ADHD treatment plan did not include medication were approximately one and a half times more likely to be overweight than children who received medication as part of their ADHD treatment.[3]

For adults, the weight ranges for overweight and obese are determined by using weight and height to calculate a number called the body mass index (BMI). BMI is used because, for most people, it correlates with the amount of body fat they have.

  • Overweight is defined as a BMI between 25.0 and 29.9.
  • Obese is defined as a BMI of 30 or higher.[4]

A child's body composition varies as he or she ages, and there are significant differences between boys and girls. Thus, a child's weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults.  For children,

  • Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex.
  • Obese is defined as a BMI at or above the 95th percentile for children of the same age and sex.[5]

Why are obesity and ADHD connected?

There are several possible reasons that might explain an increased association between obesity and ADHD.

  1. Lack of Sleep: One quarter to one half of parents of children with ADHD report that their children suffer from a sleep problem, especially problems with falling asleep and staying asleep.[6] It has been observed that adults with ADHD may also have sleep issues as well.When a person doesn't get enough sleep, a hormone in the body called leptin decreases.  Leptin alerts the brain to hunger cues; when there is a decrease of the hormone, appetite increases and metabolism slows resulting in the storage of body fat. (For more information, see ADHD, Sleep, and Sleep Disorders-WWK5D)

  2. Inadequate Levels of Dopamine: Dopamine has been shown to have a significant association with obesity. Dopamine is a neurotransmitter that plays a role in a number of functions in the brain including cognition, working memory, motivation, and perhaps most importantly, regulating the brain?s reward system. Individuals with ADHD have lower levels of dopamine in their brain, which is why some of the above-mentioned functions are often impaired.  Because of the low levels of dopamine in the brain, individuals with ADHD may seek out activities to stimulate and increase these levels. Eating is one activity that produces this increase of dopamine in the brain.[7]

  3. Impulsivity related to ADHD:  Impulsivity and the ability to self-regulate are often impairing symptoms of ADHD. Individuals with poor impulse control are at a higher risk of over-eating, making impulsivity a risk factor for obesity. [8] Individuals with ADHD often have low self-esteem; and when this is couple with poor self-regulation, the person with ADHD may turn to eating either to self-soothe or self-stimulate.  Since self-regulation is impaired, they may also disregard cues indicating their hunger has been satisfied, leading to over-eating.[9]

  4. Poor Organization related to ADHD:  Individuals with poor organization and planning skills are at a higher risk of going for long periods of time without eating, leading to low glucose levels in the brain. The brain, just like the rest of the body, needs energy to work.  Mental concentration uses up glucose from key parts of the brain associated with memory and learning, which is why it is important not to go for long periods of time without eating. Additionally, once a meal is skipped, metabolism decreases and cravings for fat, carbohydrates, and sugar increase.[10]

  5. Stress: While stress itself is not directly a symptom of ADHD, the challenges of dealing with the symptoms of ADHD can often be taxing which can lead to high levels of chronic stress. When a person is faced with high levels of stress, a hormone called cortisol is released in the body. High levels of cortisol have been associated with endocrine changes that can cause an individual to gain and retain weight.[11]

What to do if you have ADHD and problems with weight

These emerging findings suggest that untreated ADHD may contribute to weight issues in adults and children with the disorder. If you or your child has ADHD and struggles with maintaining a healthy weight, make sure that the ADHD is being treated effectively.  Just as health care professionals should routinely screen ADHD patients for other (coexisting) conditions, a comprehensive assessment of one's ADHD symptoms should include examining how ADHD symptoms may be affecting one's weight.

If weight management issues are a concern for your or your child with ADHD, speak to your health care professional about both conditions. Deciding on the appropriate course of treatment to address ADHD symptoms may help to improve your weight status.  A referral to a health care professional who specializes in weight issues or nutrition may be necessary in order to further address the weight condition.

Further Resources

If you are an adult with ADHD and you would like to learn more about managing your weight, these resources can help: 

If you are a parent or caregiver, these weight management resources targeted toward youth can help:

Updated: January 2013

[1] The Centers for Disease Control and Prevention (CDC; 2012) from http://www.cdc.gov/obesity/data/facts.html .

[2] Pagoto, S., et al. (2009) Association Between Adult Attention Deficit/Hyperactivity Disorder and Obesity in the US Population. Obesity, 17(3) 539?544.

[3] Waring, M., Lapane, K. (2008) Overweight in children and adolescents in relation to attention-deficit/hyperactivity disorder: results from a national sample. Pediatrics, 122 (1) 1-6.

[4] The Centers for Disease Control and Prevention (CDC; 2012) from http://www.cdc.gov/obesity/adult/defining.html

[5] The Centers for Disease Control and Prevention (CDC; 2012) from http://www.cdc.gov/obesity/childhood/basics.html

[6] Corkum, P.H., Tannock, R., & Moldofsy, H. (1998) Sleep disturbances in children with attention deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 37: 637-646.

[7] Cortese, S.,  Vincenzi, B. (2011) Obesity and ADHD: Clinical and Neurobiological Implications. Behavioral Neuroscience of Attention Deficit Hyperactivity Disorder and Its Treatment,   9: 199-218.

[8] ADHD and Childhood Obesity, Panzer 2006 ? the adhd report?

[9] Rosmond, R., Dallman, M. F., & Björntorp, P. (1998). Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. Journal of Clinical Endocrinology & Metabolism, 83(6), 1853-1859.

[10] Dunn-Meynell, A (2009) Relationship among Brain and Blood Glucose Levels and Spontaneous and Glucoprivic Feeding. The Journal of Neuroscience, 29(21).

[11] Rosmond, R., Dallman, M. F., & Björntorp, P. (1998). Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. Journal of Clinical Endocrinology & Metabolism, 83(6), 1853-1859.

Frequently Asked Questions
My child has been diagnosed with ADHD; isn't he automatically qualified for Section 504 services?
What is FAPE under 504?
What is the difference between Section 504 and IDEA?
My child has ADHD but doesn't qualify for an IEP; can he still qualify under Section 504?
What is LRE?
What is Executive Function?
Can you help me find a doctor or mental health professional?
Is there a simple test to diagnose ADHD?
What is Section 504?
If I request an evaluation, doesn't the school have to do it?
The school says my child has ADHD; now what do I do?
The school says my child needs Ritalin; where do I get it?
What is FAPE under IDEA?
Can someone with ADHD join the military?
I need information on ADD, not ADHD! Do you have any information on ADD?
I've heard of auditory processing disorder (APD.) Could my child have that instead of ADHD?
Are Charter Schools required to follow IDEA?
Does my child need to be physically disabled to get services?
Is it safe for a woman with ADHD to take stimulant medication when she is pregnant or planning on becoming pregnant?
I'm an adult; doesn't ADHD only affect children?
Is it illegal to carry ADHD medications?
If my child has an IEP or gets special education, does she have to be in a different classroom?
My child started taking medication and has developed tics. What do I do?
My daughter wants to play college basketball. Will NCAA rules force her to stop taking her ADHD medication?
My child is very bright. He can't have ADHD, too, can he?
Are children who take stimulant medications more likely to abuse drugs or alcohol later in life?
Can you help me find a summer camp for my child?
Now that the holidays are over, how do I get things back to normal?
I get really stressed over the holidays. Do you have any suggestions to help me cope?
Smoking and ADHD: What's the connection?
My child goes to a private (non-public) school. Do I have a right to see my child's educational records?
Marijuana is now legal in some areas of the U.S. What is the impact of taking marijuana for the teenager or young adult with ADHD?
My child was just diagnosed with ADHD.
Is she eligible for SSI?
My child has been diagnosed with ADHD and I believe she may be eligible for SSI.
What do I need to do to apply?
I've been told that an educational advocate could assist me at my child's IEP meeting. What is an educational advocate and how can I find one?
My daughter has ADHD and is a junior in college. There is a course requirement she must meet to graduate and so far she's failed the course three times. Is there any way she can get a waiver for this requirement so she can graduate?
Will my child's Individual Education Plan (IEP) or Section 504 plan transfer if he changes schools?
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