Editorial: Grappling With the Relationships of Attention-Deficit/Hyperactivity Disorder and Obesity

In this issue of the Journal, Reed and colleagues¹ explore the intersection of 2 important public health problems: overweight/obesity and attention-deficit/ hyperactivity disorder (ADHD), both having a high population prevalence and tending to start in childhood. They analyzed data cross-sectionally and longitudinally from a UK birth cohort of 7,908 youth, including 442 with ADHD by either actual diagnosis or parent-rated threshold score. This epidemiologic ADHD prevalence was comparable to those in other countries, although the actual diagnosis rate was lower. They added a cross-lagged longitudinal perspective to previous reports showing a small association of obesity with ADHD, especially in adults. Their clinically important findings include the following. (1) Both disorders are associated with slightly lower birth weight, presumably reflecting a generally less favorable gestation. (2) The shift from underweight to overweight for those with ADHD occurred in preschool years, at 3 to 5 years of age. (3) ADHD symptom severity predicted overweight: for girls, "higher ADHD symptoms at ages 7, 11, and 14 predicted higher body mass index (BMI) at 11, 14, and 17, respectively." For boys, higher ADHD symptoms at age 11 predicted higher BMI at 14 years. (4) Girls had earlier onset of obesity/overweight (not necessarily a higher rate than boys with ADHD). These have numerous clinical and research implications cutting across many areas of inquiry.