Attention-deficit/hyperactivity disorder and impairment in executive functions: a barrier to weight loss in individuals with obesity?

BMC Psychiatry

Marco Angriman⁴  Mario Speranza²  Brenda Vincenzi⁵  Erika Comencini³  Samuele Cortese¹ 

[1] Unità Autonoma di Neuropsichiatria Infantile, Ospedale G.B . Rossi, P.le L.A. Scuro, 12, Verona 37134, Italy;Child and Adolescent Psychiatry, Versailles General Hospital, Le Chesnay, France;Child Neuropsychiatry Unit, G. B. Rossi Hospital, Department of Life Science and Reproduction, Verona University, Verona, Italy;Child Neurology and Neurorehabilitation Unit, Department of Pediatrics, Central Hospital of Bolzano, Bolzano, Italy;Massachusetts General Hospital, Schizophrenia Clinical and Research Program, Boston, MA, USA

关键词: Treatment resistance;    Obesity;    Executive functions;    ADHD;   

Others  :  1123909
DOI  :  10.1186/1471-244X-13-286

 received in 2013-03-31, accepted in 2013-07-15,  发布年份 2013

【 摘 要 】

Background

An increasing body of research points to a significant association of obesity to Attention-Deficit/Hyperactivity Disorder (ADHD) and deficits in executive functions. There is also preliminary evidence suggesting that children with ADHD may be at risk of obesity in adulthood.

Discussion

In this article, we discuss the evidence showing that ADHD and/or deficits in executive functions are a barrier to a successful weight control in individuals enrolled in weight loss programs. Impairing symptoms of ADHD or deficits in executive functions may foster dysregulated eating behaviors, such as binge eating, emotionally-induced eating or eating in the absence of hunger, which, in turn, may contribute to unsuccessful weight loss. ADHD-related behaviors or neurocognitive impairment may also hamper a regular and structured physical activity. There is initial research showing that treatment of comorbid ADHD and executive functions training significantly improve the outcome of obesity in individuals with comorbid ADHD or impairment in executive functions.

Summary

Preliminary evidence suggests that comorbid ADHD and deficits in executive functions are a barrier to a successful weight loss in individuals involved in obesity treatment programs. If further methodologically sound evidence confirms this relationship, screening and effectively managing comorbid ADHD and/or executive functions deficits in individuals with obesity might have the potential to reduce not only the burden of ADHD but also the obesity epidemics.

【 授权许可】

   
2013 Cortese et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th ed. Text revision. Washington DC: American Psychiatric Association; 2000.
• [2]Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA: The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007, 164:942-948.
• [3]Faraone SV, Biederman J, Mick E: The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006, 36:159-165.
• [4]Simon V, Czobor P, Balint S, Meszaros A, Bitter I: Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry 2009, 194:204-211.
• [5]Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF: Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 2005, 57:1336-1346.
• [6]Pliszka S: Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007, 46:894-921.
• [7]Biederman J, Faraone SV: Attention-deficit hyperactivity disorder. Lancet 2005, 366:237-248.
• [8]Cortese S, Faraone SV, Konofal E, Lecendreux M: Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J Am Acad Child Adolesc Psychiatry 2009, 48:894-908.
• [9]Taylor E, Dopfner M, Sergeant J, Asherson P, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Rothenberger A, Sonuga-Barke E, Steinhausen HC, Zuddas A: European clinical guidelines for hyperkinetic disorder – first upgrade. Eur Child Adolesc Psychiatry 2004, 13(Suppl 1):I7-30.
• [10]Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Dopfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J: Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 2013, 170:275-289.
• [11]Doshi JA, Hodgkins P, Kahle J, Sikirica V, Cangelosi MJ, Setyawan J, Erder MH, Neumann PJ: Economic impact of childhood and adult attention-deficit/hyperactivity disorder in the United States. J Am Acad Child Adolesc Psychiatry 2012, 51:990-1002.
• [12]Hakkaart-van RL, Zwirs BW, Bouwmans C, Tan SS, Schulpen TW, Vlasveld L, Buitelaar JK: Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD). Eur Child Adolesc Psychiatry 2007, 16:316-326.
• [13]Cortese S, Morcillo PC: Comorbidity between ADHD and obesity: exploring shared mechanisms and clinical implications. Postgrad Med 2010, 122:88-96.
• [14]Cortese S, Vincenzi B: Obesity and ADHD: Clinical and Neurobiological Implications. Curr Top Behav Neurosci 2012, 9:199-218.
• [15]de Zwaan M, Gruss B, Muller A, Graap H, Martin A, Glaesmer H, Hilbert A, Philipsen A: The estimated prevalence and correlates of adult ADHD in a German community sample. Eur Arch Psychiatry Clin Neurosci 2012, 262:79-86.
• [16]Fuemmeler BF, Ostbye T, Yang C, McClernon FJ, Kollins SH: Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study. Int J Obes (Lond) 2011, 35:852-862.
• [17]Pagoto SL, Curtin C, Lemon SC, Bandini LG, Schneider KL, Bodenlos JS, Ma Y: Association between adult attention deficit/hyperactivity disorder and obesity in the US population. Obesity (Silver Spring) 2009, 17:539-544.
• [18]Cortese S, Angriman M, Maffeis C, Isnard P, Konofal E, Lecendreux M, Purper-Ouakil D, Vincenzi B, Bernardina BD, Mouren MC: Attention-deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature. Crit Rev Food Sci Nutr 2008, 48:524-537.
• [19]Cortese S, Ramos-Olazagasti M, Klein R, Castellanos F, Proal E, Mannuzza S: Obesity in Men with childhood ADHD: a 33-year controlled, prospective, follow-up study. Pediatrics 2013. in press
• [20]Cortese S, Faraone S, Bernardi S, Wang S, Blanco C: An epidemiologic study of adult attention-deficit/hyperactivity disorder and obesity. Br J Psychiatry 2013. in press
• [21]Altfas JR: Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment. BMC Psychiatry 2002, 2:9. BioMed Central Full Text
• [22]Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen D: Is obesity a risk factor for psychopathology among adolescents? Pediatr Int 2004, 46:296-301.
• [23]Agranat-Meged AN, Deitcher C, Goldzweig G, Leibenson L, Stein M, Galili-Weisstub E: Childhood obesity and attention deficit/hyperactivity disorder: a newly described comorbidity in obese hospitalized children. Int J Eat Disord 2005, 37:357-359.
• [24]Fleming JP, Levy LD, Levitan RD: Symptoms of attention deficit hyperactivity disorder in severely obese women. Eat Weight Disord 2005, 10:e10-e13.
• [25]Alfonsson S, Parling T, Ghaderi A: Screening of adult ADHD among patients presenting for bariatric surgery. Obes Surg 2012, 22:918-926.
• [26]Gruss B, Mueller A, Horbach T, Martin A, de Zwaan M: Attention-deficit/hyperactivity disorder in a prebariatric surgery sample. Eur Eat Disord Rev 2012, 20:e103-e107.
• [27]Nazar BP, Pinna CM, Suwwan R, Duchesne M, Freitas SR, Sergeant J, Mattos P: ADHD rate in obese women with binge eating and bulimic behaviors from a weight-loss clinic. J Atten Disord 2012. in press
• [28]Reinert KR, Po'e EK, Barkin SL: The relationship between executive function and obesity in children and adolescents: a systematic literature review. J Obes 2013, 2013:820956.
• [29]Fitzpatrick S, Gilbert S, Serpell L: Systematic review: Are overweight and obese individuals impaired on behavioural tasks of executive functioning. Neuropsychol Rev 2013. in prss
• [30]Davis C, Levitan RD, Smith M, Tweed S, Curtis C: Associations among overeating, overweight, and attention deficit/hyperactivity disorder: a structural equation modelling approach. Eat Behav 2006, 7:266-274.
• [31]van Strien T, Frijters J, Berges G, Defares P: The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Eat Dis 1986, 5:295-315.
• [32]Luman M, Tripp G, Scheres A: Identifying the neurobiology of altered reinforcement sensitivity in ADHD: a review and research agenda. Neurosci Biobehav Rev 2010, 34:744-754.
• [33]Cortese S, Isnard P, Frelut ML, Michel G, Quantin L, Guedeney A, Falissard B, Acquaviva E, Dalla BB, Mouren MC: Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents. Int J Obes (Lond) 2007, 31:340-346.
• [34]Strimas R, Davis C, Patte K, Curtis C, Reid C, McCool C: Symptoms of attention-deficit/hyperactivity disorder, overeating, and body mass index in men. Eat Behav 2008, 9:516-518.
• [35]Kelly NR, Bulik CM, Mazzeo SE: Executive functioning and behavioral impulsivity of young women who binge eat. Int J Eat Disord 2013, 46:127-139.
• [36]Dempsey A, Dyehouse J, Schafer J: The relationship between executive function, AD/HD, overeating, and obesity. West J Nurs Res 2011, 33:609-29.
• [37]Pieper JR, Laugero KD: Preschool children with lower executive function may be more vulnerable to emotional-based eating in the absence of hunger. Appetite 2013, 62:103-109.
• [38]Porrino LJ, Rapoport JL, Behar D, Ismond DR, Bunney WE Jr: A naturalistic assessment of the motor activity of hyperactive boys. II. Stimulant drug effects. Arch Gen Psychiatry 1983, 40:688-693.
• [39]Tin SP, Ho SY, Mak KH, Wan KL, Lam TH: Breakfast skipping and change in body mass index in young children. Int J Obes (Lond) 2011, 35:899-906.
• [40]Pagoto SL, Curtin C, Bandini LG, Anderson SE, Schneider KL, Bodenlos JS, Ma Y: Weight loss following a clinic-based weight loss program among adults with attention deficit/hyperactivity disorder symptoms. Eat Weight Disord 2010, 15:e166-e172.
• [41]Nicolau J, Ayala L, Francés C, Zubillaga I, Muñiz MJ, Rodriguez I, Gómez LA, Fortuny R, Masmiquel L: Frequency of attention-deficit/hyperactivity disorder (ADHD) in a bariatric post surgery sample: clinical, analytical and psychological differences among bariatric patients with ADHD criteria. Endocrine Abstracts 2013, 32:P777. doi:10.1530/endoabs.32.P777
• [42]Speranza M, Loas G, Wallier J, Corcos M: Predictive value of alexithymia in patients with eating disorders: a 3-year prospective study. J Psychosom Res 2007, 63:365-371.
• [43]Zhang L, Zhu C, Ye R, Cao Z, Tian Y, Yang P, Hu P, Wang K: Impairment of conflict processing in alexithymic individuals. Neurosci Lett 2011, 504:261-264.
• [44]Levy LD, Fleming JP, Klar D: Treatment of refractory obesity in severely obese adults following management of newly diagnosed attention deficit hyperactivity disorder. Int J Obes (Lond) 2009, 33:326-334.
• [45]Verbeken S, Braet C, Goossens L, van der Oord S: Executive function training with game elements for obese children: A novel treatment to enhance self-regulatory abilities for weight-control. Behav Res Ther 2013, 51:290-299.
• [46]Schwartz MB, Chambliss HO, Brownell KD, Blair SN, Billington C: Weight bias among health professionals specializing in obesity. Obes Res 2003, 11:1033-1039.
• [47]Albayrak O, Putter C, Volckmar AL, Cichon S, Hoffmann P, Nothen MM, Jockel KH, Schreiber S, Wichmann HE, Faraone SV, Neale BM, Herpertz-Dahlmann B, Lehmkuhl G, Sinzig J, Renner TJ, Romanos M, Warnke A, Lesch KP, Reif A, Schimmelmann BG, Scherag A, Hebebrand J, Hinney A: Common obesity risk alleles in childhood attention-deficit/hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet 2013. in press