[The relationship between attention deficit hyperactivity disorders (ADHD) and obesity]

The obesity epidemic has been recognized as a worldwide problem. More than 1/3 of the adults and about 15% of children and adolescents are overweight. In the search for the reasons for obesity and refractory obesity, some research efforts have recently been directed into the relationship between obesity and attention deficit hyperactivity disorder (ADHD). This link can be explained by two theoretical approaches: ADHD leads to obesity because of the impulsive behavior of ADHD patients; both obesity and ADHD originate from a similar psycho-pathological mechanism. ADHD is usually diagnosed in childhood with symptoms of hyperactivity, impulsivity, and distraction, often continuing into adulthood with symptoms of disorganization, frustration, and excessive emotional reaction. Treatment of ADHD requires a multidisciplinary approach of medication, psychological treatment, occupational therapy (in children) and nutritional assistance. Most studies of the association between ADHD and obesity were performed on subjects seeking help for obesity problems. In this population (both children and adults), the percentage of ADHD was found to be significantly higher than the prevalence of ADHD in the general population. Overweight subjects with ADHD, who were treated with medications, showed improved patterns of weight loss and maintenance. In addition, patients diagnosed with ADHD had lower compliance with follow-up visits after bariatric surgery. It seems that the problem is in the correct diagnosis of ADHD in obese patients, followed by medical as well as cognitive behavioral treatment, that can turn the impulsivity into an advantage, driving patients to positive pathways such as physical activity.