Long-term use of stimulants to treat attention-deficit/hyperactivity disorder (ADHD) in children may contribute to higher rates of obesity later in youth, according to a study published in the journal Pediatrics today.
The use of stimulant medications to treat children with ADHD has long been a controversial practice. Concerns have been raised about a possible growth-inhibiting effect of the treatment and the lack of long-term safety data. Despite these concerns, use of stimulants to treat children with ADHD has grown 5-fold since the late 1980s and early 1990s, according to the study authors. Between 2007 and 2010, 4.2% of children under 18 were treated with a stimulant medication. The prevalence of ADHD diagnoses among children has also grown in recent years, from 7.8% in 2003 to 9.5% in 2007 and 11% in 2011, according to the US Centers for Disease Control and Prevention.
The study authors found that children with unmedicated ADHD tended to have higher body mass index (BMI) than those without a diagnosis. In contrast, children with ADHD who were treated with stimulant medications had lower-than-average BMIs. But in those same medication-treated children, BMIs rebounded later in childhood, with longer duration of treatment associated with a more pronounced rebound in BMI. Children who had taken the medication had a steep increase in BMI, whereas those with the diagnosis but no medication leveled off after age 15.
“Our findings should motivate greater attention to the possibility that longer-term stimulant use plays a role in the development of obesity in children,” the authors state.
The authors add that the findings may suggest a greater risk of obesity for all children with ADHD, and they recommend that physicians monitor these children’s weight. The authors also note that behavioral therapies, such as parent training, can be effective nonpharmacological treatments for ADHD, and these approaches have not been associated with the risk of rebounding BMI seen with the medications.