All Obese Patients Should Be Screened For ADHD

Regular readers will recall previous posts on the association between attention deficit disorder (ADD) and obesity.

As this condition significantly affects impulse control, ability to plan, perseverance, time management, and many other factors and skills essential for weight management, this relationship should be no surprise.

In our own clinical experience (as suggested in several recent publications from others), managing ADD can often be the key step to managing weight gain.

Once you start systematically screening patients for ADD in an obesity clinic, it seems to be present in a surprisingly large number – almost 20-30%.

This number is consistent with the findings of another study, this time by Bruno Palazzo Nazar and colleagues from the Federal University of Rio de Janeiro, Brazil, published in the Journal of Attention Disorders.

The study sample consisted of women seeking nonsurgical treatment of obesity at a public endocrinology hospital with an eating disorders and obesity clinic, in Rio de Janeiro.

One hundred and fify-five consecutive patients presenting in the clinic were approached for this study. Exclusion criteria included less than 5 years of schooling/inability to read and fill out forms and questionnaires; current alcohol or drug abuse, history of bipolar or psychotic disorder; current treatment with psychoactive drugs; and presence of uncontrolled clinical, neurological, or endocrine disorders, especially if they interfere with weight, appetite, and attention; and patients older than 60 years.

Based on a battery of validated questionnaires and semi-structured interviews, 28.3% of patients were diagnosed with ADD, which, in turn, was significantly correlated with more severe binge eating, bulimic behaviors, and depressive symptoms.

As the authors note, this rate of almost 30% is far higher than the expected rate of less than 5% in the general population.

In fact, given the rather rigorous exclusion criteria, the actual prevalence of ADHD in this patient set may actually be even higher.

As a clinician, I’d certainly support the notion that we should be aware of the high prevalence of ADHD in patients presenting in obesity programs. Making this diagnosis and managing this issue, may make all the difference in long-term outcomes.

AMS
Cambridge, UK

photo credit: Peter Vidrine via photo pin cc

Nazar BP, Pinna CM, Suwwan R, Duchesne M, Freitas SR, Sergeant J, & Mattos P (2012). ADHD Rate in Obese Women With Binge Eating and Bulimic Behaviors From a Weight-Loss Clinic. Journal of attention disorders PMID: 22930790

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