Understanding health behaviors that modify the risk for obesity in ADHD

Delanie K Roberts; Dustin E Sarver; Annah R Cash; Benjamin H Walker; Crystal S Lim

doi:10.1093/jpepsy/jsae018

Understanding health behaviors that modify the risk for obesity in ADHD

J Pediatr Psychol. 2024 Mar 21:jsae018. doi: 10.1093/jpepsy/jsae018. Online ahead of print.

Authors

Delanie K Roberts¹, Dustin E Sarver^{2

3}, Annah R Cash⁴, Benjamin H Walker⁵, Crystal S Lim⁶

Affiliations

¹ Department of Psychology, Children's Hospital of Los Angeles, Los Angeles, CA, United States.
² Department of Psychiatry and Human Behavior, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, United States.
³ Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, United States.
⁴ Department of Psychology, Child Study Center, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States.
⁵ Department of Population Health, University of Mississippi Medical Center, Jackson, MS, United States.
⁶ Department of Health Psychology, University of Missouri, Columbia, MO, United States.

PMID: 38516857
DOI: 10.1093/jpepsy/jsae018

Abstract

Objective: Research provides support for the associated risk of inadequate sleep duration, limited physical activity, and excessive media use in attention-deficit/hyperactivity disorder (ADHD) and obesity. The present study aims to (1) examine the association between ADHD and overweight or obese status (OW/OB); (2) comprehensively examine sleep duration, physical activity, and media use as potential moderators of OW/OB; and (3) examine the moderating effects of these health behaviors cross-sectionally by comparing medicated youth with ADHD, unmedicated youth with ADHD, and youth without ADHD.

Methods: Data were acquired from the 2018 and 2019 National Survey of Children's Health, a nationally representative survey of caregivers conducted across the United States. The current study used data for youth 11-17 years old with a final sample size of 26,644. Hours of sleep, physical activity, and media use per day were dichotomized based on national recommendation guidelines for each health behavior (i.e., either meeting or not meeting guidelines).

Results: The OW/OB prevalence rate was 7% greater among unmedicated youth with ADHD than among medicated youth with ADHD. Medicated youth with ADHD and peers without ADHD had similar OW/OB rates. Among medicated youth with ADHD, physical activity, sleep duration, and media use did not contribute to OW/OB risk after controlling for family poverty level. However, among unmedicated youth with ADHD, meeting sleep duration guidelines was linked to a lower OW/OB risk.

Conclusion: Overall, findings suggest that clinical providers and parents may wish to prioritize improved sleep duration in the management of OW/OB risk in youth with ADHD.

Keywords: ADHD; adolescents; attention; health behavior; hyperactivity; obesity and weight management; school-age children.