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ADHD not treated with stimulants led to higher childhood BMI
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Higher childhood BMI was associated with attention-deficit/hyperactivity disorder that was not treated with stimulants, according to recent study findings published in Pediatrics.
“Stimulants appear to slow the rate of BMI growth in early to mid-childhood and then to accelerate growth rates in later childhood, generally after discontinuation of the medication,” the researchers wrote.
Brian S. Schwartz, MD, MS, of the department of environmental health sciences at Johns Hopkins Bloomberg School of Public Health, evaluated longitudinal electronic health record data from Geisinger Health System for 163,820 children aged 3 to 18 years (mean age at first BMI was nearly 9 years) to determine the associations of ADHD diagnosis and stimulant use on BMI trajectories throughout childhood and adolescence.
Diagnosis of ADHD was based on ICD-9-CM codes for outpatient encounters or medication orders. Overall, 8.4% of patients had encounter diagnoses for ADHD; of those, 24.1% had one diagnosis and 59.6% had four or more diagnoses. An order for stimulants was made in 6.8% of patients, whereas 9.5% had a stimulant order or an ADHD diagnosis.
Nearly 72% of patients who had only one ADHD diagnosis were never treated for ADHD.
More than 200,000 orders for medications were used in the analysis with a mean stimulant duration of 426.3 days. Medical assistance was more likely in those patients who received a stimulant order (54%) compared with those who did not (32%).
Across all ages groups, girls had higher BMI than boys (P<.0001). However, across all age groups, patients who received medication had higher BMI compared with those who did not (P<.0001).
Further, slower childhood BMI growth was associated with a younger age at first stimulant order; however, the researchers wrote that earlier and stronger BMI growth rebounding was associated with the earlier stimulants were ordered.
“The findings have relevance to concerns raised about growth rate and its potential adverse long-term consequences,” the researchers wrote. “Our findings should motivate greater attention to the possibility that longer-term stimulant use plays a role in the development of obesity in children.”
Disclosure: The study was funded in part by the NIH. The researchers report no relevant financial disclosures.
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