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Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

International Journal of Obesity volume 31, pages 340–346 (2007)Cite this article

A Corrigendum to this article was published on 29 August 2006

Abstract

Objective:

Preliminary evidence suggests a comorbidity between attention-deficit/hyperactivity disorder (ADHD) and obesity. This study was carried out to identify the clinical characteristics of obese adolescents with a higher probability of ADHD and advance the understanding of the potential factors underlying the comorbidity between obesity and ADHD. We evaluated the association between ADHD symptoms and bulimic behaviors, depressive and anxiety symptoms, degree of obesity, pubertal stage, age and gender in a clinical sample of obese adolescents.

Design:

Cross-sectional study.

Subjects:

Ninety-nine severely obese adolescents aged 12–17 years.

Measurements:

Subjects filled out the Bulimic Investigatory Test, Edinburgh, the Beck Depression Inventory and the State-Trait Anxiety Inventory for Children. Their parents completed the Conners Parent Rating Scale, which assesses ADHD symptoms. The degree of overweight was expressed as body mass index-z score. Puberty development was clinically assessed on the basis of Tanner stages.

Results:

Bulimic behaviors were significantly associated with ADHD symptoms after controlling for depressive and anxiety symptoms. The degree of overweight, pubertal stage, age and gender were not significantly associated with ADHD symptoms.

Conclusion:

Obese adolescents with bulimic behaviors may have a higher probability to present with ADHD symptoms independently from associated depressive or anxiety symptoms. The degree of overweight, pubertal stage, age and gender might not be useful for detecting obese adolescents with ADHD symptoms. Therefore, we suggest systematic screening for ADHD in obese adolescents with bulimic behaviors. Further studies are needed to understand which specific dimension of ADHD primarily accounts for the association with bulimic behaviors. Future research should also investigate the causal link between bulimic behaviors and ADHD and explore potential common neurobiological alterations. This may lead to a better understanding of the effectiveness of stimulants for the treatment of bulimic behaviors in obese subjects.

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Acknowledgements

This work was supported by the Grant number: AOM 95071 from programme Hospitalier de Recherche Clinique de L' Assistance Publique-Hopitaux de Paris, France. We are grateful to Dr Angelo Pietrobelli for his careful revisions and to Dr Dara Musher-Eizenman for editing the manuscript. The first author (SC) thanks Professor Caludio Maffes for his teaching about research methodology and childhood obesity.

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Authors and Affiliations

  1. AP-HP, Service de Psychopathologie de l'Enfant et de l'Adolescent, Hôpital Robert Debré, Paris, France

    S Cortese, P Isnard, G Michel, B Falissard, E Acquaviva & M C Mouren

  2. Dipartimento Materno Infantile e di Biologia-Genetica, Servizio di Neuropsichiatria Infantile, Università degli Studi di Verona, Verona, Italy

    S Cortese & B Dalla Bernardina

  3. AP-HP, Service de Psychiatrie infanto-juvenile, Hôpital Bichat-Claude Bernard, Paris, France

    P Isnard, L Quantin & A Guedeney

  4. AP-HP, Service d'endocrinologie pédiatrique, Hôpital Saint Vincent de Paul, Paris, France

    M L Frelut

  5. Centre thérapeutique Pédiatrique, Croix Rouge Française, Margency, France

    M L Frelut

  6. UPRES 2114, Université François Rabelais, Tours, France

    G Michel

  7. INSERM U669 PSIGIAM (Paris Sud Innovation Group In Adolescent Mental Health Methodology),

    B Falissard & E Acquaviva

  8. Université Paris XI, Paris, France

    B Falissard & E Acquaviva

  9. INSERM U675 ‘Analyse phénotypique, développementale et génétique des comportements addictifs’, Faculté Xavier Bichat, Paris, France

    M C Mouren

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  1. S Cortese
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Correspondence to P Isnard.

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Cortese, S., Isnard, P., Frelut, M. et al. Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents. Int J Obes 31, 340–346 (2007). https://doi.org/10.1038/sj.ijo.0803400

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