Treatment of refractory obesity in severely obese adults following management of newly diagnosed attention deficit hyperactivity disorder

Objective: To determine whether attention deficit hyperactivity disorder (ADHD) pharmacological treatment of severely obese subjects with newly diagnosed ADHD would result in sustained weight loss. Design: Longitudinal clinical intervention study of the effects of ADHD medication on weight change ov...

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Bibliographic Details
Published in:International Journal of Obesity 2009-03, Vol.33 (3), p.326-334
Main Authors: Levy, L.D, Fleming, J.P, Klar, D
Format: Article
Language:English
Subjects:
Adult
Adults
Attention Deficit Disorder with Hyperactivity - diagnosis
Attention Deficit Disorder with Hyperactivity - drug therapy
Attention Deficit Disorder with Hyperactivity - epidemiology
Attention deficit hyperactivity disorder
Binge eating
Biological and medical sciences
Bulimia
Care and treatment
Clinical medicine
Comorbidity
Complications and side effects
Diagnosis
disease severity
Drug therapy
Drugs
Eating behavior
Eating disorders
Emotional disorders
Epidemiology
Female
Health Promotion and Disease Prevention
Humans
Hyperactivity
Internal Medicine
Interviews
Male
Medical sciences
Medicine
Medicine & Public Health
Metabolic Diseases
Mood disorders
Obesity
Obesity - complications
Obesity - epidemiology
Obesity - therapy
original-article
Prevalence
Public Health
Risk factors
Sleep apnea
Treatment Outcome
Weight control
weight loss
Weight Loss - drug effects
Weight Loss - physiology
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Summary:Objective: To determine whether attention deficit hyperactivity disorder (ADHD) pharmacological treatment of severely obese subjects with newly diagnosed ADHD would result in sustained weight loss. Design: Longitudinal clinical intervention study of the effects of ADHD medication on weight change over 466 days. Subjects: 78 subjects (6 male, 72 female, mean age 41.3 years, BMI 42.7 kg m-2) out of 242 consecutively referred severely obese, weight loss refractory individuals were diagnosed as having ADHD. Sixty-five subjects received treatment and 13 remained as controls. Methods: Standard screening tests identified subjects likely to have ADHD. A diagnosis was made in 78 subjects by semi-structured clinical interview. ADHD subjects were screened for comorbid conditions (binge eating disorder, mood disorder, sleep apnea, chronic pain, gastroesophageal reflux disease). Satisfactory resolution of symptoms of comorbid conditions was achieved prior to the introduction of pharmacotherapy for ADHD. Subjects not accepting, tolerating or remaining on ADHD medication served as controls. Weight was measured at sequential clinic visits after initiation of pharmacotherapy. Results: Comorbid conditions were found to be highly prevalent (sleep apnea 56.4%, binge eating disorder 65.4%, mood disorder 88.4%). After an average of 466 days (s.d.=260) of continuous ADHD pharmacotherapy, weight change in treated subjects was -12.36% of initial weight and in controls +2.78%, P
ISSN:0307-0565
1476-5497
DOI:10.1038/ijo.2009.5