Children with attention-deficit hyperactivity disorder (ADHD) are at much greater risk of also having a loss of control eating syndrome (LOC-ES), an eating disorder similar to binge eating in adults, according to a new study by researchers at Johns Hopkins Children’s Center.
The research, published in the International Journal of Eating Disorders, demonstrates the possibility of a common biological mechanism linking the two disorders, and the potential for developing a treatment that works for both.
Although many children with ADHD lose weight when treated with the stimulant drugs typically prescribed to control it, ADHD has been also linked to being overweight or obese in this population, said study leader Shauna P. Reinblatt, M.D., assistant professor in the Division of Child and Adolescent Psychiatry at the Johns Hopkins University School of Medicine.
The reason for this link, however, has remained unclear, but experts have suspected a connection between the typical impulsivity of ADHD and dysregulation or loss of control over appetite and eating.
For the study, researchers analyzed 79 children between the ages of eight and 14 from the greater Baltimore area. Each participant underwent assessment that included objective measures and interviews.
The parents of the children also completed reports to help diagnose or rule out ADHD or LOC-ES, the diagnostic criteria for which are similar to binge eating disorder in adults. In both conditions, there is an inability to stop eating at times, even if one wants to.
All the children completed neuropsychological testing to measure how well they were able to control their impulses. For example, in one test, participants were asked to press a key as soon as a green spaceship appeared on a computer screen but refrain from pressing a key when a red spaceship appeared.
Children who had difficulties with this instruction were deemed to have more deficits in impulse control and vice versa.
The findings showed that the chances of having LOC-ES were 12 times higher for children with ADHD, compared with those without the disorder. Also, children who were overweight or obese and had LOC-ES had seven times the odds of also having ADHD, compared with overweight or obese children without LOC-ES.
When the researchers looked at rates of impulsivity regardless of an ADHD diagnosis, they found that odds of having LOC-ES rose along with increases in scores on two different tests for impulsivity.
The results suggest a connection between ADHD and disinhibited eating, although Reinblatt said the roots of the underlying connection remain unknown and need further research.
Children with ADHD who also have LOC-ES might suffer from a stronger form of ADHD marked by more impulsive behavior that particularly manifests in their eating patterns, Reinblatt said. Another hypothesis is that children with both ADHD and LOC-ES might have a shared underlying risk factor, such as a genetic predisposition to impulsivity.
Reinblatt suggested that clinicians should screen for both ADHD and disinhibited eating behaviors, such as LOC-ES.
“Our findings underscore the need for developing new treatment strategies that could help target disinhibited eating in kids who have both ADHD and LOC-ES,” she said.
Source: Johns Hopkins Medicine