Abstract
OBJECTIVE: The purpose of the present study was to compare obese patients screening positive or negative for attention deficit/hyperactivity disorder (ADHD) on pretreatment body mass index (BMI), weight loss following a 16 week clinic-based behavioral weight loss program, weight loss attempts, dietary and physical activity habits, perceived difficulty of weight control skills, and eating self-efficacy. DESIGN: Patients who completed a behavioral weight loss program were approached to complete questionnaires on ADHD and eating habits. Medical charts were reviewed to obtain weight at pre- and post-treatment. RESULTS: Participants (N=63) were 75% female, mean age was 49 (SD=10.3), mean body mass index (BMI) was 41.4 kg/m2 (SD=6.8) and 30% screened positive for ADHD on the Adult ADHD Symptom Rating Scale. Participants screening positive for ADHD did not have a higher BMI at baseline (p=0.41), but reported more previous weight loss attempts (p=0.01) and lost less weight (p=0.02) than participants who screened negative. Participants screening positive also reported consuming fast food meals more frequently (p=0.04), higher levels of emotional eating (p=0.002), greater difficulty with weight control skills (p=0.01), and lower eating self-efficacy (p=0.001). CONCLUSION: Attention-related problems appear to be common among weight treatment-seeking samples and represent a significant barrier to weight control that has not yet been addressed in the literature.
References
Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006; 295: 1549–55.
Scott KM, Bruffaerts R, Simon GE, et al. Obesity and mental disorders in the general population: results from the world mental health surveys. Int J Obes (Lond) 2008; 32: 192–200.
Pagoto SL, Bodenlos JS, Kantor L, et al. Association of major depression and binge eating disorder with weight loss in a clinical setting. Obesity 2007; 15: 2557–9.
Grilo CM, Masheb RM. A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder. Behav Res Ther 2005; 43: 1509–25.
Pagoto S, Curtin C, Lemon L, et al. Association between adult attention deficit/hyperactivity disorder and obesity in the US population. Obesity 2009; 17: 539–44.
Lam LT, Yang L. Overweight/obesity and attention deficit and hyperactivity disorder tendency among adolescents in China. Int J Obes (Lond) 2007; 31: 584–90.
Spencer T, Biederman J, Wilens TE, et al. Adults with attention-deficit/hyperactivity disorder: A controversial diagnosis. J Clin Psychiatry 1998; 59 (Suppl 7): 59–68.
Kessler RC, Adler L, Barkley R, et al. The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. Am J Psychiatry 2006; 163: 716–23.
Barkley RA. Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychol Bull 1997; 121: 65–94.
Barkley RA. Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. J Clin Psychiatry 2002; 63 (Suppl 12): 10–5.
Barkley RA, Murphy KR, Fischer M. ADHD in Adults: What the Science Tells Us. New York, Guilford Press, 2007.
Curtin C, Bandini LG, Perrin EC, et al. Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: A chart review. BMC Pediatr 2005; 5: 48.
Waring ME, Lapane KL. Overweight in children and adolescents in relation to attention-deficit/hyperactivity disorder: Results from a national sample. Pediatrics 2008; 122: e1–6.
Altfas JR. Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment. BMC Psychiatry 2002; 2: 9.
Fleming JP, Levy LD, Levitan RD. Symptoms of attention deficit hyperactivity disorder in severely obese women. EatWeight Disord 2005; 10: e10–3.
Erermis S, Cetin N, Tamar M, et al. Is obesity a risk factor for psychopathology among adolescents? Pediatr Int 2004; 46: 296–301.
Agranat-Meged AN, Deitcher C, Goldzweig G, et al. Childhood obesity and attention deficit/hyperactivity disorder: A newly described comorbidity in obese hospitalized children. Int J Eat Disord 2005; 37: 357–9.
Kessler RC, Adler L, Ames M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): A short screening scale for use in the general population. Psychol Med 2005; 35: 245–56.
Clark MM, Abrams DB, Niaura RS, et al. Self-efficacy in weight management. J Consult Clin Psychol 1991; 59: 739–44.
Wadden TA, Foster GD. Weight and Lifestyle Inventory (WALI). Obesity (Silver Spring) 2006; 14 (Suppl 2): 99S–118S.
DPP Research Group. The Diabetes Prevention Program (DPP): Description of lifestyle intervention. Diabetes Care 2002; 25: 2165–71.
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403.
Orchard T, Temprosa M, Goldberg R, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: The Diabetes Prevention Program randomized trial. Ann Intern Med 2005; 142: 611–9.
Ratner R, Goldberg R, Haffner S, et al; DPP Research Group. Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the Diabetes Prevention Program. Diabetes Care 2005; 28: 888–94.
Pagoto SL, Kantor L, Bodenlos JS, et al. Translating the Diabetes Prevention Program into a hospital-based weight loss program. Health Psychol 2008; 27: S91–8.
Adler LA, Spencer T, Faraone S, et al. Validity of pilot Adult ADHD Self-Report Scale (ASRS) to rate adult ADHD symptoms. Ann Clin Psychiatry 2006; 18: 145–8.
Clark MM, Cargill BR, Medeiros ML, et al. Changes in self-efficacy following obesity treatment. Obes Res 1996; 4: 179–81.
Fabricatore A, Wadden T, Sarwer DB, et al. Selfreported eating behaviors of extremely obese persons seeking bariatric surgery: A factor analytic approach. Surg Obes Relat Dis 2006; 2: 146–52.
Conners CK, Sitarenios G, Parker JD, et al. The revised Conners’ Parent Rating Scale (CPRS-R): Factor structure, reliability, and criterion validity. J Abnorm Child Psychol 1998; 26: 257–68.
Levy LD, Fleming JP, Klar D. Treatment of refractory obesity in severely obese adults following management of newly diagnosed attention deficit hyperactivity disorder. Int J Obes 2009; 33: 326–34.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pagoto, S.L., Curtin, C., Bandini, L.G. et al. Weight loss following a clinic-based weight loss program among adults with attention deficit/hyperactivity disorder symptoms. Eat Weight Disord 15, e166–e172 (2010). https://doi.org/10.1007/BF03325296
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03325296