Q: My seven-year-old son has recently been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). We have been fortunate enough to be getting some good support from our teachers and doctors so far and have seen some dramatic improvements in several areas. My son also struggles with his weight. We have been doing all the right things—he exercises regularly including organized sports three times a week, he eats a pretty good variety of foods, and we have done a Fit Kids program through our local hospital.
The problem seems to be that he eats too much even though we talk about “stopping when he is full” and “slowing down.” We have seen his intake decrease as a result of the medication he is on. I know this is partially because the medication (Concerta) decreases appetite. But I am also wondering if the medication’s ability to control compulsive behavior is helping his compulsive eating. While both his pediatrician and his psychologist have nodded their heads at me when I ask, I don’t get the feeling they are ready to say “yes” for sure. Have you seen a link between ADHD and overeating?
A: Yes, over and under-eating has been seen with children who have ADHD. Although there is no direct neurological link between eating disorders and ADHD (as a “developmental” disorder, there is certainly ample evidence, from a psychological perspective, that they are). Any chronic health condition—and ADHD is one that affects behavior—can most certainly affect eating behavior.
Although the effect of Concerta is generally a decrease in appetite, and it certainly may be in part due to its effect on compulsive eating, the issue of which is the best medication for the global issue of the ADHD is foremost. Because ADHD is so complex, the decision to take a medication or combinations must be judged on a variety of outcomes.
Although the “stimulant” group of medications generally cause appetite suppression and less eating, this is not always the case with every child, and in addition, other medications for ADHD may cause over-eating. Providers should definitely consider the child’s weight when prescribing medications for this “chronic” condition.
