Domestic large-scale, population-based research has confirmed a tendency for individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD) in childhood to have a relatively higher body mass index (BMI) in adulthood. In particular, those who used methylphenidate for more than one year during ADHD treatment were more likely to be classified as overweight or obese.

A research team led by Professor Park Sang-min of the Department of Family Medicine at Seoul National University Hospital and Research Professor Song Ji-hoon of Korea University Guro Hospital used data from the National Health Insurance Service to conduct a retrospective cohort study of 34,850 children and adolescents newly diagnosed with ADHD between 2008 and 2013. The team followed them for up to approximately 12 years, tracking them into adulthood (ages 20–25) to analyze changes in adult BMI and height.

ADHD is a representative neurodevelopmental disorder of childhood and adolescence characterized by inattention, hyperactivity, and impulsivity. Methylphenidate is widely used as a first-line treatment that is effective in controlling symptoms, but long-term follow-up evidence has been limited regarding how diagnosis and treatment during growth affect physical indicators in adulthood.

The research team analyzed 12,866 individuals diagnosed with ADHD in childhood (ages 6–11) and 21,984 individuals diagnosed in adolescence (ages 12–19). A control group without ADHD was matched 1:1 based on age, sex, and income level. Use of methylphenidate was classified according to cumulative prescription records during the four years following diagnosis.

The analysis found that the group diagnosed with ADHD in childhood had a significantly higher mean BMI in adulthood than the control group without ADHD. The likelihood of being classified as overweight or obese was also about 1.5 times higher in the ADHD diagnosis group. This tendency was more pronounced in the group treated with methylphenidate, with the highest mean BMI observed among those whose treatment duration was one year or longer.

With respect to height, no difference in mean adult stature was identified based solely on ADHD diagnosis. In the group with experience of methylphenidate treatment, mean height was slightly lower, but even among women, the observed difference was less than 1 cm and therefore not of major clinical significance. The likelihood of being classified as having short stature was somewhat higher in the treatment group, but overall, the correlation between cumulative prescription duration and height was not substantial.

Research Professor Song Ji-hoon stated, “Methylphenidate is an effective medication for controlling ADHD symptoms, and these findings do not imply that treatment should be discontinued,” adding, “However, when long-term treatment is administered to patients during the growth period, it suggests that regular monitoring of changes in weight and height is necessary.” Professor Park Sang-min explained, “This study is significant in that it used nationwide data to conduct long-term analysis of the association between experiences of ADHD treatment in childhood and adolescence and physical indicators in adulthood.”

The findings of this study were published in the latest issue of the international journal ‘JAMA Network Open’.

Popular News