Misuse of prescription stimulants for weight loss, psychosocial variables, and eating disordered behaviors

Jeffers, Amy J.; Benotsch, Eric G.; Koester, Stephen

doi:10.1016/j.appet.2013.01.008

Cited by 72 publications

(59 citation statements)

References 22 publications

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“…For example, prevalence of stimulant misuse specifically for cognitive enhancement was estimated to be <2% in a sample of preuniversity (students preparing to attend university) and university students in Germany, but prevalence estimates of stimulant misuse for the purpose of weight loss has been reported to be nearly 12% 99,100. Studies assessing stimulant misuse among general samples of college students have reported rates between approximately 8% and 34% 54,101,102.…”

Section: Resultsmentioning

confidence: 99%

“…One of the reviewed studies found that college students who are upper classmen or live off-campus may be more likely to engage in nonmedical stimulant use 90. Additional correlates of stimulant misuse among college students have included affiliation with a Jewish religion, perceiving stimulant use as normative, and engaging in problematic weight loss strategies 100,101,115. Weight loss, however, may not be unique to college students, as adolescent prescription stimulant misusers have been found to be more likely to have an eating disorder than students who did not misuse stimulants 96.…”

Section: Resultsmentioning

confidence: 99%

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Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

Weyandt

Oster

Marraccini

et al. 2014

PRBM

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Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and characteristics such as sex, race, use of illicit drugs, and academic performance are associated with misuse of stimulant medications. Results also indicate that individuals both with and without ADHD are more likely to misuse short-acting agents than long-acting agents. These findings have implications for intervention, prevention, and future research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

Weyandt

Oster

Marraccini

et al. 2014

PRBM

View full text Add to dashboard Cite

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“…This dissatisfaction can result in the search for alternative behaviors and unhealthy habits, which are frequently extreme, inadequate, and ineffective [35-38]. …”

Section: Discussionmentioning

confidence: 99%

Change in body weight and body image in young adults: a longitudinal study

2015

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BackgroundThe goal of this study was to identify the effect of the change in body mass index (BMI) from childhood to adulthood on body image satisfaction at 23 years of age in members of the 1982 Pelotas Birth Cohort in Pelotas, RS, Brazil.MethodsThe study used data from the 1986 and 2004–5 follow-up studies. Body shape satisfaction was evaluated using the Stunkard scale. Body shape dissatisfaction was defined as the difference between the figures chosen for the current and ideal body size. BMI z-score changes were calculated as the difference between z-score values at 4 and 23 years of age, using the population internal z-score as standard. The analysis was stratified by sex, and multinomial logistic regression was used in crude and adjusted analyses.ResultsA total of 1963 men and 1739 women were analyzed. The mean age of the participants in 2004–5 was 22.7 years. Of the participants exhibiting increased BMI z-scores, 17% perceived themselves as thinner than ideal, whereas 48% perceived themselves as fatter than ideal. The prevalence of dissatisfaction was higher in women because they perceived themselves as fatter than ideal on the three categories of z-score change (≥ + 0.5 sd; −0.49 to + 0.49 sd and ≤ −0.5 sd); 81% of women exhibiting an increased BMI z-score reported dissatisfaction. The analysis adjusted for confounding factors revealed that women with increased BMI z-scores were less prone to feel thinner than ideal. Additionally, the increased risk of dissatisfaction due to perceiving oneself as fatter than ideal was similar between men and women (RRR = 3.52 95% CI: 2.17 to 4.56 and RRR = 4.08 95% CI: 3.00 to 5.56, respectively) using −0.49 to +0.49 sd as the reference category.ConclusionsIndividuals exhibiting increased BMI z-scores between 4 and 23 years of age reported higher risks of body dissatisfaction at 23 years of age. This finding is important because body dissatisfaction can cause psychological, social, self-esteem problems, and well-being.

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“…Amphetamine use may therefore be associated with dieting and purging behaviour rather than binging behaviour, which might be expected given its role in aiding weight loss, however data is inconsistent. A recent study by Jeffers et al (2013) reported on the wide use of prescribed stimulants (usually used in the treatment of ADHD) as weight loss aids in a group of 705 undergraduate students [28]. …”

Section: Reviewmentioning

confidence: 99%

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

2013

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IntroductionResearch has shown that eating disorder (ED) patients who abuse substances demonstrate worse ED symptomatology and poorer outcomes than those with EDs alone, including increased general medical complications and psychopathology, longer recovery times, poorer functional outcomes and higher relapse rates. This article provides a broad overview of the prevalence, aetiology, assessment and management of co-morbid EDs and substance use disorders (SUDs).ReviewThe co-occurrence of EDs and SUDs is high. The functional relationship between EDs and SUDs vary within and across ED subtypes, depends on the class of substance, and needs to be carefully assessed for each patient. Substances such as caffeine, tobacco, insulin, thyroid medications, stimulants or over the counter medications (laxatives, diuretics) may be used to aid weight loss and/or provide energy, and alcohol or psychoactive substances could be used for emotional regulation or as part of a pattern of impulsive behaviour. A key message conveyed in the current literature is the importance of screening and assessment for co-morbid SUDs and EDs in patients presenting with either disorder. There is a paucity of treatment studies on the management of co-occurring EDs and SUDs. Overall, the literature indicates that the ED and SUD should be addressed simultaneously using a multi-disciplinary approach. The need for medical stabilization, hospitalization or inpatient treatment needs to be assessed based on general medical and psychiatric considerations. Common features across therapeutic interventions include psycho-education about the aetiological commonalities, risks and sequelae of concurrent ED behaviours and substance abuse, dietary education and planning, cognitive challenging of eating disordered attitudes and beliefs, building of skills and coping mechanisms, addressing obstacles to improvement and the prevention of relapse. Emphasis should be placed on building a collaborative therapeutic relationship and avoiding power struggles. Cognitive behavioural therapy has been frequently used in the treatment of co-morbid EDs and SUDs, however there are no randomized controlled trials. More recently evidence has been found for the efficacy of dialectical behavioural therapy in reducing both ED and substance use behaviours.ConclusionFuture research would benefit from a meta-analysis of the current research in order to better understand the relationships between these two commonly co-occurring disorders.

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Misuse of prescription stimulants for weight loss, psychosocial variables, and eating disordered behaviors

Cited by 72 publications

References 22 publications

Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

Change in body weight and body image in young adults: a longitudinal study

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

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