Prevalence and Correlates of Attention-Deficit Hyperactivity Disorder in a Diverse, Treatment-Seeking Pediatric Overweight/Obesity Sample

Abstract

Objective: Attention-deficit hyperactivity disorder (ADHD) and obesity are highly prevalent, impairing, and costly conditions, affecting about 10% of children each. Research indicates heightened prevalence of childhood obesity among youth with ADHD. However, more research is needed, examining comorbid ADHD among youth with overweight/obesity (OV/OB) from diverse demographic backgrounds and effects on medically relevant behaviors. The aim of the current study was to examine the prevalence of ADHD in a racially diverse sample of youth in a weight management clinic. Furthermore, we examined the effects of race, rurality, and ADHD on weight status and health behaviors in this under-researched population. Method: Participants included 1003 patients (M age 5 12.55; 58% female; 67% Black/African American; M BMI Z-Score 5 2.54; 98.6% with obesity) in a pediatric weight management clinic serving a rural and urban/suburban area in the southern United States. Parent-reported demographics, ADHD diagnosis, and child health behaviors were recorded. Result: In total, 17.6% (n 5 177) of the sample had an ADHD diagnosis. ADHD status interacted with race to predict standardized body mass index (BMIz), and rurality predicted higher BMIz. Children with comorbid ADHD had significantly more meals per day and fewer active days compared with children with OV/OB without ADHD. Conclusion: ADHD prevalence was higher in this diverse sample of children seeking obesity treatment (17.6%) compared with the prevalence nationally (9%-10%) and in other obesity samples. Comorbid ADHD was related to higher weight status among racial minority youth and increased engagement in unhealthy lifestyle behaviors often targeted in weight management treatment. It is critical to screen for ADHD in pediatric specialty clinics and assess healthy lifestyle behaviors.

Childhood and adolescence physical activity and multimorbidity later in life: A systematic review

“…Nine studies 39 – 42 , 44 – 46 , 48 – 51 were cross-sectional and two were longitudinal (one retrospective and one prospective). 43 , 47 In one longitudinal study 43 physical activity was evaluated from 7 to 55 years old participants through face-to-face interviews administered paper-based questionnaire.…”

“…Height and weight were assessed during clinical visits, with obesity defined as BMI ≥95th percentile (comorbidity). Conversely, a study 42 enrolled obese children (6-19 years old) defined with a clinically assessed BMI ≥95th percentile. Parent-reported days physically active per week, defined as 30 minutes or more of purposeful physical activity were considered.…”

“…Overall, the concept of multimorbidity with a combination of chronic conditions without priorities given on one condition, has been investigated in two studies. 43 , 48 Nine studies 39 – 42 , 44 – 47 , 49 – 51 assessed comorbidities in addition to an index chronic condition at the beginning of the study: ADHD and obesity in four studies, 41 , 42 , 46 , 49 cancer and multiple comorbidities in one study reported in two articles, 44 , 45 congenital heart disease and obesity as comorbidity in one study, 50 hypertension/ type 2 diabetes and obesity as comorbidity in one study. 47 Questionnaires were employed in three studies 43 – 45 , 50 while one study reported in two articles 39 , 40 used accelerometers for physical activity measurements.…”

“… 47 Questionnaires were employed in three studies 43 – 45 , 50 while one study reported in two articles 39 , 40 used accelerometers for physical activity measurements. Seven studies 41 , 42 , 46 – 49 , 51 used interviews to investigate the physical activity with questions directed either to children and adolescents or reported by their parents. The characteristics of the included studies are summarized in Table 1 .…”

Design, Implementation, and Examination of a Remote Patient Monitoring System for Pediatric Obesity: Protocol for an Open Trial Pilot Study

“…Second, the RPMS being evaluated here was designed by the pediatric obesity clinic providers at this specific clinic for its specific target population. Generally, among the patients treated at this clinic, approximately 60% are African American or Black, and approximately 35% live in rural areas of the state [ 31 ]. Thus, this specific RPMS may not be generalizable to clinics located in other parts of the country.…”