The Impact of ADHD on Outcomes Following Bariatric Surgery: a Systematic Review and Meta-analysis

Mocanu, Valentin; Tavakoli, Iran; Macdonald, Andrew; Dang, Jerry; Switzer, Noah; Birch, Daniel W.; Karmali, Shahzeer

doi:10.1007/s11695-019-03735-5

Cited by 21 publications

(21 citation statements)

References 26 publications

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“…The conclusion of the Levy et al study are in line with the findings from another more recent clinical study [43] highlighting how symptoms of ADHD were associated with an attenuation of weight loss following bariatric surgery in 30 adults with severe obesity, accounted for by deficit in emotional regulation. Interestingly, the Levy et al study also resonates with the findings of a recent meta-analysis [44], showing that, compared to patients without ADHD, those with ADHD presented with a statistically significant reduction in postoperative follow-up (poor adherence to follow-up visits). Although the results of the study by Levy et al and the most recent studies are potentially highly relevant, caution should be used when interpreting them, as they are not based on randomised evidence.…”

Section: Which Are the Implications Of The Link Adhd–obesity For Tsupporting

confidence: 71%

The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling

Cortese

2019

Brain Sciences

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This narrative review is aimed at presenting the most recent evidence on the association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The review is informed by previous relevant systematic reviews and a search in Pubmed and PsycINFO up to 1 August 2019. Although the association between ADHD and obesity would seem, at first, paradoxical, in the past two decades there has been an increasing number of studies on this topic. The present review shows that there is meta-analytic evidence supporting a significant association between these two conditions, at least in adults. Growing evidence is also being published on the genetic and environmental factors underlying the association. However, the cause–effects paths, as well as the exact mechanisms explaining the association, remain unclear. Additionally, empirical evidence guiding the management/treatment of patients with the two conditions is still limited. Therefore, after almost 20 years from the first report of a link between ADHD and obesity, this association continues to be puzzling.

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Section: Which Are the Implications Of The Link Adhd–obesity For Tsupporting

confidence: 71%

The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling

Cortese

2019

Brain Sciences

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“…Leib et al found no association between ADHD and weight loss, and this is in agreement with previous findings in adults . A 2019 meta‐analysis of outcomes in adults after bariatric surgery also showed no significant difference in weight loss between patients with and without ADHD . Leib et al's findings that those diagnosed with ADHD lost as much weight as controls, and those reporting ADHD symptoms lost more than controls, might not seem surprising.…”

supporting

confidence: 75%

“…4 A 2019 meta-analysis of outcomes in adults after bariatric surgery also showed no significant difference in weight loss between patients with and without ADHD. 8 It is obvious that we need to know more about ADHD, obesity and MBS in adolescents. The figures that are available on ADHD in adolescents seeking MBS range widely from 6% to 29% and outcome data beyond one year are lacking.…”

Section: E D I T O R I a Lmentioning

confidence: 99%

“…First of all, the 2019 meta-analysis that found no difference in weight loss between adult patients with and without ADHD, at the same time found that patients with ADHD had significantly fewer follow-up visits after MBS than patients without ADHD. 8 The currently available guidelines tell us to provide extra attention and care to young patients with psychiatric disorders. If the same patterns were to emerge in adolescents with ADHD, how could we possibly deliver high-quality follow-up care to patients who repeatedly do not attend appointments?…”

Section: E D I T O R I a Lmentioning

confidence: 99%

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We still need to know more about adolescents with attention deficit hyperactivity disorder who undergo surgery for severe obesity

Järvholm

2019

Acta Paediatrica

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“…It remains unknown whether the presence of ADHD would affect weight loss and other clinical outcomes in adolescents following bariatric surgery. In the study by Mackey et al, ADHD diagnosis was not related to weight change after bariatric surgery, as previously found in adults . However, there is evidence that the presence of behavioural traits associated with ADHD at the time of treatment, such as impulsivity, inattention or hyperactivity, might still be a barrier to successful weight loss during conservative obesity treatment .…”

Section: Introductionmentioning

confidence: 56%

High prevalence of attention‐deficit/hyperactivity disorder in adolescents with severe obesity seeking bariatric surgery

et al. 2019

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Aim To examine the prevalence of attention‐deficit/hyperactivity disorder (ADHD) and related post‐surgical weight loss in adolescents with severe obesity seeking bariatric surgery. Methods The study population included 84 adolescents (age 13‐19 years; 44 males, 40 females) with severe obesity who sought bariatric surgery at the Sheba Medical Centre in Israel during the years 2011‐2017. Anthropometric and clinical data were collected from medical records. A subgroup of 20 participants filled questionnaires that evaluated ADHD‐like symptoms, eating behaviours and quality of life. Data on adolescents that ultimately underwent surgery (n = 45) were also obtained. Results The prevalence of ADHD was 28.6% in adolescents seeking bariatric surgery, much higher than that of the general adolescent population of Israel (17.1%, P < .001). There were no significant differences in reductions of weight, body mass index, body mass index standard deviation scores and body fat percent between participants with or without ADHD. In the subgroup that filled questionnaires, higher scores on ADHD‐Rating Scale at baseline were associated with greater excess weight loss. Conclusion The prevalence of ADHD in adolescents seeking bariatric surgery was very high. Diagnosed ADHD was not related to post‐surgical weight loss, whereas baseline ADHD‐related behaviour was associated with higher post‐surgical weight loss.

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The Impact of ADHD on Outcomes Following Bariatric Surgery: a Systematic Review and Meta-analysis

Cited by 21 publications

References 26 publications

The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling

The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling

We still need to know more about adolescents with attention deficit hyperactivity disorder who undergo surgery for severe obesity

High prevalence of attention‐deficit/hyperactivity disorder in adolescents with severe obesity seeking bariatric surgery

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