ADHD tied to higher BMI, short stature

Children with attention-deficit/hyperactivity disorder (ADHD), especially those treated with methylphenidate, tend to have a higher BMI and be slightly shorter by the time they reach adulthood compared with those who do not have the condition, according to a retrospective cohort study.

Researchers used data from the Korean National Health Insurance Service. They identified 34,850 youths with newly diagnosed ADHD, of which 12,866 were prepubertal children aged 6–11 years (mean age 9.3 years, 72.5 percent male) and 21,984 were adolescents aged 12–19 years (mean age 14.5 years, 66.6 percent male). A control group comprising an identical number of children and adolescents without ADHD was established.

In the ADHD cohort, methylphenidate use was documented in 6,816 children (53 percent) and 10,658 adolescents (48.5 percent).

The primary outcomes were BMI and height at adulthood (mean age 21.8 years). Overweight/obese was defined as a BMI of ≥25 kg/m² for males and ≥23 kg/m² for females, while short stature was defined as a height of <174.4 cm for males and <161.8 cm for females.

Among prepubertal children, those with vs without ADHD had a higher BMI (mean 24.3 vs 23.3 kg/m²; p<0.001) but not a similar height (167.8 vs 167.9 cm; p=0.10) at adulthood. Notably, those with ADHD who received MPH therapy had greater odds of a BMI classified as overweight/obese (adjusted odds ratio [AOR], 1.60, 95 percent confidence interval [CI], 1.51–1.71; p<0.001) and short stature (AOR, 1.08, 95 percent CI, 1.02–1.15; p=0.01) at adulthood.

Similar results were observed when the analysis was extended to adolescents with ADHD and methylphenidate exposure.

Additional research is needed to identify modifiable risk factors, optimize treatment strategies, and develop comprehensive guidelines for monitoring growth and metabolic health in populations with ADHD.