Stimulant Medication Use Linked to Sharp Increase in BMI by Eighth Grade

New evidence suggests that children on ADHD medication may have stunted growth initially but more rapid increases in body mass over time

Peter Simons
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New research, led by April Bowling at Merrimack College, has found that stimulant medication use by children diagnosed with ‘ADHD’ predicts lower BMI for several years, then a sharp increase in BMI by eighth grade. The article, published in the journal Obesity, provides evidence that children who used stimulant medications for ADHD initially had the typical stunted growth shown in other studies. However, during fifth through eighth grade, children taking these medications experienced a much higher growth in BMI than other children.

“BMI in fifth grade, when children were an average of 11 years old, was significantly lower among children taking medication to manage their ADHD symptoms as compared to children who were not taking medication,” Bowling reports. However, “the children in our analysis taking stimulants […] experienced greater increases in BMI between fifth and eighth grade.”

Photo Credit: “Adderall,” Flickr

Children taking stimulants experienced this pattern of sudden sharp increase in BMI between fifth and eighth grade. However, children who were not taking medications for ADHD experienced the same BMI change as children who did not have an ADHD diagnosis.

One previous study, led by Brian Schwartz, was published in the journal Pediatrics in 2014. Schwartz found a similar increased BMI in adolescence for students who were prescribed ADHD medications.

Schwartz’s study used a longitudinal analysis of health record data from 163,820 children in Pennsylvania. In that study, there was no increased BMI trajectory for unmedicated children. However, children who were taking stimulants experienced a sharp increase in BMI, leading to overweight and obesity classifications by high school. Schwartz described this as a “rapid rebound to higher BMIs.”

In the current study, Bowling set out to replicate this finding with a more nationally representative sample, including more diverse racial groups—and to be able to rule out dietary and exercise changes that might have contributed.

The study focused on stimulant medications, such as Adderall (amphetamine salts) and Ritalin (methylphenidate). Bowling wanted to study a large, diverse group of children to determine if these medications were associated with increased BMI over time. Previous researchers had hypothesized that this BMI increase might be due to dietary or exercise changes, instead of medication use. However, the current study is able to rule out these other potential causes.

The current study included 8,250 children. 650 of those (8%) carried an ADHD diagnosis. Almost 60% (380) of the children with an ADHD diagnosis were prescribed a medication by 8th grade. All children taking medication were considered to be taking stimulants since stimulants are by far the most common medications for ADHD.

Unfortunately, Bowling’s study could not follow the children past eighth grade, so the researchers could not say for sure whether the increasing BMI trend would have continued into overweight and obesity. However, they cite Schwartz’s study as an example of evidence that it might.

Of course, the BMI has been criticized as a measure of health. Previous criticisms focus on outliers, such as heavily muscled athletes, who have high BMIs. Other criticisms include some evidence suggesting that higher BMIs are not actually correlated with poor health outcomes.

However, it is still a standard method of calculating body fat and appears to generally correlate with metabolism, which is a helpful metric in this study. It serves as an example of a physical effect that is seen only in the children taking stimulant medication—an effect that may have potential health consequences as the children reach adolescence.

As expected, the ADHD diagnosis was also correlated with poor diet. However, this was true regardless of whether the child was taking medication or not. Thus, poor diet could not have been responsible for the effect. Likewise, in the analysis, exercise levels were not found to be responsible for the effect.

The researchers suggest that clinicians assess diet and exercise for children diagnosed with ADHD, but that this is likely not responsible for the BMI rebound. Instead, they suggest that more research be conducted into the potential metabolic side effects of prescription stimulants that are given to children.

 

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Bowling, A., Davison, K., Haneuse, S., Beardslee, W., & Miller, D. P. (2017). ADHD medication, dietary patterns, physical activity, and BMI in children: A longitudinal analysis of the ECLS‐K study. Obesity. doi:10.1002/oby.21949 (Link)

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Peter Simons
MIA-UMB News Team: Peter Simons comes from a background in the humanities where he studied English, philosophy, and art. Now working on his PhD in Counseling Psychology, his recent research has focused on conflicts of interest in the psychopharmaceutical research literature, the use of antipsychotic medications in the treatment of depression, and the general philosophical and sociopolitical implications of psychiatric taxonomy in diagnosis and treatment.

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17 COMMENTS

    • Maybe the medication induces nutrient deficiencies, the weight gain caused by the insufficient amounts of said nutrients in the individuals’ diets, so they eat more trying to get them. Remember, none of this needs conscious awareness of the situation by the individuals involved.

      • Quite probably BCharris. I believe I was nutrient deprived during my 24 years on Rx drugs. Anemic and low on Vitamin B and about everything regardless of what I ate. And 350 pounds and the potential for more because I was hungry all the time. Really, I was never full no matter what. Now, I have lost over 20 pounds and actually can experience satiety again.

  1. BMI takes height into account. If they’re fed a diet suitable for a child of average height, it’s more food than they need. And do they not take the drugs to limit physical activity, the H, for Hyperactivity, in ADHD.

    But I do believe weight gain is a known thing in meth users. Meth causes users to remain fixed in one place, typically in front of a computer these days, burning calories only in their brains.

    Plus, a few years ago, I thought I noticed that the women in methie social sets are built like boys with beer bellies. I even asked an endocrinologist if meth affects sex hormones. For what it’s worth, she said it does. It’s similar enough to Adderall that I expect Adderall does the same thing (if meth really does it).

  2. Let’s hope some day our society will learn that putting millions of children of drugs, chemically identical to cocaine, was a really stupid idea. From my perspective, only satanists would believe doing such was a good idea. Although, the doctors do call me crazy for belief in the Holy Spirit.

          • I find it is harder to be fat – not only for the social reasons (fat shaming) that you mention.

            I find I have to fight harder for medical treatment – because after all, my BMI is the source of “all of my health problems” according to doctors.

            The endocrinologist brought out a tape measure and humiliatingly measured me to tell me that my belly was too big. Well, duh! The reason I was seeing him was the difficulty I have losing weight, in spite of a fairly good (not perfect) diet and 3x exercise weekly with daily walks.

            I think that about 30 kilos would make my knees and hips hurt less. I think that carrying around 2 big bags of kitty litter makes it harder to climb stairs, and makes my heart work harder.

            I do believe that how fit I am is more important than how fat I am. But I do believe it would be easier on my body and my social settings to be thinner.

            This has nothing to do with eugenics, and a lot to do with iatrogenic damage. I was always so skinny before the drugs and surgeries…

            I shudder to think how damaging and difficult it would be to have this struggle from the age of 10, instead of the age of 40.

          • Jan, I’m not a naturally skinny person myself. But I would probably weigh 170-180 pounds rather than 350 if I hadn’t gone on this crap at 18. If I put effort into it, after going off the poisons, I can probably lose 75% of the excess weight the drugs packed on. Lost 20 so far. Gonna try to lose 120 more before my next birthday (almost a year away.) Fear if I wait too long I will never lose it!

            Btw, my idiot doctor says I should weigh 120 pounds and lose all the weight between bimonthly visits while taking my “cocktail.” The quack is dumb as they come. Still believes SSRI’s “unmask” mental “diseases” and SMI labels don’t cause discrimination. He’s an ignoramous, a liar, or both; and I don’t trust him. Doesn’t know I have gone drug free either, and I’m not about to tell him!

  3. My nephew is on Rx drugs now at age ten. I’m really upset about it. Not sure what they are; my brother says they are to “help” with his anxiety so they could be any one of a number of poisons. He’s only ten years old, but as a former worker for Eli Lilly if my brother acknowledged these drugs are harmful his conscience would probably really bother him.

    • Oh YetAnother, that’s awfully young.

      If it’s “anxiety” it is likely to be: 1. Mood stabiliser (anti-seizure drug), 2. Antidepressant (really gonna be hard for him to reach sexual maturity), or 3. Neuroleptic (“anti-psychotic”) which is life destroying.

      If you can tease out the drug name, you can name the horrible side effects in the young. Only Prozac is approved for people so young, so this is bound to be off-label prescribing.