Studies Link Psychiatric Labels and Drugs to Obesity and Diabetes Risk Factors, Yet Screening Falls Short

This week, Mad in America examines three studies around mental health diagnosis, psychotropic drug use, obesity, and diabetes screening. The first study links ADHD diagnosis and prescription stimulant use to increased BMI and obesity. The second finds an association between mental health diagnoses, psychotropic drug use, and risk factors for diabetes, including abnormal blood lipids and obesity. The third finds that people with a mental health diagnosis are less likely to receive recommended diabetes monitoring than their peers without a diagnosis. Taken together, these studies tell the story of people placed at higher risk of diabetes linked to psychiatric labels and drugs, who are then systematically neglected in terms of diabetes monitoring.

ADHD Diagnosis and Stimulant Prescription Use Linked to Higher Risk of Obesity

A new study published in JAMA Open finds that South Korean children with an ADHD diagnosis were more likely to be obese in adulthood compared to those without a diagnosis. This link was stronger for people that took the prescription stimulant methylphenidate (MPH). The current work, led by Jihun Song of Korea University, additionally finds that this association was strongest in people with long-term exposure to MPH.

The goal of this research was to examine the link between ADHD diagnosis and MPH prescription (commonly sold as Ritalin) in children to increased BMI, obesity rates, and short stature in adulthood. Using data from the National Health Insurance Service on children between the ages of 6 – 12 and adolescents between the ages of 12 – 19, the authors extracted Information on ADHD diagnosis, MPH prescriptions, other psychotropic drug prescriptions, height, and weight.

Patients that were newly diagnosed with ADHD between 2008 and 2013 were matched with controls in terms of age, sex, and income level for the purposes of comparison and analysis. In order to be included in the current work, participants had to have at least two outpatient visits that endorsed an ADHD diagnosis and had to have gone for at least one national health examination between 2018 and 2022 after reaching adulthood.

Compared to the group without an ADHD diagnosis, those with a diagnosis were 51% more likely to be overweight, including 43% increased likelihood for those not prescribed MPH and 60% increased likelihood in those with an MPH prescription. The group with both an ADHD diagnosis and an MPH prescription was 13% more likely to be overweight or obese compared to the group with an ADHD diagnosis and no MPH prescription.

Long-term (more than one year) MPH prescriptions were more strongly associated with being overweight or obese. Those prescribed MPH for less than one year were 51% more likely to be obese compared to those with no ADHD diagnosis, while the group prescribed MPH for more than one year was 89% more likely to be overweight or obese. Compared to the group without an ADHD diagnosis, those prescribed MPH for less than 1 year were 74% more likely to be severely obese, while those prescribed MPH for more than one year were 129% more likely to be severely obese.

Both the ADHD label and MPH prescription in childhood were linked to increased risk of being overweight in adulthood. While there is evidence in this study associating the ADHD label to increased risk of being overweight or obese, it is important to note that lifestyle was not considered. It is unlikely that this difference is due to biological, genetic, or other internal factors and is probably a function of lifestyle, circumstance, and other environmental variables.

Overall, short stature was not significantly associated with ADHD diagnosis or MPH prescription.

The authors acknowledge several limitations to the current research. Due to the observational design, this data can only say that ADHD diagnosis and MPH use are linked to obesity, not that they definitively cause it. Some confounding variables were not considered, such as parents BMI, nutrition, sleep time, lifestyle, etc. Only people that went for at least one health exam as adults were included. People going for health exams as adults may differ in terms of socioeconomic status and health behaviors from those that did not. The MPH data was based on MPH prescriptions being filled, not actual MPH use. As this research was carried out within South Korea, generalizability to other populations is limited.

Obesity is linked to numerous adverse health outcomes, including cardiovascular disease, liver disease, and diabetes.

Mental Health Diagnosis and Psychotropic Drug Use Linked to Abnormal Blood Lipids

A new Denmark-based study published in the Community Mental Health Journal finds that having a mental health diagnosis is linked to abnormal blood lipids in people that qualify as obese. The current work,led by Mikkel Emil Iwanoff Kolind of Odense University Hospital in Denmark, additionally finds links between psychotropic drug use and obesity related disease such as metabolic syndrome and diabetes. In this research, the strongest link to obesity related illness was BMI.

The aim of this research was to investigate the links between mental health diagnosis and obesity related diseases as well as how psychotropic medication use affects obesity related disease. The authors used data from the South Danish Obesity Initiative at the University Hospital of Southern Denmark, Esbjerg. This program screens people with a BMI of 30 or higher for obesity related disease. The authors included people screened through this program between September 2021 and October 2024.

Participants were divided into groups based on their mental health diagnosis. Those with no diagnosis were placed in the “no mental disorder” group. Other subgroups included schizophrenia, bipolar disorder, depression, and anxiety. Participants with multiple mental health diagnoses were placed in multiple groups corresponding with their diagnoses. In total, the authors examined data from 662 participants, 345 with a mental health diagnosis and 317 without.

Once adjusted to account for the use of psychotropic drugs, having any mental health diagnosis was linked to elevated triglycerides (60% increased odds), triglycerides-HDL-C ratio (130%), and fatty liver disease risk (80%). It is important to note that while this study presents evidence that psychiatric labels are linked to an increased likelihood of abnormal blood lipids, the authors did not account for lifestyle or socioeconomic variables. This means these elevated levels are likely related to environmental and lifestyle factors rather than a biological, genetic, or other internal factor shared by people with a mental health diagnosis.

Overall, participants that were using psychotropic drugs were at elevated risk of metabolic syndrome (70%), elevated triglycerides (100%), high total-to-HDL cholesterol (130%), elevated triglyceride-to-HDL ratio (200%), and non-alcoholic fatty liver disease (60%).

Anxiolytics were linked to increased odds of diabetes (380%). Antidepressants were linked to increased odds of elevated triglycerides (160%), elevated TotalC-HDL ratio (180%), and elevated triglycerides-HDL ratio (220%). Mood stabalizers were associated with increased odds of elevated triglycerides-HDL ratio (190%). Antipsychotics were linked to increased triglyceride levels (90%), elevated TotalC-HDL ratio (120%), and elevated triglycerides-HDL ratio (230%). Hypnotics were linked to elevated triglycerides-HDL ratio (370%).

All the participants in this study had a BMI of 30 or more, indicating obesity. The risk of abnormal blood lipids and diabetes is already elevated in this group. What this research reports is further increased risk of these complications linked to mental health diagnoses and psychotropic drug use within a sample already at increased risk.

The current work included only people with high BMI (30 or above). This means the results may no be generalizable to people that are not considered obese. The authors relied on self-reported data about mental health diagnosis. Self-report data is susceptible to bias through misremembering, misreporting, and giving answers that are socially acceptable rather than true. This research did not included data on lifestyle and socioeconomic status. As this research was carried out within a single program in a Danish hospital, generalizability to other populations is limited.

This study found a link between both mental health labels, psychotropic drug use, and abnormal blood lipids. Past research has linked abnormal blood lipids to diabetes. Anxiolytic drugs in particular were linked to higher rates of diabetes in the current work. Studies have also found an association between antidepressants, antipsychotics, and increased risk of diabetes.

People with a Mental Health Diagnosis Receive Lower Quality of Care for Diabetes Screening

A new study published in the Lancet Psychiatry finds that people with a mental health diagnosis are less likely to receive recommended diabetes monitoring compared to people without a mental health diagnosis. The current work, led by Elias Wagner from the University of Augsburg in Germany, also finds that people with a mental health diagnosis are more likely to receive insulin and less likely to receive a GLP-1 receptor agonist.

The goal of this research was to investigate disparities in diabetes care between people with and without a mental health diagnosis. The authors conducted a systematic review and meta-analysis of previous research that examined disparities in diabetes care related to mental health diagnoses. In total, the authors included data from 49 studies with 5,503,712 participants. The majority of the studies came from the US (28). Six studies came out of the UK, four from Canada , two each from Germany and Denmark, and one each from Italy, Israel, Taiwan, Qatar, Australia, Finland, and France.

Having a mental health diagnosis was linked to 19% decreased odds of receiving any recommended diabetes monitoring. This included reduced odds of blood glucose monitoring (19%), retinal screening (23%), lipid and cholesterol measurement (17%), foot examination (15%), and renal examination (22%). Mental health diagnosis was also associated with 52% increased odds of being prescribed insulin and 74% decreased odds of being prescribed a GLP-1 receptor agonist, such as Ozempic.

There were several limitations for the current work. Some studies combined several different results into one overall measure, assuming that all those results matter equally. But in reality, some of those results may be more important or relevant than others. Some outcomes and mental health diagnoses had small sample sizes. The many countries included in the current research all have different guidelines, care models, and follow-up periods from diabetes. Most studies did not provide data on psychotropic drug use. Some regions, such as Asia, South America, and Africa were not represented at all, or under-represented, limiting generalizability.

Despite the observation of elevated risk factors for diabetes in people with mental health diagnoses, especially those taking psychotropic drugs, this group is less likely to receive recommended diabetes monitoring.

****

Kolind, M. E., Beier, C. P., Nygaard, N.-P. B., Stenager, E., & Juhl, C. B. (2025). Obesity associated disease in people with mental disorders: The role of psychotropic medication and BMI. Community Mental Health Journal, 62(3), 432–442. (Link)

Song, J., Park, S. J., Yu, J., Chung, J., Jeong, S., & Park, S. M. (2026). ADHD and methylphenidate use in prepubertal children and BMI and height at adulthood. JAMA Network Open, 9(1). (Link)

Wagner, E., Højlund, M., Fiedorowicz, J. G., Nielsen, R. E., Østergaard, S. D., Høye, A., Heiberg, I. H., Poddighe, L., Delogu, M., Holt, R. I., Correll, C. U., Cortese, S., Carvalho, A. F., Boyer, L., Dragioti, E., Du Rietz, E., Firth, J., Fusar-Poli, P., Hartman, C. A., … Solmi, M. (2026). Disparities in diabetes treatment and monitoring for people with and without mental disorders: A systematic review and meta-analysis. The Lancet Psychiatry, 13(2), 112–124. (Link)