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Attention Deficit Hyperactivity Disorder

Relationship Between ADD and Overeating

01/10/2000

Question:

I am 64 and have two conditions that I have had during my lifetime. I now wonder if they might be related and if there might be treatment available. First, I have been extremely overweight most of my life , dieting a lot then gaining it back several times after losing substantial amounts from 70 to 100 lbs. Secondly, my interest in things has always been very wide and seems to jump from one thing to another, for example lately from computers to fishing to web-site development to woodworking to running to working out,etc. I am a CPA with an MBA degree also, at one time years ago I was an engineering student. With that background, my question is: Has there been any link established between ADD and the inability to control weight and is there any medication available? I have just recently lost over 120 lbs and have already gained back over 40...knowing the dangers and not being able to control the binge urges.

Answer:

I have seen no information in the medical literature on ADD and overeating. On a personal, anecdotal note, I have seen three types of overweight patients who get treated for ADD: 1. A few very overweight patients who have a good appetite while taking their ADD-related stimulants but continue to lose weight. Those patients have all had two things in common; better attention allowed them to think about what they were eating rather than eat impulsively, and better attention to themselves allowed them to prioritize exercise into their schedules. 2. I have seen a few overweight patients remain anorectic (not hungry) on their stimulants even after many weeks. Usually, true anorexia is not a good situation, even in fairly overweight persons, since it makes it difficult to eat even the nutrients you need. Thus, even if you are one of the few people who remain unable to enjoy food on stimulants, it is not helpful because you can`t stay that way and do well. 3.Finally, by far, most overweight persons with ADD I have treated lose weight for the first 2-6 weeks (the usual time frame of stimulant induced anorexia), then go back to baseline if no conscious effort has been made to exercise. Most of the new weight-related medical literature makes a very good case for exercise as the only way to keep weight off. In studies of identical twins, even those raised apart, the only time they are not almost the exact same weight as adults is when one exercises regularly and the other does not. Another interesting research note is that the reason exercise seems to be the only way to go is because it is that our appetites appear to be genetically predetermined. Appetite has more effect than other genetically determined variables such as the initial number of fat cells or basic metabolic rate. Since appetite does not increase proportionately to energy used with exercise, the more we exercise the more we can lose and, more importantly, keep off. Of course, binge eating is a different and additional concern. It may reflect a problem in the area of the ADD-related disorders we so often see (compulsive behaviors, impulsivity, depression) so get yourself a good diagnostician familiar with ADD, its related disorders, and behavioral and pharmacologic therapies. In addition, you may want to try our SPORTS MEDICINE site for exercise specifics, as well as our DIET and NUTRITION site. The best of luck to you. I am well aware that true lifestyle change is one of the most difficult tasks we will each ever face!

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati