Updated 18 July 2017

ADHD medications may cause teenage weight gain

Stimulants like Adderall or Ritalin could be a risk factor for childhood and adult obesity rather than childhood ADHD.


Stimulant medications, rather than the childhood ADHD they are used to treat, could be linked to weight gain during the teenage years, according to a new analysis of medical records.

Read:Medication can cause weight gain

As of 2011, 11% of US kids ages four to 17 had been diagnosed with ADHD, according to the Centres for Disease Control and Prevention. About half of those kids were taking stimulant medications like Adderall or Ritalin. Previous studies suggested ADHD could be a risk factor for childhood and adult obesity.

Schwartz worked on the new study at the Johns Hopkins Bloomberg School of Public Health in Baltimore. He said the results changed researchers' understanding of how ADHD relates to obesity.

'Rebound' after stopping medication

In his study, kids who had taken stimulant medications at a younger age tended to have a "rebound" in weight gain as teens, even after they stopped taking the medication. But researchers said it's not clear why the drugs might cause this delayed jump in weight.

The authors tracked the electronic health records of more than 150 000 children ages three to 18, noting those diagnosed with ADHD, if and when they were treated with stimulant medications and their body mass index (BMI) over time. BMI measures weight in relation to height.

Kids tended to start taking stimulant medications before age 10. Half of the kids took the drugs for less than six months. Kids with ADHD who were not treated with stimulants tended to initially have a higher BMI than kids without ADHD or those treated with stimulants, according to results published in Paediatrics.

But the difference was small, so parents shouldn't think stimulants are helping keep kids' weight down when they are young, Schwartz said.

What's more, kids treated with stimulants appeared to gain more weight in their teen years and ended up with a BMI higher than that of youths without ADHD or past stimulant use. The earlier kids started on stimulants, the earlier and higher their BMIs appeared to rebound upward in adolescence.

"Stimulant-treated ADHD kids had slower BMI growth in early childhood and faster BMI growth in later childhood. These effects were much larger than the ADHD alone effects," Schwartz said. These findings "point a much stronger finger of concern at stimulant use in accounting for the obesity than they do at ADHD itself," Schwartz said. "We believe the treatment is the problem, not the diagnosis itself."

Stimulants suppress appetite

Stimulants may keep weight down at first, he said, because they usually suppress appetite. In fact, the drugs used to treat obesity in recent years have been similar to ADHD drugs, or exactly the same, he said.

Schwartz and his co-authors speculate that stimulant medications may retard growth at first, until the body develops resistance to growth inhibition and eventually "rebounds". But Stephen V. Faraone, who studies ADHD at SUNY Upstate Medical University in Syracuse and was not involved with the study, believes it is too soon to say stimulants cause the rebound.

It is possible that longer-term stimulant use leads to obesity later on, he told Reuters Health in an email. "But this assumes that, for example, patients with 10 years of (stimulant) treatment have the same severity of illness as those with one to two months of treatment," Faraone said. "Clearly, that is not the case.

"It could be that kids with the worst ADHD symptoms end up on medication earlier or for longer, and when they go off the medication their ADHD symptoms return and lead to obesity-inducing behaviours, like overeating," he said. That would mean the ADHD itself, not the medication, leads to weight gain. The data are still stronger for that theory, he said.

Apparent overuse

"The observation of 'rebound' is important, even though we cannot be sure how to explain it," Faraone said. More and more stimulants have been prescribed in recent years, strongly influenced by pharmaceutical companies, Schwartz said. "These findings should really give us pause about such apparent overuse," he said.

Since kids with ADHD are at greater risk for obesity, their doctors should check their BMI at least once a year, the authors write."Our findings suggest parents may want to be aware that a possible side effect of such treatment is rapid weight gain after the stimulants are stopped," Schwartz said.

Read more:

ADHD and diet


Parenting a child with ADHD

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Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation ( She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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