Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated with Overeating with and without Loss of Control in Youth with Overweight/Obesity

Background: There is growing evidence that attention-deficit/hyperactivity disorder (ADHD) and loss of control (LOC) eating, both prevalent in children and adolescents, may be related to one another. However, the relationship between ADHD and overeating without LOC has been largely unexamined, thus precluding an understanding of the independent contributions of LOC and episode size in these associations. The current study sought to examine associations between ADHD symptoms and maladaptive eating by evaluating three different types of eating episodes characterized by the presence/absence of LOC and the amount of food consumed: objectively large LOC episodes [objective binge eating (OBE)], subjectively large binge episodes [subjective binge eating (SBE)], and objectively large overeating episodes without LOC [objective overeating (OO)]. Methods: Participants were 385 youth (M age=10.89, SD=2.25) drawn from five different research protocols at institutions across the United States. Participants and their parents completed questionnaires and semistructured interviews to assess ADHD symptoms, OBE, SBE, and OO. Results: As hypothesized, negative binomial regressions revealed that ADHD symptoms were significantly associated with OBE, (2)(1)=16.61, p<0.001, and with OO, (2)(1)=10.64, p<0.01. Contrary to expectations, they were not associated with SBE. Conclusions: These results indicate the need for future studies to explore possible shared mechanisms (e.g., impulsivity) underlying associations between ADHD symptoms, OBE, and OO. Clinical implications include support for considering ADHD symptoms in programs that target both prevention of LOC eating and obesity more generally.