Association between binge eating and attention-deficit/hyperactivity disorder in two pediatric community mental health clinics

Objective Attention-Deficit/ Hyperactivity Disorder (ADHD) has been linked with obesity; however its relationship with binge eating (BE) is less clear. We aimed to explore the associations among ADHD, weight, and BE in pediatric mental health clinics. Method We retrospectively reviewed consecutive intakes in two pediatric mental health clinics (N=252). BE was assessed using the C-BEDS scale. Associations between ADHD, BE, and BMI-z score were assessed via regression. Results Mean age was 10.8 (3.7 SD) years. Twelve percent (n=31) had BE. The association between ADHD and BE was statistically significant (OR 16.1, p<.001), and persisted after adjusting for comorbid diagnoses, medications, demographic variables, and clinic. There was a statistically significant association between ADHD and BMI z-scores (β=0.54, p<.001). After adjusting for BE, the relationship between ADHD and BMI z-scores was attenuated (β=0.35, p=.025), and the coefficient for BE was decreased (β=0.75, p=.001). Although stimulant use was associated with a three-fold increase in odds of BE (OR 3.16, p=.006), stimulants were not associated with greater BMI-z scores (β=0.18, p=.32). Discussion There was a significant association between ADHD and BE in two pediatric mental health clinics. Although these data are cross-sectional, and cannot be used to make causal inferences, these findings are compatible with the hypothesis that BE partially mediates the association between ADHD and BMI z-scores. In mental health clinics, children with ADHD may present as overweight or obese. Further, children with ADHD may exhibit BE. Future prospective studies should elucidate the complex relationships among ADHD, weight, stimulants, and BE.