Obesity in Men Diagnosed With ADHD as Children

在童年被診斷為 ADHD 的男性中的肥胖問題

By Kermit Cole – May 20, 2013

作者：科米特·科爾 – 2013年5月20日

A 33-year controlled, prospective study conducted as a collaboration by researchers in New York, Mexico, and Verona, Italy found that men diagnosed with ADHD as children had significantly higher rates of obesity as adults.

紐約、墨西哥和義大利維羅納的研究人員合作進行了一項為期33年的對照前瞻性研究，發現童年被診斷為 ADHD 的男性在成年後有顯著更高的肥胖率。

The causal link, however – whether a common neurobiological dysfunction underlies both ADHD and obesity, or a tendency toward impulsiveness, or an effect of ADHD medication – is unclear.

然而，因果關係尚不明確——不確定 ADHD 與肥胖是否由共同的神經生物學功能障礙引起，還是因為衝動傾向，或者是 ADHD 藥物的影響。

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Of further interest:

此外，您可能感興趣：

Childhood ADHD linked to obesity in adulthood (Salon)

童年 ADHD 與成年肥胖的關聯（來源：Salon）

上面這段文章來源:
https://www.madinamerica.com/2013/05/obesity-in-men-diagnosed-with-adhd-as-children/

Obesity in Men With Childhood ADHD: A 33-Year Controlled, Prospective, Follow-up Study

童年 ADHD 男性肥胖：一項為期 33 年的對照前瞻性隨訪研究

Samuele Cortese, MD; Maria A. Ramos Olazagasti, PhD; Rachel G. Klein, PhD; F. Xavier Castellanos, MD; Erika Proal, PhD; Salvatore Mannuzza, PhD

山姆艾雷·柯爾特斯醫學博士；瑪麗亞·A·拉莫斯·奧拉扎加斯蒂博士；雷切爾·G·克萊恩博士；F·澤維爾·卡斯特亞諾斯醫學博士；埃里卡·普羅爾博士；薩爾瓦托雷·曼努札博士

Address correspondence to F. Xavier Castellanos, MD, Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, One Park Ave, 7th Floor, 10016 New York, NY. E-mail: francisco.castellanos@nyumc.org

通訊地址：F·澤維爾·卡斯特亞諾斯醫學博士，菲麗絲·格林與蘭道夫·考恩兒童神經科學研究所，紐約大學朗格尼醫學中心兒童研究中心，地址：紐約市公園大道一號，7樓，郵編 10016。電子郵件：francisco.castellanos@nyumc.org

FINANCIAL DISCLOSURE:

財務披露：

Dr. Cortese has received financial support to attend medical meetings from Eli Lilly & Company (2008) and Shire Pharmaceuticals (2009–2010) and has been co-investigator in studies sponsored by GlaxoSmithKline (2007), Eli Lilly & Company (2008), and Genopharm (2009). He has served as scientific consultant for Shire Pharmaceuticals (2009–2010).

柯爾特斯醫生曾獲得 Eli Lilly & Company（2008年）和 Shire Pharmaceuticals（2009-2010年）的資助參加醫學會議，並在 GlaxoSmithKline（2007年）、Eli Lilly & Company（2008年）和 Genopharm（2009年）贊助的研究中擔任共同研究者。他也曾在 2009-2010 年間擔任 Shire Pharmaceuticals 的科學顧問。

The other authors have indicated they have no financial relationships relevant to this article to disclose.

其他作者表示，他們與本文無相關的財務關係需要披露。

OBJECTIVE:

目標：

To compare BMI and obesity rates in fully grown men with and without childhood attention-deficit/hyperactivity disorder (ADHD). We predicted higher BMI and obesity rates in: (1) men with, versus men without, childhood ADHD; (2) men with persistent, versus men with remitted, ADHD; and (3) men with persistent or remitted ADHD versus those without childhood ADHD.

比較在童年時被診斷為注意力不足/過動症（ADHD）與未被診斷為 ADHD 的成年男性的 BMI（體重指數）和肥胖率。我們預測較高的 BMI 和肥胖率出現在以下群體：(1) 有童年 ADHD 的男性相較於無童年 ADHD 的男性；(2) ADHD 持續存在的男性相較於 ADHD 緩解的男性；(3) ADHD 持續存在或緩解的男性相較於無童年 ADHD 的男性。

METHODS:

方法：

Men with childhood ADHD were from a cohort of 207 white boys (referred at a mean age of 8.3 years), interviewed blindly at mean ages 18 (FU18), 25 (FU25), and 41 years (FU41). At FU18, 178 boys without ADHD were recruited. At FU41, 111 men with childhood ADHD and 111 men without childhood ADHD self-reported their weight and height.

患有童年 ADHD 的男性來自一個包含 207 名白人男孩的隊列（平均被診斷年齡為 8.3 歲），他們在平均 18 歲（FU18）、25 歲（FU25）和 41 歲（FU41）時接受了盲測訪談。在 FU18 時，招募了 178 名未患 ADHD 的男孩。在 FU41 時，111 名童年患有 ADHD 的男性和 111 名無 ADHD 的男性自報了他們的體重和身高。

RESULTS:

結果：

Men with childhood ADHD had significantly higher BMI (30.1 ± 6.3 vs 27.6 ± 3.9; P = .001) and obesity rates (41.4% vs 21.6%; P = .001) than men without childhood ADHD. Group differences remained significant after adjustment for socioeconomic status and lifetime mental disorders. Men with persistent (n = 24) and remitted (n = 87) ADHD did not differ significantly in BMI or obesity rates. Even after adjustment, men with remitted (but not persistent) ADHD had significantly higher BMI (B: 2.86 [95% CI: 1.22 to 4.50]) and obesity rates (odds ratio: 2.99 [95% CI: 1.55 to 5.77]) than those without childhood ADHD.

有童年 ADHD 的男性的 BMI（30.1 ± 6.3 vs 27.6 ± 3.9；P = .001）和肥胖率（41.4% vs 21.6%；P = .001）顯著高於無童年 ADHD 的男性。經調整社會經濟狀況和終生精神疾病後，群體差異仍然顯著。ADHD 持續存在（n = 24）和 ADHD 緩解（n = 87）的男性在 BMI 或肥胖率上沒有顯著差異。即使經過調整，ADHD 緩解（但非持續存在）的男性的 BMI 顯著較高（B：2.86 [95% CI：1.22 至 4.50]），肥胖率顯著較高（比值比：2.99 [95% CI：1.55 至 5.77]）相較於無童年 ADHD 的男性。

CONCLUSIONS:

結論：

Children with ADHD are at increased risk of obesity as adults. Findings of elevated BMI and obesity rates in men with remitted ADHD require replication.

童年患有 ADHD 的兒童在成年後有更高的肥胖風險。對於 ADHD 緩解男性中 BMI 和肥胖率升高的發現需要進一步驗證。

Topics: adult attention deficit hyperactivity disorder, attention-deficit/hyperactivity disorder, body mass index procedure, obesity

主題： 成人注意力不足/過動症，注意力不足/過動症，體重指數程序，肥胖

ADHD and Obesity, a 33-Year Study

注意力不足/過動症 (ADHD) 與肥胖：一項33年的研究

August 19, 2013
Franz Fogt

2013年8月19日
弗朗茲·福格特

Dear Sir,

尊敬的先生，

I have read with interest the article, by Cortese et al., Obesity in Men With Childhood ADHD: A 33-Year Controlled, Prospective, Follow-up Study in Pediatrics 2013;131. The study enrolled 6-12 year old subjects with ADHD and controls and followed them for 33 years to review the body mass index later in life.

我非常有興趣地閱讀了科爾特斯等人撰寫的文章《童年 ADHD 男性的肥胖：一項為期33年的對照前瞻性隨訪研究》，該文發表於《兒科學》2013年；131。這項研究招募了6-12歲患有 ADHD 和對照組的受試者，並對他們進行了33年的隨訪，以觀察成年後的體重指數。

I find this study very interesting, but I have a couple of comments regarding the study set up. The methodology section indicates that the study was “a prospective follow-up of 6- to 12-year-old boys with ADHD and boys without childhood ADHD”. If this is a 33 year study which finished in 2013, the patient collective was originated in 1980, the year ADHD was introduced in DSM-III, however, the patients were already 8 years of age when enrolled into the study, which would represent the pre-DSM-III era.

我認為這項研究非常有趣，但我對研究的設置有幾點意見。方法部分指出，這項研究是“對6至12歲患有 ADHD 的男孩和沒有 ADHD 的男孩的前瞻性隨訪”。如果這是一項於2013年結束的33年研究，那麼受試者群體應該在1980年開始，而1980年正是 ADHD 被引入 DSM-III（《精神疾病診斷與統計手冊》第三版）的年份。然而，這些受試者在參加研究時已經8歲，這應該屬於 DSM-III 出版之前的時代。

At this time, children with behavioral difficulties, some of which may be now associated with a diagnosis of ADHD, were commonly diagnosed as “minimal brain damage”. Were the diagnoses from 1980 reevaluated to 1994 standards and how was that done?

當時，有行為困難的兒童，其中一些可能如今會被診斷為 ADHD，通常會被診斷為“輕微腦損傷”。1980年的診斷是否根據1994年的標準重新評估？如果是，這是如何進行的？

In addition, requirement #4 was based upon classroom observations by “blind” observers. Blind observers would introduce a kind of prospective element to the study to a very large number of potential study patients (since the incidence of ADHD is approximately 5%), the full cohort of controls and patients who certainly would have come from a large geographical area and many of such blind observers would have to have been employed to carry out this task.

此外，要求 #4 是基於“盲測”觀察者對課堂中的觀察。盲測觀察者會為研究引入一種前瞻性元素，針對大量潛在的研究受試者（由於 ADHD 的發生率約為 5%），整個對照組和受試者肯定來自於廣泛的地理區域，並且需要聘用許多此類盲測觀察者來完成這一任務。

It is difficult for me to understand how such observers would be able in 1980 to diagnose according to criteria published in 1994. If the “blind” observers were teachers, the discussion must include the possibility that some observation bias may have been present.

我很難理解這些觀察者如何能夠在1980年按照1994年發布的標準進行診斷。如果“盲測”觀察者是老師，那麼討論中必須考慮到觀察偏差可能存在的情況。

Conflict of Interest:
None declared

利益衝突：
無

Submitted on August 19, 2013

提交日期：2013年8月19日

Sleep Problems May Explain ADHD-Obesity Link

睡眠問題可能解釋 ADHD 與肥胖的關聯

May 23, 2013
Karen A. Bonuck

2013年5月23日
凱倫·A·博努克

The finding that childhood ADHD increases the risk of obesity in later life in men, is yet another reason to pay close attention to sleep problems in childhood. Sleep disordered breathing (SDB), which ranges from snoring to obstructive sleep apnea syndrome, significantly elevates the risks for both ADHD and obesity in children.

童年 ADHD 會增加男性在成年後肥胖風險的發現，是另一個需要密切關注兒童睡眠問題的理由。睡眠呼吸障礙（SDB），從打鼾到阻塞性睡眠呼吸暫停綜合症，顯著提高了兒童 ADHD 和肥胖的風險。

Short sleep duration has also been shown to be associated with higher rates of obesity in longitudinal studies. Both SDB and short sleep duration lead to impaired glucose tolerance, insulin resistance, and inflammation, all of which predispose to obesity.

縱向研究還顯示，睡眠時間短與更高的肥胖率有關。SDB 和短暫的睡眠時間都會導致葡萄糖耐受性下降、胰島素抵抗和炎症，這些都會導致肥胖。

SDB’s role in ADHD is more likely tied to abnormal gas exchanges that occur during nighttime sleep interrupted by SDB, along with accompanying sleep fragmentation and adverse neuronal impacts.

SDB 在 ADHD 中的作用更可能與夜間睡眠中由 SDB 打斷的氣體交換異常有關，並伴隨著睡眠片段化和對神經元的不利影響。

The Cortese et al. study likely did not capture information about either sleep disorder, so we cannot know if and how sleep problems were an unobserved, but potentially strong confounding factor in their findings.

科爾特斯等人的研究可能未捕捉到關於任何睡眠障礙的信息，因此我們無法得知睡眠問題是否以及如何成為一個未觀察到但可能強大的混淆因素。

Conflict of Interest:
None declared

利益衝突：
無

Submitted on May 23, 2013

提交日期：2013年5月23日

Children with ADHD are more likely to be overweight

患有 ADHD 的兒童更容易超重

by Vladimir Hedrih, March 21, 2024, in ADHD

作者：弗拉基米爾·赫德里希，2024年3月21日，於 ADHD 研究

New research has found that children aged 4-7 with attention-deficit/hyperactivity disorder (ADHD) are more likely to be overweight or obese. Additionally, children with ADHD tend to perform worse on fitness tests and consume more calories than their peers without ADHD. The paper was published in the Journal of Pediatric Psychology.

新的研究發現，年齡在 4 至 7 歲的注意力不足/過動症（ADHD）兒童更容易超重或肥胖。此外，ADHD 兒童在體能測試中的表現通常較差，且比未患 ADHD 的同齡兒童攝取更多的卡路里。這篇文章發表於《兒科心理學雜誌》。

ADHD is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity, which interfere with daily functioning.

ADHD 是一種神經發育障礙，其特徵是持續的注意力不集中、過動和衝動，這些症狀會影響日常生活功能。

Symptoms include difficulties maintaining attention, disorganization, and forgetfulness. Hyperactivity and impulsivity symptoms often manifest as excessive talking, fidgeting, and difficulty waiting one’s turn. ADHD, typically diagnosed in childhood, can persist into adulthood and negatively affect various life aspects, including academic performance, social interactions, and work productivity.

其症狀包括注意力難以集中、組織能力差和健忘。過動和衝動的症狀通常表現為過度說話、坐立不安，並且難以等待輪到自己。ADHD 通常在童年被診斷出來，可能會持續到成年，並對學業表現、社交互動和工作效率等各方面產生負面影響。

The exact cause of ADHD is not fully understood. Treatment often includes a combination of behavioral therapy, psychoeducation, and medication to manage symptoms and improve functioning. In the United States, estimates state that around 9-10% of children suffer from this disorder.

ADHD 的具體病因尚未完全明確。治療通常包括行為療法、心理教育和藥物治療，以控制症狀並改善功能。在美國，估計有約 9-10% 的兒童患有此病。

Study author Madeline M Curzon and her colleagues noted that ADHD might have shared neurobiological underpinnings with obesity.

研究作者瑪德琳·M·科爾森和她的同事指出，ADHD 可能與肥胖共享相同的神經生物學基礎。

Both of these disorders include deficits in the brain’s sensitivity to rewards and issues with executive functioning. ADHD might also be contributing over time to poor health behaviors. To examine this, these authors conducted a study in which they compared a group of children with ADHD to their peers without this disorder.

這兩種疾病都包括大腦對獎勵的敏感性缺陷和執行功能問題。ADHD 可能隨著時間的推移，會導致不良的健康行為。為了研究這一點，研究者進行了一項研究，將患有 ADHD 的兒童與未患此病的同齡兒童進行比較。

The study included 223 children aged 4 to 7, recruited from a U.S. region with a large Hispanic population for a broader clinical intervention study on ADHD. Of these, 127 displayed clinically significant ADHD symptoms, according to parent reports. The cohort was predominantly male (66%) and Hispanic (over 80%), with 74% having married parents and 83% of the data reported by mothers.

這項研究包括 223 名 4 至 7 歲的兒童，這些兒童來自美國一個西班牙裔人口較多的地區，參與一項更廣泛的 ADHD 臨床干預研究。其中，根據父母的報告，127 名兒童表現出臨床顯著的 ADHD 症狀。研究隊列中，男性佔大多數（66%），且超過 80% 為西班牙裔，74% 的兒童父母已婚，83% 的數據由母親提供。

During a one-hour laboratory visit with their parents, the children’s height and weight were measured, and they completed a brief fitness test. Parents provided information on their children’s dietary habits. At the visit’s end, an accelerometer was attached to each child’s wrist, and parents were instructed to ensure its wear for the following week. This device measures physical activity and movement, offering data on intensity, frequency, and duration.

在一次與父母進行的一小時實驗室訪問中，兒童的身高和體重被測量，並完成了一項簡短的體能測試。父母提供了有關孩子飲食習慣的信息。在訪問結束時，每個孩子的手腕上都安裝了一個加速計，並告知家長確保孩子在接下來的一周佩戴該裝置。這個裝置可以測量身體活動和運動，提供強度、頻率和持續時間的數據。

Results showed that children with ADHD were twice as likely to be overweight or obese compared to their peers without this disorder.

結果顯示，患有 ADHD 的兒童比未患此病的同齡兒童超重或肥胖的可能性高出兩倍。

Girls, but not boys, with ADHD showed higher physical activity compared to girls without this disorder as represented by the number of steps made during a day. However, children with ADHD tended to show poorer physical fitness compared to children without this disorder.

與未患此病的女孩相比，患有 ADHD 的女孩顯示出更高的身體活動量，這可以通過她們一天內的步數來表現。然而，患有 ADHD 的兒童的體能表現往往比未患此病的兒童更差。

There was no significant difference in diet quality between the groups, based on the Healthy Eating Index, but children with ADHD tended to consume more calories than those without the disorder.

根據健康飲食指數，兩組兒童的飲食質量沒有顯著差異，但患有 ADHD 的兒童往往比未患此病的兒童攝入更多的卡路里。

“Our results provide evidence that those with ADHD may be at greater risk for being less fit, consuming more calories, and ultimately having greater risk for having an Ov/O BMI [overweight or obese body mass index values] compared to TD children [children without ADHD].

“我們的結果提供了證據，顯示與普通兒童（TD 兒童）相比，患有 ADHD 的兒童可能面臨較大的體能不足、攝取更多卡路里，最終導致超重或肥胖 BMI 值（Ov/O BMI）的風險更大。

Given the age and ethnicity of our sample, it appears that the relationship between ADHD and poor physical health may be prevalent in Hispanic/Latinx populations and may be occurring earlier than previously identified. As the obesity epidemic continues, identifying vulnerable populations is essential for prevention,” the study authors concluded.

考慮到我們樣本的年齡和族裔，ADHD 與身體健康不佳之間的關係似乎在西班牙裔/拉丁裔人群中更為普遍，且可能比先前所識別的更早發生。隨著肥胖流行的持續，識別易受影響的人群對於預防至關重要，”研究作者總結道。

The study sheds light on the links between ADHD and obesity. However, it should be noted that most of the study participants came from one ethnic group.

這項研究揭示了 ADHD 與肥胖之間的聯繫。然而，需要指出的是，大多數研究參與者來自同一個族群。

Given that cultural norms and living habits are very strong determinants of both physical activity and dietary habits, it is possible that results might not be the same for children from other cultures.

由於文化規範和生活習慣對身體活動和飲食習慣具有很強的決定性，因此不同文化背景的兒童可能不會得到相同的結果。

The paper, “Exploring Differences in Physical Health in Young Children With and Without ADHD,” was authored by Madeline M Curzon, Anthony S Dick, Catherine Coccia, and Paulo A Graziano.

這篇題為《探討 ADHD 和非 ADHD 兒童身體健康差異》的文章由瑪德琳·M·科爾森、安東尼·S·迪克、凱瑟琳·科西亞和保羅·A·格拉齊亞諾撰寫。

文章討論:

Donna – 2013年5月20日晚上11:20

這篇文章忽視的許多事情之一是，對患有 ADHD 的兒童強行使用的“兒童可卡因”及其他藥物，或所謂的“男孩病”，實際上會導致兒童對學校作業和其他事情過度專注，類似強迫症，這嚴重干擾了孩子們的社交能力以及與同齡人建立和維持友誼的能力，正如彼得·布雷金博士和許多其他專家所指出的那樣。由於學校和父母將問題歸咎於孩子們，他們在年幼時就被貼上了 ADHD、雙相情感障礙或其他錯誤的 DSM 診斷標籤，而這些問題通常源於家庭問題、衝突、虐待、創傷、離婚、藥物/酒精濫用及其他危機。這不僅損害了孩子的自信，還會帶來污名化、孤立、霸凌等問題，這些已知會導致自我毀滅行為，如吸煙、飲酒、吸毒、暴飲暴食等，此外，隨著年齡增長，這些孩子也會與同樣陷入困境的兒童/青少年為伍，而他們現在都被標籤為 ADHD 或雙相情感障礙，正如精神科醫師和家庭暴力專家卡羅爾·沃肖博士和其他專家所指出的那樣。

最近另一個嚴重問題是，許多兒童在被錯誤診斷為 ADHD 後，由於利他林類藥物的醫源性影響，大多數被重新診斷為雙相情感障礙，並被強迫服用致命的非典型抗精神病藥物，這些藥物已知會導致代謝綜合症、肥胖、糖尿病和其他健康威脅，就像文章中提到的 ADHD 男性一樣。同樣地，現在許多兒童僅因行為問題而被開具這些非典型藥物，甚至不需要任何“健康”問題的借口。

因此，我認為這又是一篇來自精神病學的錯誤文章，推廣他們典型的偽科學，試圖繼續假裝 DSM 所發明的社會構建標籤是遺傳的、腦部神經錯亂的，或其他毫無根據的說法。他們完全沒有提到這些男孩/男性服用的藥物及其他相關因素，事實上更有可能的是，肥胖和糖尿病的增加是由致命藥物的醫源性作用引起的，因為 ADHD 是一種捏造出來的“疾病”，根本不是被證實的疾病。

最後，他們只是證明了任何有知識的人早已知道的事情：與生物精神病學接觸，接受其偽造的生活毀滅性標籤和有毒藥物，對健康/體重、人際關係、學校表現和其他方面，甚至聲譽、就業機會、保險（健康/人壽/殘障）等，都是極大的危害。精神病學的主要目標是將一時的生活問題和危機變成永久性的，以便最大限度地從受害者的痛苦中獲利，讓他們成為精神病學的永久性“病人”，直到這些受害者因早逝而終結。

這篇關於 DSM 虛假標籤的文章讓我非常憤怒，正如神經科學家弗雷德·博格曼博士以及許多其他人所指出的那樣，ADHD（以及雙相情感障礙）是百分之百的欺詐。博格曼博士撰寫了《ADHD 詐騙》一書，指出使用這些虛假的標籤來推銷致命的藥物是人類歷史上最嚴重的醫學犯罪之一。

現在，隨著主流媒體也開始參與揭露 DSM 背後的偽科學，真希望他們能停止這種不斷散播的謊言，關於所謂基因發現與這些虛構的 DSM 標籤的關聯，這些謊言是為了推廣最新的專利致命藥物。他們難道一點羞恥心都沒有嗎？

Subvet416 – 2013年5月21日早上7:57

Roger Mason, the biochemist, has an excellent explanation of how and why stimulant use can result in obesity.

生物化學家羅傑·梅森對於刺激藥物如何及為何導致肥胖有一個極好的解釋。

http://www.youngagain.org/c26.html

Donna – 2013年5月21日上午11:09

Subvet416,

Subvet416，

Thanks for the link. Very interesting and very applicable to the connection between stimulant drugs and obesity. It is well known that insomnia can contribute to weight gain.

謝謝提供這個連結。這非常有趣，且與刺激藥物和肥胖之間的關聯非常相關。眾所周知，失眠會導致體重增加。

spemat – 2014年4月19日上午11:21

I spent years on dexedrine and it made me lay around and slow etc… never ate much but without them I eat more, I eat very healthy, organic no soda etc. I am more muscular now that they decided not wanting other medications after trying them all and having some feel like I was dying to supposedly being given desoxyn which did nothing at all. If I didn’t have a big mouth I would have dodged it but they never did anything but make my brain feel like it’d subdue… after the brand name ones went though it was never really too great and different… I took the tablets too so I ate during the day.

我服用了多年 Dexedrine（苯丙胺），它讓我變得懶散、行動緩慢，等等……我從來吃得不多，但停藥後，我吃得更多，而且我的飲食非常健康，都是有機的，沒有喝汽水等。我現在比以前更有肌肉，這是因為我嘗試了各種藥物之後，他們決定不再給我其他藥物，並曾經試圖給我 Desoxyn（甲基安非他命），但那完全沒有任何效果。如果我當時閉嘴不說話，我可能就避開這一切了，但這些藥物從來沒有讓我的大腦感覺正常，只是感覺像是被壓制了……當那些品牌藥過期之後，效果就真的不是太好，感覺完全不同……我也服用過片劑，所以我在白天吃東西。