title: Association between binge eating and attention-deficit/hyperactivity disorder in two pediatric community mental health clinics.
abstract: 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine, Baltimore, Maryland.|Division of Child and Adolescent Psychiatry, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Shauna P
authors.initials: SP
authors.lastname: Reinblatt
authors.affiliation: Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Jeannie-Marie S
authors.initials: JM
authors.lastname: Leoutsakos
authors.affiliation: Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine, Baltimore, Maryland.|Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland.
authors.forename: E Mark
authors.initials: EM
authors.lastname: Mahone
authors.affiliation: Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Forrester
authors.affiliation: Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine, Baltimore, Maryland.|Division of Child and Adolescent Psychiatry, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Holly C
authors.initials: HC
authors.lastname: Wilcox
authors.affiliation: Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine, Baltimore, Maryland.|Division of Child and Adolescent Psychiatry, the Johns Hopkins University School of Medicine, Baltimore, Maryland.|Department of Pediatrics, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Riddle
mesh_terms: D000293:Adolescent; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D056912:Binge-Eating Disorder / Q000150:complications* / Q000523:psychology; D001835:Body Weight; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000697:Central Nervous System Stimulants
keywords: ADHD; Attention Deficit Hyperactivity Disorder; adolescents; binge eating; children; disinhibited eating; loss of control eating; obesity; overweight; stimulant