title: Circadian rhythm disruption as a link between Attention-Deficit/Hyperactivity Disorder and obesity?
abstract: OBJECTIVE
  Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) have a high prevalence of obesity. This is the first study to investigate whether circadian rhythm disruption is a mechanism linking ADHD symptoms to obesity.
  
  
  METHODS
  ADHD symptoms and two manifestations of circadian rhythm disruption: sleep problems and an unstable eating pattern (skipping breakfast and binge eating later in the day) were assessed in participants with obesity (n= 114), controls (n= 154), and adult ADHD patients (n= 202).
  
  
  RESULTS
  Participants with obesity had a higher prevalence of ADHD symptoms and short sleep on free days as compared to controls, but a lower prevalence of ADHD symptoms, short sleep on free days, and an unstable eating pattern as compared to ADHD patients.We found that participants with obesity had a similar prevalence rate of an unstable eating pattern when compared to controls. Moreover, mediation analyses showed that both sleep duration and an unstable eating pattern mediated the association between ADHD symptoms and body mass index (BMI).
  
  
  CONCLUSIONS
  Our study supports the hypothesis that circadian rhythm disruption is a mechanism linking ADHD symptoms to obesity. Further research is needed to determine if treatment of ADHD and circadian rhythm disruption is effective in the prevention and treatment of obesity in patients with obesity and/or ADHD.
authors.affiliation: PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands. Electronic address: s.vogel@psyq.nl.
authors.forename: Suzan W N
authors.initials: SW
authors.lastname: Vogel
authors.affiliation: PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands.
authors.forename: Denise
authors.initials: D
authors.lastname: Bijlenga
authors.affiliation: PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Tanke
authors.affiliation: PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands.
authors.forename: Tannetje I
authors.initials: TI
authors.lastname: Bron
authors.affiliation: Department of Clinical Child and Adolescent Studies, Leiden Institute for Brain and Cognition, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
authors.forename: Kristiaan B
authors.initials: KB
authors.lastname: van der Heijden
authors.affiliation: Department of Clinical Child and Adolescent Studies, Leiden Institute for Brain and Cognition, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
authors.forename: Hanna
authors.initials: H
authors.lastname: Swaab
authors.affiliation: Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands.
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.affiliation: PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands.
authors.forename: J J Sandra
authors.initials: JJ
authors.lastname: Kooij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000523:psychology*; D056912:Binge-Eating Disorder; D015992:Body Mass Index; D002940:Circadian Rhythm; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology*; D015995:Prevalence; D012890:Sleep; D055815:Young Adult
keywords: ADHD; Binge eating; Circadian rhythm; Obesity; Sleep