Attention-Deficit/Hyperactivity Disorder (AD/HD) and obesity (BMI > 30) are complex and costly disorders with profound effects on the physical, emotional, and social well-being of individuals, and society. Both are associated with comorbid physical and psychological conditions, and billions of dollars in healthcare costs. Prevalence studies reveal a disproportionate incidence of AD/HD in obese individuals, who often require greater treatment time, incur greater treatment costs, and are frequently less successful treating their obesity than their counterparts without AD/HD, leaving them at higher risk for physical and emotional complications of obesity. Impaired executive function (EF), the cognitive ability for self-understanding and regulation, is a fundamental characteristic of AD/HD. However, EF and AD/HD are rarely considered in assessment or treatment of obese individuals. Little is known about EF, adult AD/HD symptoms, and their relationship with overeating behaviors contributing to obesity.
The purpose of this study was to test the hypothesis that low EF in the domains of attention and impulsivity is seen in individuals with 4 or more symptoms of adult AD/HD, and is associated with specific overeating behaviors of increased emotional eating, low cognitive restraint to food, high disinhibition around food, and high susceptibility to hunger which contribute to adult obesity. A non-experimental single group design was used. Data collected from 125 volunteer community participants included: the Stroop Test (ST) and the Barratt Impulsivity Scale-11 (BIS-11), EF measures; the Adult Self-Rating Scale-IV.I, a screen of adult AD/HD symptoms; the Emotional Eating Scale (EES) and Eating Inventory (EI) measures of overeating behaviors; and Body Mass Index (BMI), an obesity measure.
Analysis of variance (ANOVA) between AD/HD and non-AD/HD participants revealed a subgroup with unique characteristics which lead to obesity. Path analysis was used to test the hypothesized model. Guided by theory, the hypothesized model was modified to better fit the data, and tested using chi square (x2=6.15, 6 df, p = 0.4). Results increase awareness of need to assess for decreased EF and AD/HD symptoms in obese individuals. Strategies need to be developed and tested to address unique challenges of individuals with AD/HD in managing overeating behaviors which lead to obesity.