Half of all adolescents with severe obesity have neuropsychiatric problems, according to a study led by researchers from Lund University and Gothenburg, Sweden. Two thirds of the adolescents suffered from some type of mental health problem, as reported by themselves or their parents. The outcomes were reported in the paper, ‘High prevalence of neurodevelopmental problems in adolescents eligible for bariatric surgery for severe obesity’, published in Acta Paediatrica
Previous research has reported a long observed a connection between obesity and ADHD/depression/eating disorders, but it has seldom been studied. For their study, the investigators assessed the prevalence of neurodevelopmental problems in adolescents with severe obesity and their associations with binge eating and depression.
Data were collected at inclusion in a randomised study of bariatric surgery in 48 involving 48 teenagers (73% girls), with an average age of 15 and an average BMI of 42. Half of the participants received medical treatment for obesity, while the other half underwent surgery. Parents completed questionnaires assessing their adolescents’ symptoms of attention‐deficit/hyperactivity disorder and autism spectrum disorder and reported earlier diagnoses. Patients answered self‐report questionnaires on binge eating and depressive symptoms.
The results show that over half (26/48 adolescents, 54%) of the parents estimated that their teenagers had difficulties resembling ADHD and/or autism, despite only 15% of them having been previously diagnosed with these conditions. Some 32% of adolescents reported binge eating, and 20% reported symptoms of clinical depression. No significant associations were found between neurodevelopmental problems and binge eating or depressive symptoms. Only a third of the adolescents reported no problems in either area.
"Symptoms of ADHD mean that the person has difficulty with impulse control. This increases the risk of eating without being hungry and the tendency to opt for quick solutions such as fast food," explained Dr Kajsa Järvholm, a psychology researcher at Lund University and the University of Gothenburg. "People on the autism spectrum are sometimes more selective in their eating than others. They only accept certain dishes but may eat more of them as a result. Contrary to our expectations, the adolescents with neuropsychiatric difficulties did not have more problems with binge eating and depression than the other adolescents in the group.”
Altogether, the information provided by the parents and adolescents revealed that two thirds of the patients in the study had difficulties arising from neuropsychiatric problems, binge eating and/or depression.
The researchers believe that the findings reveal a need to personalise treatments for adolescents with severe obesity as the majority also reported mental illness.
“Two thirds of adolescents with severe obesity presenting for treatment at tertiary obesity clinics have substantial mental health problems as reported by themselves or their parents,” the authors concluded. “This indicates the importance of a multi‐professional approach to adolescent obesity treatment and the necessity to screen these patients and initiate treatment for any concurrent mental health disorders they may have. The obesity treatment offered might also need to be tailored for better effectiveness in the presence of neurodevelopmental problems.”
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