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Are Girls with ADHD at Risk for Eating Disorders? Results from a Controlled, Five-Year Prospective Study

Biederman, Joseph, MD*†; Ball, Sarah W., SCD*; Monuteaux, Michael C., SCD*†; Surman, Craig B., MD*†; Johnson, Jessica L., BS*; Zeitlin, Sarah, BA*

Journal of Developmental & Behavioral Pediatrics: August 2007 - Volume 28 - Issue 4 - p 302-307
doi: 10.1097/DBP.0b013e3180327917
Original Article

Objective: To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) and eating disorders in a large adolescent population of girls with and without ADHD.

Method: We estimated the incidence of lifetime eating disorders (either anorexia or bulimia nervosa) using Cox proportional hazard survival models. Comparisons between ADHD girls with and without eating disorders were then made on measures of comorbidity, course of ADHD, and growth and puberty.

Results: ADHD girls were 3.6 times more likely to meet criteria for an eating disorder throughout the follow-up period compared to control females. Girls with eating disorders had significantly higher rates of major depression, anxiety disorders, and disruptive behavior disorder compared to ADHD girls without eating disorders. Girls with ADHD and eating disorders had a significantly earlier mean age at menarche than other ADHD girls. No other differences in correlates of ADHD were detected between ADHD girls with and without eating disorders.

Conclusions: ADHD significantly increases the risk of eating disorders. The presence of an eating disorder in girls with ADHD heightens the risk of additional morbidity and dysfunction.

From the *Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, MA; †Department of Psychiatry, Harvard Medical School, Boston, MA.

Received July 2006; accepted December 2006.

This work was supported in part by a grant from USPHS (National Institute of Child Health and Human Development), 5RO1 HD-36317-07 (J.B.).

Address for reprints: Joseph Biederman, M.D., Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Warren 705, 55 Fruit Street, Boston, MA 02114; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.