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ADHD, self-reported mental health and weight loss 10 years after metabolic-bariatric surgery during adolescence

Björk, Anna ; Dahlgren, Jovanna ; Gronowitz, Eva ; Bruze, Gustaf ; Wentz, Elisabet ; Flodmark, Carl-Erik LU ; Marcus, Claude ; Olbers, Torsten and Järvholm, Kajsa LU orcid (2025) In Obesity Facts
Abstract
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is overrepresented among children and adults with obesity, but knowledge about how ADHD may affect outcomes following metabolic and bariatric surgery (MBS) is limited. The aim of this study was to examine mental health and weight outcomes after undergoing MBS during adolescence in individuals with and without ADHD. Methods: In a multicenter prospective study, 81 adolescents (13-18 years; mean BMI 45.5 kg/m²) underwent Roux-en-Y gastric bypass between 2006 and 2009. ADHD and Autism Spectrum Disorder (ASD) were assessed using the Adult ADHD Self-Report Scale and Autism Quotient 10 respectively, or clinical diagnosis. BMI, anxiety, depression, and binge eating were measured before... (More)
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is overrepresented among children and adults with obesity, but knowledge about how ADHD may affect outcomes following metabolic and bariatric surgery (MBS) is limited. The aim of this study was to examine mental health and weight outcomes after undergoing MBS during adolescence in individuals with and without ADHD. Methods: In a multicenter prospective study, 81 adolescents (13-18 years; mean BMI 45.5 kg/m²) underwent Roux-en-Y gastric bypass between 2006 and 2009. ADHD and Autism Spectrum Disorder (ASD) were assessed using the Adult ADHD Self-Report Scale and Autism Quotient 10 respectively, or clinical diagnosis. BMI, anxiety, depression, and binge eating were measured before MBS and at 1-, 2-, 5-, and 10-year follow-ups. Results: ADHD was present in 33 of 81 participants (41%). At 10-year follow-up, 91% of individuals with ADHD reported anxiety or depression, compared to 21% in the group without ADHD (p=0.002), despite no reported difference at baseline. A significant time-by-group interaction (p=0.018) indicated increasing differences between groups over time. Binge eating returned to preoperative levels in the ADHD group (p<0.001) after 10 years following initial improvement. No significant difference in BMI was observed at 10 years, but weight loss was significantly lower in the ADHD-group at 2 and 5-year follow-ups. At the 10-year follow-up, significantly more participants with clinical diagnosis of ADHD had dropped out (56% vs 25%, p=0.013). ASD was present in 14 out of 81 participants (17%) and showed a high degree of overlap with ADHD (79%). Conclusions: ADHD was associated with higher levels of anxiety, depression, and binge eating 10 years after MBS during adolescence. Weight loss was lower in the ADHD group at 2 and 5 years but not at 10 years, potentially due to a high dropout in the ADHD group at 10 years. Preoperative screening for ADHD in adolescents with early initiation of treatment and tailored postoperative follow-up may improve long-term outcomes. (Less)
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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Obesity Facts
publisher
Karger
external identifiers
  • pmid:41428570
ISSN
1662-4033
DOI
10.1159/000550210
project
Adolescent Morbid Obesity Surgery
language
English
LU publication?
yes
id
f4b36e7a-1599-47b7-b43f-3d1b0b410e77
date added to LUP
2025-12-23 09:15:58
date last changed
2026-01-07 09:32:31
@article{f4b36e7a-1599-47b7-b43f-3d1b0b410e77,
  abstract     = {{Introduction: Attention-deficit/hyperactivity disorder (ADHD) is overrepresented among children and adults with obesity, but knowledge about how ADHD may affect outcomes following metabolic and bariatric surgery (MBS) is limited. The aim of this study was to examine mental health and weight outcomes after undergoing MBS during adolescence in individuals with and without ADHD. Methods: In a multicenter prospective study, 81 adolescents (13-18 years; mean BMI 45.5 kg/m²) underwent Roux-en-Y gastric bypass between 2006 and 2009. ADHD and Autism Spectrum Disorder (ASD) were assessed using the Adult ADHD Self-Report Scale and Autism Quotient 10 respectively, or clinical diagnosis. BMI, anxiety, depression, and binge eating were measured before MBS and at 1-, 2-, 5-, and 10-year follow-ups. Results: ADHD was present in 33 of 81 participants (41%). At 10-year follow-up, 91% of individuals with ADHD reported anxiety or depression, compared to 21% in the group without ADHD (p=0.002), despite no reported difference at baseline. A significant time-by-group interaction (p=0.018) indicated increasing differences between groups over time. Binge eating returned to preoperative levels in the ADHD group (p&lt;0.001) after 10 years following initial improvement. No significant difference in BMI was observed at 10 years, but weight loss was significantly lower in the ADHD-group at 2 and 5-year follow-ups. At the 10-year follow-up, significantly more participants with clinical diagnosis of ADHD had dropped out (56% vs 25%, p=0.013). ASD was present in 14 out of 81 participants (17%) and showed a high degree of overlap with ADHD (79%). Conclusions: ADHD was associated with higher levels of anxiety, depression, and binge eating 10 years after MBS during adolescence. Weight loss was lower in the ADHD group at 2 and 5 years but not at 10 years, potentially due to a high dropout in the ADHD group at 10 years. Preoperative screening for ADHD in adolescents with early initiation of treatment and tailored postoperative follow-up may improve long-term outcomes.}},
  author       = {{Björk, Anna and Dahlgren, Jovanna and Gronowitz, Eva and Bruze, Gustaf and Wentz, Elisabet and Flodmark, Carl-Erik and Marcus, Claude and Olbers, Torsten and Järvholm, Kajsa}},
  issn         = {{1662-4033}},
  language     = {{eng}},
  publisher    = {{Karger}},
  series       = {{Obesity Facts}},
  title        = {{ADHD, self-reported mental health and weight loss 10 years after metabolic-bariatric surgery during adolescence}},
  url          = {{http://dx.doi.org/10.1159/000550210}},
  doi          = {{10.1159/000550210}},
  year         = {{2025}},
}