Makin Lauren, Meyer Adia, Zesch Elisa, Mondelli Valeria, Tchanturia Kate
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London SE5 8AF, UK.
Nutrients. 2025 Feb 24;17(5):787. doi: 10.3390/nu17050787.
Autism and ADHD shape behaviours related to food, exercise, and body image, potentially influencing obesity treatment outcomes, as seen in eating disorder research. Resultantly, autistic and ADHD patients with obesity may have distinct experiences and differences compared to non-autistic and non-ADHD patients. This review maps existing literature on autism and ADHD in adults with obesity. Following PRISMA guidelines, six databases (Embase, MEDLINE, PsycINFO, Web of Science, CENTRAL, and Scopus) were searched for studies on autism and/or ADHD (diagnosed, probable, or traits) in adults with obesity. Screening and data extraction were conducted twice independently for each record. Thirty-one studies were included, with 1,027,773 participants. Two case reports described successful use of weight loss drugs in autistic people with obesity. Eight prevalence studies suggested ADHD is overrepresented in obesity, regardless of binge eating status. Nineteen studies examined clinical profiles: ADHD patients had lower socioeconomic status, poorer health-related quality of life, increased impulsivity, cognitive inflexibility, and neuroticism, alongside lower agreeableness, conscientiousness, self-directedness, and cooperativeness. ADHD patients also exhibited higher psychopathology, problematic alcohol use, and disordered eating. Eight studies assessed treatment responses, noting poorer outcomes from behavioural programs and obesity pharmacotherapy, but similar post-surgical weight outcomes, despite increased complications. Two studies considered ADHD-specific treatment adaptions, one reporting a successful trial of ADHD medication for weight loss and the other reporting on switching to transdermal ADHD medications after bariatric surgery. This review underscores the need for more research on autism and obesity. For ADHD, findings suggest frequent co-occurrence with obesity, but lived experiences and tailored interventions remain underexplored.
如饮食失调研究所示，自闭症和注意力缺陷多动障碍会塑造与食物、运动和身体形象相关的行为，可能影响肥胖症治疗效果。因此，与非自闭症和非注意力缺陷多动障碍患者相比，患有肥胖症的自闭症和注意力缺陷多动障碍患者可能有不同的经历和差异。本综述梳理了有关肥胖成年人自闭症和注意力缺陷多动障碍的现有文献。按照系统评价和荟萃分析优先报告的条目（PRISMA）指南，检索了六个数据库（Embase、MEDLINE、PsycINFO、Web of Science、CENTRAL和Scopus），以查找有关肥胖成年人自闭症和/或注意力缺陷多动障碍（已确诊、可能或特质）的研究。对每条记录独立进行了两轮筛选和数据提取。纳入了31项研究，共1027773名参与者。两项病例报告描述了减肥药物在患有肥胖症的自闭症患者中的成功应用。八项患病率研究表明，无论暴饮暴食状况如何，注意力缺陷多动障碍在肥胖症患者中占比过高。19项研究考察了临床特征：注意力缺陷多动障碍患者社会经济地位较低，健康相关生活质量较差，冲动性增加、认知灵活性降低、神经质增加，同时宜人性、尽责性、自我导向性和合作性较低。注意力缺陷多动障碍患者还表现出更高的精神病理学、酒精使用问题和饮食紊乱。八项研究评估了治疗反应，指出行为项目和肥胖症药物治疗效果较差，但手术后体重结果相似，尽管并发症有所增加。两项研究考虑了针对注意力缺陷多动障碍的治疗调整，一项报告了减肥的注意力缺陷多动障碍药物试验成功，另一项报告了减肥手术后改用经皮注意力缺陷多动障碍药物。本综述强调需要对自闭症和肥胖症进行更多研究。对于注意力缺陷多动障碍，研究结果表明其与肥胖症经常同时出现，但生活经历和量身定制的干预措施仍未得到充分探索。
