Relationship of childhood behavior disorders to weight gain from childhood into adulthood

OBJECTIVE Obesity and behavior disorders are important conditions that affect the health of children and adolescents; some evidence suggests that they are associated. However, these relationships have not been studied longitudinally from childhood to adulthood. We investigated childhood to adulthood weight change associated with attention-deficit and disruptive behavior disorders.
METHODS We analyzed data from a prospective cohort study in which 655 individuals observed before age 16.6 years, and assessed in 1983 (when aged 9.1 to 16.6 years), 1985-1986 (when 11.1 to 20.8 years), 1991-1994 (when 16.6 to 26.9 years), and 2001-2003 (when 27.7 to 38.3 years). Attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder (collectively, "disruptive disorders") were assessed by trained interviewers who used the Diagnostic Interview Schedule for Children. We evaluated the association of disruptive disorders (assessed when youth were <16.6 years) with longitudinal body mass index (BMI) z scores from childhood to adulthood using linear mixed-effects models.
RESULTS Female subjects with disruptive disorders were estimated, at all ages, to have mean BMI z scores 0.23 (95% confidence interval, 0.03-0.44) units higher than female subjects without disruptive disorders. Male subjects with disruptive disorders were estimated, at all ages, to have mean {BMI} z scores 0.20 (95% confidence interval, 0.00-0.39) units higher than male subjects without disruptive disorders. For male and female subjects, annual BMI z-score change was statistically unrelated to disruptive disorder history.
CONCLUSIONS Disruptive disorders were associated with elevated weight status that was maintained from childhood into adulthood. These findings suggest that associations between behavior disorders and increased weight begin early in childhood and may have lifelong health effects.