Endocrine Abstracts

Background: There is an increasingly aware of strong associations between obesity and attention-deficit/hyperactivity disorder (ADHD), with high rates of ADHD (26–61%) in patients seeking weight loss. Psychological evaluation is mandatory in patients presenting for bariatric surgery (BS), although it is focused on eating disorders and depression, with data lacking on ADHD. ADHD could increase the risk for less successful results after surgery because of noncompliance with recommendations.

Aims: To determine the frequency of ADHD in a BS sample. To investigate if there are any differences among clinical, analytical and psychological parameters in individuals with ADHD.

Methods: Sixty patients (78.3% females, age 46.35±9.89, months since BS 46.28±28.1) who underwent BS, with a minimum follow up of 12 months, were evaluated cross-sectionally. Initial and current BMI, eating patterns, comorbidity, sociodemographic and biochemical parameters were recorded. For the screening of ADHD, ASRS-v1.1 was administered.

Results: Nineteen individuals out of sixty (31.6%) had a positive screening for ADHD. This group had higher levels of HDL-cholesterol (62.84±17.35 vs 53.59±9.92 mg/dl; P=0.011) and Apo-A (177.79±28.48 vs 154.94±34.77 mg/dl; P=0.015), as well as an increased consumption of lipids (42.2±7.12 vs 36.76±8.34%; P=0.019). The average intake time per meal was lower (13.89±9.99 vs 20.49±11.55 min; P=0.036). Also, there was a greater personal history of prebariatric psychiatric disorders (84.2 vs 48.8%: P=0.009), being the commonest depression (n=12) and anxiety disorder (n=5). Furthermore, there was a tendency of developing eating disorders (52.6 vs 21.9%; P=0.059). ADHD subjects had more difficulties in following visits after BS (52.6 vs 24.3%; P=0.011). We could not find any differences in achieved BMI, depressive symptoms or quality of life.

Conclusions: Patients of BS with ADHD criteria face significant difficulties with compliance in follow-up, but we could not find differences in major clinical outcomes. Surprisingly, this group of patients could have a protective lipid profile, probably related to dietary habits.