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ADHD and Methylphenidate Use in Prepubertal Children and Adult BMI and Height

jamanetwork.com

22 points by wjb3 a day ago · 35 comments

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brasscupcakes 11 hours ago

The BMI being higher is slightly interesting (you would guess it would be the reverse), but the height differential seems vanishingly small.

Concerns that stimulant meds taken as children reduced adult height have been around for three decades.

To my mind, the bigger take away here is that ADHD meds don't significantly impact adult height.

  • rrobukef 10 hours ago

    The fact that the height of adult males with ADHD is greater than that of males without ADHD (first figure/graphs, G & H) should indicate that there is no causative link that the medication has an impact. For females, the average does not show this, but if you look carefully, the variation is bigger. The same selection bias is possible in this case.

    Instead, to me it looks like there is selection bias going on. Shorter males are more likely to get MPH prescribed is an equally valid explanation.

    Luckily, the conclusion makes no assertions about height either, nor does the paper make conclusions about any causative relation.

  • DaanDL 10 hours ago

    Maybe they have a higher BMI because they become less active :D

    • snuxoll 9 hours ago

      Or, alternatively, because many of us have a tendency to eat when we are uninterested in other tasks...simply how much I snack, whether I feel like eating at regular mealtimes, and the correlated impact on my weight, is a pretty big indicator that I need to ask my physician to adjust the dose of my Vyvanse next time I send a message for my next fill.

wjb3OP a day ago

Patients with ADHD, particularly those treated with MPH, had a higher BMI and shorter height at adulthood than individuals without ADHD.

ravenstine 3 hours ago

Could the BMI thing be simply explained by the treated children expending less kinetic energy? In other words, they are less hyperactive, so it seems logical that they might actually be prone to some weight gain.

danr4 11 hours ago

This is not known enough.

I was prescribed Ritalin when i was 6 years old, and was considered one of the short kid my entire childhood (and suffered the consequences).

I decided to stop taking meds when I was 17, and in a few years became the tallest of my friend group.

I'm older now, and occasionally have periods where I take what I consider "better" meds like Vyvanse, but there ain't no way i'm letting my kids take ANYTHING until they are much much older and can decide for themselves.

  • cml123 6 hours ago

    I don't think the evidence is on your side for the outcomes. Kids cannot be assured to make the best choices in their own interest for every scenario. I was on meds for ADHD from ages 4 to 14 before I asked to stop. In elementary school I was among the most talented students in my class, but I was very close to failing to graduate high school. I later failed out of community college. Through great effort I managed to get employed as a software developer, though my original passion and hope was biology. I now take Vyvanse to keep sustained focus in my work.

    I'm confident if I had stayed on my meds that I would have been far more academically successful in high school and beyond. I pushed to get off Adderall as a kid because I started to feel like a zombie on it, but maybe my parents could have instead helped me to find a treatment that was better suited for me or adjust my dosage.

    • wafflemaker 4 hours ago

      Getting the dosage right with ADHD meds is super difficult. And your needs and body change with time.

      I wonder if it wasn't the puberty that made you somehow more susceptible to amphetamine. Lot of things change in the body at that time and it could have also been the enzymes that process the amphetamine.

    • danr4 3 hours ago

      4 is absolutely insane

  • wafflemaker 7 hours ago

    Unless the kids have a feeling they should go off meds to get taller (like you did), isn't it better for them to be on meds?

    Average first time for sex with adhd girls is 13y vs 17y for non adhd or medicated.

    Probability to be addicted to drugs or alcohol halves for when on meds vs without.

    Same goes for obesity, etc.

    I didn't get meds when I was younger. Now I have top 1% IQ (likely average here on hn), but work as a butcher at a slaughterhouse. My mom didn't want to stigmatise me with a diagnosis.

    Don't have time to finish the post, and I don't believe I'm entitled to anything. But if I had less problems at school, I might've been doing sth more fun now and less demanding on the body.

    • danr4 3 hours ago

      i did not stop to get taller, it just felt like crap. I think as you get older and more independent it starts messing with your sense of self.

      is it better to be on meds? maybe i don't know. all i have is my experience. and looking back i'd much rather my parents told the school "fu im not giving my kid stimulants just challenge him" and to provide the challenge if the school didn't.

      if you're top 1% (definitely not hn average), it's very likely you had "problems at school" simply because it was boring. don't know how old you are but with 1% there's really nothing preventing you from learning whatever it is you want to learn and go do something else.

    • snuxoll 2 hours ago

      > I didn't get meds when I was younger. Now I have top 1% IQ (likely average here on hn), but work as a butcher at a slaughterhouse. My mom didn't want to stigmatise me with a diagnosis.

      I really hope I'm not stating the obvious to you here, but don't let your current situation define you like it guarantees the course of the rest of your life.

      > But if I had less problems at school, I might've been doing sth more fun now and less demanding on the body.

      Even on Adderall in my teenage years, I fucked around in school - it didn't interest me, which is not uncommon in 2e individuals with ADHD. Dropped out at 16, got my GED a few years later, never went to college, resigned myself to the fact that I would be working class like my parents for the rest of my life.

      But the right doors opened because I kept pulling at the knobs when I saw them, while the thousands of hours of my free time messing around with dozens of linux distros, writing toy programs for personal use, and a little bit of selling the unique talents my atypical neurology gives me, were enough to get me through one interview, and then the next.

      The non-traditional path still very much exists in many fields, but it always starts at smaller companies that are less glamorous to work at, and often don't pay as well. None of us may be entitled to anything, but that doesn't mean we should resign ourselves to wasting our talents because the traditional paths didn't work out for our unique situations.

    • rayiner 6 hours ago

      > I didn't get meds when I was younger. Now I have top 1% IQ (likely average here on hn), but work as a butcher at a slaughterhouse. My mom didn't want to stigmatise me with a diagnosis

      Yeah, get your kids diagnosed and get them medicated if they need to be. Adderall is one of the most well studied medications in the world. Whatever downsides there are pale in comparison to the academic and social downsides of untreated ADHD.

  • DaanDL 10 hours ago

    Anecdotical...Also: "clinically modest, reduction in adult height"

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