Int J Pediatr Endocrinol. 2012 Dec 05;2012(1):30. doi: 10.1186/1687-9856-2012-30.

Weight loss on stimulant medication: how does it affect body composition and bone metabolism? - A prospective longitudinal study.

International journal of pediatric endocrinology

Alison Poulton, Julie Briody, Thomas McCorquodale, Elaine Melzer, Markus Herrmann, Louise A Baur, Gustavo Duque

PMID: 23216890 PMCID: PMC3549744 DOI: 10.1186/1687-9856-2012-30

Abstract

OBJECTIVE: Children treated with stimulant medication for attention deficit hyperactivity disorder (ADHD) often lose weight. It is important to understand the implications of this during growth. This prospective study was designed to quantify the changes in body composition and markers of bone metabolism on starting treatment.

METHODS: 34 children (29 boys) aged 4.7 to 9.1 years newly diagnosed with ADHD were treated with dexamphetamine or methylphenidate, titrating the dose to optimise the therapeutic response. Medication was continued for as long as clinically indicated. Body composition and bone density (dual-energy X-ray absorptiometry) were measured at baseline, 6 months and 3 years; changes were analysed in Z-scores based on data from 241 healthy, local children. Markers of bone turnover were measured at baseline, 3 months and 3 years.

RESULTS: Fat loss of 1.4±0.96kg (total fat 5.7±3.6 to 4.3±3.1kg, p<0.001) occurred in the first 6 months. There were significant reductions over 3 years in the sex and height corrected Z-scores for lean tissue, bone mineral content, bone mineral density and ratio of central to total fat (-0.84±0.86, p=0.003; -0.55±0.31, p<0.0001; -0.41±0.28, p<0.0001 and -0.55±0.62, p=0.006 respectively). Propeptide of type I collagen indicated a significant reduction in bone turnover after 3 months (564±202 to 458±96ng/ml, p=0.019), which was fully recovered after 3 years (619±276ng/ml).

CONCLUSIONS: Stimulant medication was associated with early fat loss and reduced bone turnover. Lean tissue including bone increased more slowly over 3 years of continuous treatment than would be expected for growth in height. There was long-term improvement in the proportion of central fat for height. This study shows that relatively minor reductions in weight on stimulant medication can be associated with long-term changes in body composition. Further study is required to determine the effects of these changes on adult health.

References

1. J Child Neurol. 2000 Jul;15(7):436-9 - PubMed
2. Vital Health Stat 11. 2002 May;(246):1-190 - PubMed
3. Int J Obes (Lond). 2005 Nov;29(11):1353-60 - PubMed
4. J Pediatr Endocrinol Metab. 2003 Jun;16(5):711-8 - PubMed
5. J Am Acad Child Adolesc Psychiatry. 2002 Feb;41(2 Suppl):26S-49S - PubMed
6. J Am Acad Child Adolesc Psychiatry. 2008 Sep;47(9):994-1009 - PubMed
7. Arch Dis Child. 2005 Aug;90(8):801-6 - PubMed
8. Int J Obes Relat Metab Disord. 2004 May;28(5):685-9 - PubMed
9. Int J Obes (Lond). 2011 Jan;35(1):38-45 - PubMed
10. J Paediatr Child Health. 2003 Apr;39(3):180-5 - PubMed
11. J Pediatr Endocrinol Metab. 2009 Sep;22(9):781-94 - PubMed
12. Int J Obes (Lond). 2008 Apr;32(4):619-28 - PubMed

Publication Types

• Journal Article