Open Access Highly Accessed Debate

Attention-deficit/hyperactivity disorder and impairment in executive functions: a barrier to weight loss in individuals with obesity?

Samuele Cortese127*, Erika Comencini1, Brenda Vincenzi3, Mario Speranza45 and Marco Angriman6

Author Affiliations

1 Child Neuropsychiatry Unit, G. B. Rossi Hospital, Department of Life Science and Reproduction, Verona University, Verona, Italy

2 Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA

3 Massachusetts General Hospital, Schizophrenia Clinical and Research Program, Boston, MA, USA

4 EA4047, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France

5 Child and Adolescent Psychiatry, Versailles General Hospital, Le Chesnay, France

6 Child Neurology and Neurorehabilitation Unit, Department of Pediatrics, Central Hospital of Bolzano, Bolzano, Italy

7 Unità Autonoma di Neuropsichiatria Infantile, Ospedale G.B . Rossi, P.le L.A. Scuro, 12, Verona 37134, Italy

For all author emails, please log on.

BMC Psychiatry 2013, 13:286  doi:10.1186/1471-244X-13-286

Published: 7 November 2013



An increasing body of research points to a significant association of obesity to Attention-Deficit/Hyperactivity Disorder (ADHD) and deficits in executive functions. There is also preliminary evidence suggesting that children with ADHD may be at risk of obesity in adulthood.


In this article, we discuss the evidence showing that ADHD and/or deficits in executive functions are a barrier to a successful weight control in individuals enrolled in weight loss programs. Impairing symptoms of ADHD or deficits in executive functions may foster dysregulated eating behaviors, such as binge eating, emotionally-induced eating or eating in the absence of hunger, which, in turn, may contribute to unsuccessful weight loss. ADHD-related behaviors or neurocognitive impairment may also hamper a regular and structured physical activity. There is initial research showing that treatment of comorbid ADHD and executive functions training significantly improve the outcome of obesity in individuals with comorbid ADHD or impairment in executive functions.


Preliminary evidence suggests that comorbid ADHD and deficits in executive functions are a barrier to a successful weight loss in individuals involved in obesity treatment programs. If further methodologically sound evidence confirms this relationship, screening and effectively managing comorbid ADHD and/or executive functions deficits in individuals with obesity might have the potential to reduce not only the burden of ADHD but also the obesity epidemics.

ADHD; Executive functions; Obesity; Treatment resistance