Are Kids Overdiagnosed and Overmedicated Into Obesity?

Blue and Green

A reader who wanted to be anonymous wrote by email:

So many doctors and parents are quick to run for that medicine cabinet! My niece is on so many prescriptions, it is startling, to say the least. Gross amount, seriously! All of them for ‘behavior’ problems like attention disorder, anger, depression… don’t get me started it makes me angry.

Andrew M. Weiss of Hofstra University specializes in school-clinical psychology and has published a number of articles about technology in education. He says a million toddlers, children as young as one year, are on psychoactive medications; and about 10% of all children have been prescribed stimulants because of ADHD.

In the Skeptical Inquirer, Weiss asserted that around 8 million youngsters (ages 2 to 18) are on prescriptions for autism, bipolar disorder, depression, short or non-existent attention spans, inability to concentrate, poor impulse control, and many other mental conditions. Weiss wrote,

Concomitant side effects range from unpleasant to devastating, including: insulin resistance, narcolepsy, tardive dyskinesia…, agranulocytosis…, accelerated appetite, vomiting, allergic reactions, uncontrolled blinking, slurred speech, diabetes, balance irregularities, irregular heartbeat, chest pain, sleep disorders, fever, and severe headaches… The attempt to control these side effects has resulted in many children taking as many as eight additional drugs every day, but in many cases, this has only compounded the problem. Each ‘helper’ drug produces unwanted side effects of its own.

Several of the side effects, such as insulin resistance, accelerated appetite, and diabetes, also have something to do with obesity. The connection between the prescriptions written for children and the obesity epidemic is worth looking into. We have mentioned how kids being treated for bipolar disorder tend toward obesity and diabetes. Responding by email to that, another reader said,

I used to take medications regularly (psychiatric) and I packed on the weight. I have an acquaintance who takes a lot of medications for psychiatric reasons and she says she gets depressed (she has medication for depression too) because she can’t seem to lose weight because of medication.

Even the so-called “atypical antipsychotics,” which are supposed to be less harmful than the old kind, cause changes in the body that often lead to rapid weight gain and/or diabetes.

A while back, Caroline Cassels reported at Medscape.com on research done by Dr. Christoph U. Correll, who said,

This study adds to the prevailing suspicion that antipsychotic use in children and adolescents significantly increases the risk for early, age-inappropriate weight gain as well as metabolic abnormalities… Secondly, these abnormalities do not appear to be as much related to a new onset of illness or hospitalization but really seem to be due to the medications themselves.

In the name of eliciting more acceptable behavior, kids are being dosed with stuff that messes with their glucose and lipid metabolism, among other things, and generally bring along a whole slew of unintended consequences. Cassels also mentions that a great deal of the research into atypical antipsychotics is supported by the pharmaceutical industry itself, which could indicate a conflict of interest.

In the March 2011 issue of Current Psychiatry, Editor-in-Chief Henry A. Nasrallah, M.D., discussed some common yet incorrect ideas held by some of his colleagues. Many doctors believe that while atypical antipsychotics are associated with weight (link is PDF) increase, the older ones don’t have this effect. He said this is a fallacy:

The evidence from the European First Episode Schizophrenia Trial (EUFEST) debunked both beliefs by finding substantial weight gain with all antipsychotic drugs, old or new, after 1 year of treatment… Neither old antipsychotics… nor metabolically ‘benign’ atypicals,… are exceptions.

Then there are the stimulants. Dr. Mark Hyman recently wrote,

We also know that amphetamines are natural appetite suppressants and reduce cravings. That is why children who take stimulant ADHD drugs (which are actually just fancy amphetamines) that stimulate dopamine receptors have trouble gaining enough weight as they grow.

Stimulants may suppress the appetite in children and even teens, but not enough is known about the long-range effects on the body. Even back in the 1960s and 1970s, many children were being treated with Ritalin, etc., for hyperactivity. They are now middle-aged. Among the very great number of obese, middle-aged Americans, it would be interesting to know how many of them have spent their childhoods on Ritalin — but look at them now.

Your responses and feedback are welcome!

Source: “The Wholesale Sedation of America’s Youth,” Skeptical Inquirer, 12/08
Source: “First-Time Antipsychotic Use Linked to Rapid Weight Gain, Adverse Metabolic Changes in Kids,” Medscape.com, 10/29/09
Source: “Folie en masse! It’s so tempting to drink the Kool-Aid” (PDF), Current Psychiatry, March 2011
Source: “Stopping Addiction to Sugar: Willpower or Genetics?,” DrHyman.com, 02/05/11
Image (modified) by colros (Sandra Cohen-Rose and Colin Rose), used under its Creative Commons license.

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