Attention deficit hyperactivity disorder (ADHD) is usually associated with the image of a child jumping off walls and being physically active. Still, a recent study found that ADHD-induced impulsivity can make people more likely to over-eat and have a higher body mass index — particularly if they live in a smaller city with lower access to mental health services and opportunities for physical activity.
On the other hand, people with ADHD who live in larger cities are less likely to become obese due to better accessibility to mental health services. One of the study authors, Tian Gan, a Ph.D. student at the Tandon School of Engineering at New York University said in a press release: “Our research reveals a surprising urban advantage: as cities grow, both obesity and ADHD rates decrease proportionally. Meanwhile, mental health services become more accessible, helping combat physical inactivity—a key link between ADHD and obesity. This pattern suggests larger cities offer protective factors against these interconnected health challenges.”
Gan and colleagues analyzed data from 915 cities in the United States to investigate how impulsivity caused by ADHD could be contributing to a higher risk of obesity and how urban living conditions influence this correlation.
“Within each State, cities are different with respect to any of these features, confirming the inequalities in the United States in lifestyle, education, healthcare, and access to resources,” the authors noted in the study that was published in the journal PLoS Complex Systems. “Our analysis highlights the role of physical activity as a feasible target for intervention, being sensitive to variations in college education, food insecurity, and access to mental health providers.”
Since the last decade, researchers have hypothesized that people with ADHD might be less likely to be physically active and engage in the recommended levels of physical activity due to “poor motor skills and executive function deficits.”
Especially because ADHD causes executive dysfunction that impairs an individual’s ability to follow exercise routines or adhere to stringent regimens required to exercise consistently. Prior studies conducted on Dutch and Korean children with ADHD found that living with this neurodevelopmental condition put them at a higher risk of being overweight and obese than their counterparts without ADHD.
“Our analysis suggests that mental health care may contrast these tendencies, promoting awareness about health values of physical activity in city dwellers,” the study authors highlighted. Because mental health treatments are mainly accessible in large cities, along with big city dwellers having higher levels of education and lower risks of food insecurity, they found that these benefits reduced the risk of over-eating and physical inactivity among ADHDers.
“Our research suggests that supporting physical activity, especially in children with ADHD, could significantly improve long-term health outcomes. Surprisingly, we discovered ADHD influences obesity through dual pathways: reduced physical activity and independent biological mechanisms related to impulse control and eating behaviors—indicating that effective interventions need to address both aspects,” explained Simone Macrì, a study author from the Centre for Behavioural Sciences and Mental Health at the Istituto Superiore di Sanità in Rome, Italy, in a press release.