Visceral Adipose Tissue Accumulation in Children With Obesity and Co-occurring ADHD: A Case-Control Analysis of Body Fat Distribution Patterns

Abstract

Objective:

ADHD and obesity frequently co-occur in children, yet differences in visceral adipose tissue (VAT) distribution between co-occurring ADHD + Obesity and obesity alone are incompletely characterized. This study compared depot-specific adiposity between these groups.

Methods:

This cross-sectional analysis (December 2022–2024, Beijing Children’s Hospital) included 306 children (6–12 years) stratified into: ADHD + Obesity (n = 65), obesity-only (n = 77), and Control (n = 164). Body composition was assessed using bioelectrical impedance. Group comparisons for depot-specific adiposity and metabolic markers were performed using multivariable linear regression, adjusting for age, sex, and BMI z-score.

Results:

The ADHD + Obesity group exhibited significantly greater visceral adiposity than the Obesity-only group, as reflected by a 16.84 cm² larger visceral fat area (VFA) and a 1.03 kg/m² higher fat mass index (FMI). The ADHD + Obesity group also showed a more adverse metabolic profile, including elevated liver enzymes and fasting glucose.

Conclusion:

Excess visceral adiposity represents a distinct phenotypic feature of ADHD + Obesity. These findings support the need for integrated clinical management addressing both neurobehavioral and metabolic domains and inform future mechanistic investigations.

Keywords

ADHD obesity body composition visceral adipose tissue subcutaneous adipose tissue

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