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.