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People with A.D.D. Have Trouble Losing Weight
Monday, December 10, 2012 11:35 am Email this article
In the past I have described groups of people with little success losing weight. Morbidly obese people, Latinos, and people who talk too much in the office. In this Message I will describe another group—people with attention deficit disorder or ADD. They comprise only 5% of the population, but they number among your best friends. They are attractive shakers and movers; they make life interesting, but they finish few of the projects and relationships they start.
ADD is caused by a faulty dopamine beta-hydroxylase gene causing the brainstem reticular activating system (RAS) to underperform in waking up the cortex by showering it with norepinephrine in the morning. RAS activity declines over the day so everyone has some ADD at night, but the ADD people, more so.
Phentermine works as well as Ritalin in treating ADD. It causes neurons to release norepinephrine, the very thing you want to do. The trouble is, we have to let phentermine wear off at night so the patient can sleep. As a result, ADD-eating is the worst at night.
ADD people are identifiable by the characteristics listed below. Not every patient has all the symptoms, but every ADD patient has most of them. The problem for me is that while phentermine (and Ritalin, etc.) is very effective in promoting concentration, it is less effective in improving impulse control.
- Poor concentration
- Easy distractibility
- Poor impulse control
- Interrupting & disrupting others
- Oppositional behavior
- Low self-esteem
- Rapid turnover of jobs & friendships
- Functional illiteracy
- Frequent missed appointments
For ADD people to have success in life, they must be medicated. The medicine is not a "crutch"; it is a necessary element to level the playing field.
For ADD people to lose weight, another person must remove all food-temptations from the ADD person’s reach. If food is available to be eaten, it will be eaten. It is not a moral issue; it is a neurochemical fact. Unmedicated ADD people cannot inhibit an impulse.
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