Effect of methylphenidate on body mass index in children and adolescents in relation to baseline weight status
7 affiliations
- 1Unit of Clinical Pharmacology, Department of Pharmaceuticals, Sahlgrenska University Hospital, Bruna Stråket 21, Gothenburg, Region Västra Götaland 41345 Sweden
- 2Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- 3Swedish Medical Products Agency, Uppsala, Sweden
- 4Department of Pharmacy, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
- 5Bioinformatics and Data Centre, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- 6The NEPI foundation-Network for Pharmacoepidemiology, Stockholm, Sweden
- 7Department of Clinical Sciences, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
Abstract
This study aimed to evaluate methylphenidate-associated body mass index (BMI) changes and treatment discontinuation across weight status groups in children and adolescents, using real-world data. We used data from the BMI Epidemiology Study (BEST) Gothenburg cohort linked to the Swedish National Prescribed Drug Register. We included children (< 18 years) initiating methylphenidate, with BMI measurements available at baseline and one year. A subgroup also had BMI measurements at two years. We analysed changes in standardized BMI (zBMI) by baseline weight status and evaluated the impact of dosing and drug discontinuation. Methylphenidate treatment was associated with significant zBMI reduction across all weight status groups in the first treatment year, with the largest decrease observed in those with obesity (-0.5 SD, p = 0.01). Higher dose increases, younger age, and female sex were associated with larger zBMI reductions. During the first year, obesity prevalence decreased from 10.4% to 5.7% (p < 0.001), while underweight increased from 6.6% to 13.1% (p < 0.001). Individuals with underweight or normal weight had higher odds of discontinuation, compared with those with overweight or obesity (OR = 1.73, p = 0.004). In the second year, zBMI and weight status remained largely stable. In conclusion, in this real-world setting, methylphenidate was associated with BMI reductions across all weight status groups during the first treatment year. The greatest reduction was seen in individuals with obesity. For those continuing treatment the second year, BMI remained stable.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00787-026-03070-y.
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BibTeX
@article{izsak2026effect,
title = {{Effect of methylphenidate on body mass index in children and adolescents in relation to baseline weight status}},
author = {Julia Izsak and Elin E. Kimland and Jari Martikainen and Elin Dahlén and Linda Halldner and Jenny M. Kindblom},
journal = {European Child \& Adolescent Psychiatry},
year = {2026},
month = jun,
doi = {10.1007/s00787-026-03070-y},
url = {https://doi.org/10.1007/s00787-026-03070-y},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effect of methylphenidate on body mass index in children and adolescents in relation to baseline weight status
AU - Julia Izsak
AU - Elin E. Kimland
AU - Jari Martikainen
AU - Elin Dahlén
AU - Linda Halldner
AU - Jenny M. Kindblom
PY - 2026
DA - 2026/06/27
JO - European Child & Adolescent Psychiatry
DO - 10.1007/s00787-026-03070-y
UR - https://doi.org/10.1007/s00787-026-03070-y
AB - This study aimed to evaluate methylphenidate-associated body mass index (BMI) changes and treatment discontinuation across weight status groups in children and adolescents, using real-world data. We used data from the BMI Epidemiology Study (BEST) Gothenburg cohort linked to the Swedish National Prescribed Drug Register. We included children (< 18 years) initiating methylphenidate, with BMI measurements available at baseline and one year. A subgroup also had BMI measurements at two years. We analysed changes in standardized BMI (zBMI) by baseline weight status and evaluated the impact of dosing and drug discontinuation. Methylphenidate treatment was associated with significant zBMI reduction across all weight status groups in the first treatment year, with the largest decrease observed in those with obesity (-0.5 SD, p = 0.01). Higher dose increases, younger age, and female sex were associated with larger zBMI reductions. During the first year, obesity prevalence decreased from 10.4% to 5.7% (p < 0.001), while underweight increased from 6.6% to 13.1% (p < 0.001). Individuals with underweight or normal weight had higher odds of discontinuation, compared with those with overweight or obesity (OR = 1.73, p = 0.004). In the second year, zBMI and weight status remained largely stable. In conclusion, in this real-world setting, methylphenidate was associated with BMI reductions across all weight status groups during the first treatment year. The greatest reduction was seen in individuals with obesity. For those continuing treatment the second year, BMI remained stable. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00787-026-03070-y.
SN - 1018-8827
SN - 1435-165X
ER -