🎥 Now Available April's Parent Group Recording: Wired, Tired, and Hungry with Dr Matthew Lindquist
- Kristen
- 2 days ago
- 31 min read
At our April Parent Group Event, Dr. Matthew Lindquist walked us through a cluster of conditions that often show up together:
ADHD
Anxiety
Obesity & metabolic health challenges
Binge eating
Sleep difficulties
These are not separate issues—and they are not personal failures.
They are deeply connected through biology.
He explained how:
Poor sleep worsens executive function and increases sugar cravings
Anxiety and stress (cortisol) disrupt sleep and contribute to weight gain
ADHD-related dopamine differences can drive reward-seeking behaviors like overeating
These conditions create cycles that reinforce each other
Chapters
00:00 Understanding ADHD and Its Impact on Families
02:01 The Connection Between ADHD and Obesity
03:39 The Anxiety and Sleep Loop
05:47 Binge Eating and Emotional Eating
08:09 Executive Function and Impulse Control
10:19 Strategies for Managing ADHD and Weight
12:32 Nutrition and Its Role in ADHD Management
14:44 Creating Structure for Success
16:53 Conclusion and Final Thoughts
23:21 Healthy Eating Strategies for Kids
26:51 Sleep Challenges and Solutions for ADHD
29:09 Navigating ADHD and Anxiety
30:52 Empowering Kids with ADHD
32:12 Practical Tips for Parents
34:20 Intermittent Fasting and Eating Patterns
38:01 Vitamins, Supplements, and Sleep
42:23 Intuitive Eating and ADHD
About the Speaker
Dr. Matthew Lindquist is a passionate obesity-medicine physician. He is triple board-certified in Internal Medicine, Pediatrics, and obesity. He founded the University Health Weight Management clinic, started lectures on the disease of obesity for medical students and residents at UMKC School of Medicine, and is a board member of the Midwest Obesity Society. He started the MoKan Weight Loss and Metabolic Health LLC, an evidence-based medical weight loss program to help people achieve lifelong wellbeing.
He brings a neurobiological lens to ADHD and related conditions, helping families understand how brain-based differences affect behavior, health, and daily functioning. His approach emphasizes science, clarity, and practical understanding without shame or oversimplification.
Dr. Lindquist loves to teach both medical professionals and patients about the disease. His clinical interest is pharmacotherapy and genetics as well as finding individualized treatment courses for optimal overall health and wellbeing.
AI Generated Transcript for April's Parent Group Event
speaker (00:00)
Welcome everyone. My name is Sara Whelan I am one of the volunteers for CHADD's Chapter ⁓ in Kansas City. And ⁓ we are excited to have you here as part of our monthly parent group, parent presentation. And if you are near your screen right now, we have some slides that actually feature upcoming
speaker-1 (00:07)
sure.
speaker (00:24)
⁓ events that our organization is having. We have many different options for you, even if you're not a parent or you are and you're like, hey, I want to go to something for women or adults. We have those listed here and lots of interesting things come every month, really several things. So check out our upcoming events page on our website and
A few things I just wanna get out of the way in terms of expectations and CHADD is our parent organization and We wanna make sure we're talking about that we ⁓ have a community where we respect each other and are inclusive of other individuals who join.
Part of that is just maintaining respectful language. If asking questions or making comments, we generally don't have any issues with that, but we always just like to review. And that in general, we want to keep in mind that things that we discuss on here, although this is not like therapy session, however sensitive topics come up and we want to make sure we're maintaining privacy and confidentiality as much as possible.
But to the real reason why we're all here tonight, I am excited to welcome Dr. Matt Lindquist here. And he is an obesity medicine physician and is triple board certified, which I understand is quite difficult to do. It's quite the accomplishment and board certified in internal medicine, pediatrics and obesity medicine.
And I know you've had quite a few years in Children's Mercy and founded a clinic there, program there, and have now opened your own business called MOKAN Weight Loss. And welcome. We are so happy to have you. Yeah, thanks. Happy to be here. Thanks for having me. Yeah, it's a fun topic and one that I've been pretty
speaker-1 (02:13)
you
speaker (02:22)
pretty passionate about since I started obesity medicine. Mainly seen a lot more people with binge eating. And then it was about six years ago or so that one of our colleagues out of published just a great article about this overlap and really opened my eyes. And so I love talking to.
parents and families about it and fellow learners. So happy to kind of go over this and what it means for families and kids.
Okay, I'm internal medicine and pediatrics, but I've really just been doing obesity medicine here for about a decade. Started MOKAN weight loss and metabolic health in Prairie Village, really to take care of families with obesity. But again, this is something kind of near and dear to my heart.
So we're going to talk about how the ADHD brain impacts our weight, sleep, and binge eating because unfortunately they are close friends.
Couple important disclaimers. This is educational only. So this is not your individual medical advice. You know, talk to your doc, talk to your pediatrician. Hope to give you some good, some good insight and some good takeaways and pointers, but please don't put my name on your treatment plan. I'm happy to talk in clinic if you'd like. And of course, every child and family is different.
And for what it's worth, no financial disclosures either.
So this cluster, okay, so it's just a cluster of diagnoses or kind of behaviors that unfortunately travel together. those are ADHD, obesity, anxiety, binge eating, and sleep problems. That's kind of a couple there. And
And how I've described this to people in the past is, so especially in pediatrics, we kind of know that if you, you know, someone has allergies, so seasonal allergies, we often see like asthma and like eczema, some skin issues, they just travel together, they're close friends. And now, this is,
I've talked to families and other, or the docs about how these, you know, these diseases, disorders, if you will, also just travel really closely together. They don't have to be in the same bunch. So one of the friends might be hanging out, you know, somewhere else. But when you see one or two, you know, we get a little bit more worried about the others. And they also just make each other a little bit worse, which is part of problem.
as good or bad friends do. so this is, you know, one thing, this is a predictable in biologic pattern. Okay, it's not accidental. These aren't, you know, these aren't failures of you or your child. It's biology.
I realized this is going to be like the word like like if there's like an anti ADHD slide like what not to do here you go
So what I'll explain here and I'll simplify it a little bit is I mean basically like we're all getting like overwhelmed just looking at this and this is what's happening is like you know we're starting with some anxiety and that may worsen your sleep which can worsen your executive function. Let go back here.
which is going to increase your risk of like poor food choices and weight gain and worse mental health. And it's like, you know, it's this like snowball of not good. Simplifying one of these really kind of more critical concepts is just like the anxiety and sleep loop. So, you know, a lot of times it kind of starts with this where, you know, anxiety,
kind of keeps our brain like turned on, right? And so, so falling asleep might be come difficult, you know, become a challenge or, know, maybe you wake up in the middle of the night or early in the morning. And then our tired brains just don't work as well. Right. And, and, um, I'd love to see we got two, two weeks from now, we got someone who's got an executive function panel. Um, so I'm not, uh, I trust that this is a audience that is familiar with this, but
you know, it's that part of our brains making like the, you know, kind of those tough decisions. And so then not only do we like kind of lose some of that, but then we individually kind of get these like increased sugar cravings, increased hunger, okay? We want that quick energy almost like as a replacement for a lack of sleep. And then, okay, and now we're on this bad cycle. Okay. So.
So this is just like one of the kind of loops that kicks things off. A couple of the pieces of this is anxiety can in itself can cause us like unhealthy stress. So there's some healthy stresses, but this is in this case, it's this unhealthy stress and that's, know, an important piece of the story, not the whole story is cortisol, right? So kind of our bad stress hormone.
that in and of itself can worsen sleep further. then the really annoying thing about cortisol is not only will it kind of deposit fat around our belly, so exactly all the places we don't want it, and then that can cause all the kind of like health problems down the road, but it also like breaks down our muscle.
really important for our metabolism and weight maintenance long term, and then increases insulin resistance, which we want good insulin sensitivity. So if we want to use energy appropriately.
Then, okay, so then a little bit, you know, we got adding that bad sleep, so kind of diving into like what that means further. So inadequate sleep, we can have decreased metabolism, hunger hormones go up, and then satiety, so we have a whole different bucket of like, what we call satiety or like fullness hormones, okay, those go down. So like all these things that we don't want to happen when we're trying to maintain our weight and our health are going the opposite ways.
speaker-2 (07:44)
hunger hormone.
speaker (07:58)
So.
We're kind of just getting into this like, why? Why does this happen? And why is it so important to make sure we're addressing each piece of this puzzle?
Then now coming back to this cluster, one of the biggest pieces of this is just this reward deficiency. So dopamine, sure you guys have heard it plenty in these talks. One of the very important pieces of ADHD as well as norepinephrine, one of our adrenaline type hormones.
kind of just have this low baseline dopamine a lot of times in an ADHD brain. So it's seeking for that, seeking for that stimulation a lot in the environment.
So then when it comes to our weight management and just overall health, one of the easiest things we can do to go get that, increase the dopamine is our food. And unfortunately, we're here in America in 2026 where we have a bit too much of an abundance of fast, reliable, no fiber, highly palatable foods.
And this is evolution problem. Our brains, if we were, you know, thousand years ago and we didn't have any food around, we would, I mean, would search pretty hard to go find something. And if you didn't get this big burst of happy hormone, you might not go chase that lion. So it's there for a reason, but it's just not as adaptive anymore.
And, you know, and then with these foods and just like fast food, for example, you know, we don't have to plan for it. No preparation. just it's it's just quick. Okay, so
speaker-2 (09:29)
So again.
speaker (09:30)
You know, this is a biology problem. It's not a discipline problem, doing things wrong. It's just that's how we were created and then how our brains work a little bit different.
Now, with that, I want to just kind of like briefly mention this kind of binge or emotional eating. We won't like dive too far into it, but it comes up a lot and some binge eating, so kind of the definition here is just like kind of eating like way more than what
speaker-2 (09:48)
No.
speaker (09:58)
a quote like normal person would in like one sitting, if you will. We've all done it. So we've all had to, you know, sat down with like some popcorn, bag of chips, you know, something like that. And we're like, okay, what the hell? did I just do? So understand this is, you know, we all have it to some extent. Where it becomes more of a like disorder is
is the one the frequency. So, so if this is happening a couple times a week, some people it's every day. But, but the cutoff here is about two episodes a week. If it's a couple times, you know, a couple times a month, okay, some behavioral behavioral things you can do. If it's if it's more than twice a week, and over a longer period, that's when we kind of start to get you know, a little bit more concerned and we have some some
further questions and the treatment options. But, you know, the other really important pieces of this is there's like this loss of control. It's not, I'm still hungry, so I'm still eating. It's no, was satisfied. I kept going. just, could not stop. And then if you don't care about it, she's like, yeah, I did it. It's fine. That's okay in a sense.
But but oftentimes it comes with this like shell shame guilt, you know, just kind of beaten up on yourself. And and importantly, there are no other like purging. So. You or a kid aren't making themselves sick afterwards, doing like excess running, taking laxatives, things like that. So so I thought very, you know.
Important to know that hey this if it happens every once in a while, that's pretty normal There's some things that you can do behaviorally to minimize it, but if that's happening pretty often You know, that's that's something to make sure you know talk to your talk to your pediatrician about come see a specialist, etc because it's it's a Thankfully there are medications. There's also plenty of behavioral things you can do and it's
much easier to earlier in the lifespan than it is when someone's 50.
A couple notes, counseling around eating disorders, it's super hard to come by. Most that you're gonna find are gonna come from like an eating disorder background, which...
if you or your kid also happens to have obesity.
That could be a hard fit.
Because I mean ideally you can't avoid you can't ignore one or the other you have to treat both They're both problematic. They're both a risk for their health long term So so you want someone that that can address that but without Like totally ignoring the disease of obesity because it is So so just be careful of that little nuance
I'm happy to announce we've got Dr. Amy Beck, amazing clinical psychologist. I worked with her for years at Children's Mercy. She works with us at MOKAN. I there's some others in town, unless you're doing intensive outpatient or inpatient stuff, it's just hard to find people in the eating disorder space. Fivans or Lisdex amphetamine.
Currently only FDA approved medication for Binging disorder. Well, classic ADHD stimulant med. Contrave, plenty of evidence that contrave could be really beneficial in these patients as well. It's FDA approved for weight management, but it's an old...
So it's a combination of two old generic drugs that we've been using, if appropriate, and been using for kids in a while. Now, Trexone less so, but we've absolutely been doing it for years.
GLP-1s, you have to be very careful in finding the right kid for GLP-1s in the setting of any eating disorder, for sure. So definitely a time when I'll do that for binge eating, but there are some things that you have to have in place. Otherwise, you're kind of putting the kid at a little bit more risk.
And then let's talk about the executive function of all this. So kind of the, you know, the quarterback of all this and where things can fall apart from, you know, from step one or where we start putting it all together. So you kind of think of this like your air traffic controller of the brain.
So it helps us plan, pause before we make action, prioritize what we're doing today, regulating emotions and behaviors. It helps us stop and think. In ADHD, it's just overwhelmed. Too many decisions, can't organize it, can't put it together, gets jumbled in the chaos. And so...
So having these things, these intentions of like, I know what to do and I know I need to go exercise and you need to prep dinner. But those plans and the actual actions, those steps between that and doing the action is often this void.
And so, you know, so if you think about, you know, if you've got your, if you're trying, you know, if you're responsible for taking care of an air traffic controller, make, they make high risk decisions. And you don't want to be responsible for a plane crash or a couple. And that's, you know, kind of a metaphor for your, your child and family's health. So you want to set them up for success. So
In this context, when we have these, you know, kind of these glitches, if you will, in the controller, executive function, you know, we have the poor impulse control. We kind of eat before we decide, man, I actually didn't, like, I'm not that hungry, or you know what, this does not align with my health goals. Time blindness. This is, I mean, I see this every single day in clinic. ⁓ you know, I just forget.
I head out in the morning and I forget to have breakfast and then I'm like, you know, you're hyper-focused, which is total ADHD, right? And you like forget, you go through lunch and then pretty soon you hit dinner and the train's off the tracks. Now your blood sugar's crashing, hunger is through the roof and then that is in the setting of this, you know, this ADHD brain and this is when binge eating happens. Okay, we overdo it, we make, you know,
We get fast food because our brain is just like, let's just do whatever is easiest and fastest because we need this now. this isn't like, you're not being bad. It's just we have this delayed regulation problem. So how do we fix that?
So to think about how we take care of this air traffic controller, to not mess up very important high-risk traffic, we give it structure. And so we structure the day. So all these little decisions, these little steps, you don't have to think about them. It's kind of automated. If you're sleep deprived, you would not want someone sleep deprived taking care of, you know,
being responsible for us when we're in like, we're in the air and we're trying to land, right? And I'm kind of thinking like, okay, what would I do? How would I take care of this person? exercise. You start the day with exercise, middle of the day, get the move in, get the blood flow in a little bit. Exercise dramatically increases our brain function over at least like four to six hours, can be a little bit longer.
Um, but, but I, I love to tell my, like my, you know, fellow nerds in clinic, you know, if they're like a, like, oh, I want to be a doctor, go to college. I'm like, okay, you're crushing it in grades. Like they could be better. You could think even better. And that's, and that's where you plug in that exercise. And then, um, and then nutrition, we don't want them, we don't want their sugar crashing. Um, if they're starving, their brain isn't getting, you know, getting nutrients it needs.
That's that's not that's not again not good for me in the air. I don't want that to happen They're gonna have just worse functioning in the in the moment So so you want this you want to build structure I'm gonna help them get good sleep I'm get that activity and you want to get just that that right nutrition So all of these things so their brain can function at its at its best
So, know, so particularly when it comes to, you know, obesity or just, you know, kind of weight management, you know, we like to change this question of like, how, you know, help me lose weight. How do I lose weight? To in this context and for you all, how do we support this regulation so they can make better choices, get better sleep, get the exercise? So first is just, you know, it's kind of being aware of this stuff.
So I'm a why person. You tell me to do something and like, better be a why there otherwise it ain't gonna happen, right? this first part of this talk is really just for your awareness. Why do these come together? Why does your brain work like this? So just knowing, some of us, and again, it's an evolution problem, our brain is wired to seek stimulation. Okay, so just understand that.
And in our current world with all the crap around us for food, it's brain is doing its job, but it's doing it too well in a bad environment for him. So not your fault. And there's things we can do.
So first, so kind of think about this like dopamine menu. If you got a limited menu, like food's the only option, yeah, we got trouble, right? And if you don't plan the options, then again, we're gonna go to like what's easiest. And food, could be drugs, right? Et cetera. And so we build it around this like, so one, mention movement.
novel things, creative things. We don't want to default to the easy, you know, the really easy stuff. want to build in these, these good venues. So, so here's our little, ⁓ a little ADHD, menu. So we've got our appetizers and kind of the quick, the quick ones, be petting the dog, chin little, you know, 10 jumping jacks, your favorite song. ⁓
I love this one, like splashing cold water. If you want to go so far as to do like a cold immersion, some cold bath, cold shower. It's not for everyone, but I love it. Our entrees, know, this would be a little deeper, a little longer engagement. I it could be gaming. Create a project, a walk outside.
Body doubling is kind of a newer one for me. It's a little tougher to set up, but basically it's, you if you need things you like really need to do with ADHD, just working in the same area as someone doesn't have to be doing the same thing. We work a lot better.
Some sides, some low effort, low effort stim. Fidget toys, little podcasts, or just like some background music, weighted lap pad, here are desserts, socializing, high intensity workout. So just kind of coming up with this, I think kind of a, yeah, this menu or like toolbox of things throughout the day.
Okay, the nutrition. Critical for managing all these things, but particularly with ADHD, starting a date with protein is super essential. Couple things, this was... I forgot this, it's been about solid...
solid 20 years since I had a biochemistry, trying to try to you know forget it but our protein has these amino acids which are building blocks of dopamine and norepinephrine. So if you're not getting this you can have I mean you can literally have this like short-term deficiency in the essential things to make dopamine and norepinephrine.
You're going to have, we're going to have troubles with, you know, impulse control, executive function. if your kid's on stimulants, having it with a protein can kind of slow down that absorption. Okay. And kind of ease that, that evening fall off. So it's not just like this cliff. then we're going to, you know, trains off the tracks. the, the other piece of that is, is the like,
emotional kind of binge eating stuff. So making sure we're getting those kind of consistent meals throughout the day. And and starting not with like simple starches and sugars, but some protein and or fiber. It's just going to kind of cool those like any like potential sugar crashes. And just those big hunger peaks. When when that's that's our kind of a big risk for
like the loss of control leading.
So again, structure, right? Talking about structure. Critical here, so this so as much as possible, try to avoid sugar. I will tell you as a fellow parent of like little kids, my wife is a pediatrician too soon, like, and you know, so it's our wheelhouse, but it's still, it has still taken us about a solid like two, three years to continue to sift through all the trash.
that ⁓ is so common in our kids' lives as far as like snacks that have added sugar when you're like this is, you know, this should not have added sugar, but it is everywhere. So, you know, I'm sorry, but this is our environment and the odds are stacked against you. And, but I will tell you the more time you put into kind of looking at nutrition facts and...
and trying to cut out the added sugars is worth your time. But no, you're not alone in thinking, ⁓ my gosh, this is it's everywhere. So and I'll say part of why I do it is purely self is so selfish, purely self preservation. If you like we have had studies for years showing that if you like even without ADHD, if you get kids sugary breakfast, sugary cereals, that kind of stuff.
they are going to be more irritable and have worse executive function. So I'm really just looking out for me. My ⁓ toddlers are wild enough. I don't want to add fuel to the fire. And I doubt you do either. So some simple options here.
speaker-2 (22:51)
and then...
speaker (23:01)
eggs, cottage cheese, Greek yogurt, you know, careful with like regular yogurts, a lot of times they're going to be loaded with sugar. I mean, to the point of like a can of Coke. So again, got to look in nutrition facts, but that's, that's just our reality. Protein shakes are totally fine. You know, if you need convenience, you know, get to something out the door in the
in the bus, on the drive, it's a good option. Snacks, try to keep fruits, veggies, nuts around. Careful with granola bars. They are well-marketed candy bars, unfortunately. So I know you're all well-meaning and want your kids to do well and give them the right stuff. These have carried on a...
a title and of a health food but they don't fit the they don't don't fit it anymore. Drinks you know I'll say particularly so for kids particularly like sodas how I how I discuss like sodas etc with with families is
speaker-1 (23:47)
it.
speaker (23:58)
And remember, this is in the setting of like obesity and, you know, kind of like pre-diabetes, et cetera. There's no such thing as a healthy soda. Okay. Let's just like, let's start there. Then, you know, from there it's, okay. So if we have sugar in them, okay, we're going to more problems with, you know, irritability, the executive function, et cetera. And of course in my realm,
It's, you know, obesity, fatty liver is terrible when it comes to sugary drinks. And then of course, you know, you get high cholesterol all the time with them. If that doesn't make sense, you holler at me, well, happy to chat. And so I almost always recommend switching over to Zero Sugar. They've got their own baggage.
But in our current environment, it's just a dramatically, dramatically healthier choice for the most part.
⁓
speaker-1 (24:51)
then
speaker (24:51)
Again, kind coming back to that structure, right? Tell us parents every day, set up your environment for success. So if it's out there, if it's visible, it's gonna be eaten. So, and even then, and I guess beyond that, if you keep sweets in the house, mean, ask my kids if there's ice cream in the house, every single night, it's a fight.
Again, their brains love it. They want it. It's an evolution problem. So if you don't want your kids to eat it, keep it out of the house.
speaker-1 (25:20)
How's?
speaker (25:20)
My connection okay, it looks like it was a little delayed there. Yeah, so if you don't want your kids eating something, keep it on the house. We'll go, I love ice cream. If it's there, I'm gonna eat it every night, even if I don't want to. We walk down to get it, we walk back. I love it, and we go about our day. So, do not be the food police. That doesn't go well for anyone.
It's just gonna be a daily fight. Everyone's pissed. No one likes it. it's, I know it's hard with families. You got more than one person in the house, but sometimes, you know, your parents, you do hard things.
Then couple other tricks you can use like kind of opaque, know, non-clear bins, put some of the stuff in higher shelves. And, you know, and again, if it's visible, right? So we want the default, the easy decision to be the healthy one. So, you know, put your fruits, veggies, nuts, proteins on the counters, not our junk food. And just remember this.
Design beats self control. Structure will beat self control.
You don't want to or don't want your kid to wait for their hunger cues. So if portions are a problem, if binge eating is a problem, you don't want to wait till they're really hungry. Our ADHD brains, right? We mentioned this, they miss early hunger signals. So put them on a schedule, right? Because this small, healthy breakfast, lunch, dinner, that will
prevent lots of problems. And that stability is going to prevent blood sugar crashes, binging, help with better mental function throughout the day. It's great for the kids.
A couple of things with sleep. So this is not, I mean, I know we mentioned that anxiety can, ADHD itself can kind of worsen sleep, but just the kind of typical ADHD brain, it's a kind of a couple interesting notes with that. One, often have this like melatonin leg. So,
as
Connection, okay. There we go. So there's this melatonin leg. So we all have this normal cycle of melatonin and it starts to go up in the afternoon and further into the evening. But in a lot of people with ADHD, there's about an hour and a half to two hour delay from kind neurotypical people.
Okay, so.
So now we've got this later bedtime, even if you have the structure in place. And then what happens when we're off and up later? We get snacky. And then now we're getting more of our calories. And again, our executive function, we're all wiped at the end of the day, and that's when we make less good decisions. And so we're not eating broccoli at.
at 11 p.m. So now we're getting more carb heavy foods, having higher calories in the evening when our metabolism is starting to drop. Okay. And we're going into this like energy storage mode. So one just melatonin supplements, you know, no, I mean, it's not a sleeping pill. It's not going to just like put you to sleep. But in this.
in this setting, can correct that delay a little bit. One thing, most of the supplements you'll see in stores are like two, three, five milligrams, 10 milligrams. Those are way too much. And with those, and especially for kids,
too high of a dose, can actually have that like, you know, get kind of like overly sleepy in the morning, you're still kind of sedated. It's like 0.5 to one milligram for kids. And actually a couple hours before bed can kind of correct that melatonin leg. Now this isn't everyone, okay, so some people are just like, hey, go to bed fine, fall asleep fine, but no.
Kids and adults with ADHD are just more likely to have that delay and troubles with sleep onset. this, you know, talk to your doc, but this can be a good option for them.
And then a couple really common traps. So, ADHD and then anxiety.
particularly so coffee particularly with ADHD it's it's oftentimes like self-medicating so we'll get this big little bit you know a little bit like dopamine hit and and there's just a little higher risk for like kind of coffee overuse and and the main problem so so one
speaker-2 (29:27)
The ma-
speaker (29:29)
Coffee in the setting of obesity is actually great. Every time we study coffee, assuming there's no junk in it, About two cups a day is like the nadir the best point in our mortality curve. Every time we study this. So it helps weight loss, it helps risk for like pre-diabetes, et cetera.
The problem with it's afternoon coffee, everyone has their cutoff. Mine's like 11 a.m. If I have it after 11 a.m., I got sleep problems. And even if you can fall asleep fine, your sleep quality will be disrupted. So quantity can be the same, but you're not gonna get as good of sleep. And now, right, we talked about that cycle, we talked about the stuff of like,
you know, sleep, et cetera, what that causes. and then same thing with alcohol. So again, a little bit higher risk and like anxiety, NHD, ADHD, and plenty of people like, yeah, it helps me fall asleep. And, but absolutely make up for that later in the night. And our, your sleep quality is terrible with alcohol. So,
that's a pattern for any parents out there. Note noted.
And then, you know, how to talk to ADHD brains. So kids with ADHD brains. So as you all know, kids know everything and they know that you know absolutely nothing. and most of time the same goes for me in clinic. So help them find their why. So you know your kids the best. You know what drives them.
you know, do they want to be a good athlete? They want to go to college? They want this job? Like, whatever. I mean, you can you can tie in nutrition, exercise, sleep to I have I have yet to come up with a or, you know, hear a why that I couldn't tie these behavioral things to. So. So if you help them find those answers themselves.
And this is like, basically this is motivational interviewing. But the more that you can guide them to find those answers and feel like they're the ones making the decision, because, hey, I want to be a better student. I want to beat Becky at soccer tomorrow, you know. The easier these behaviors are going to be. But if you just tell them what to do, like, I think you know what's going to happen.
And to parents, you're not failing. You're crushing it, you're here, you're in the support group. You're doing awesome. None of this is bad parenting. I love this analogy. You're raising a Ferrari brain with bicycle brake regulation. But know that support, know, this little support,
absolutely changes outcomes hey i called it didn't i
speaker-2 (31:52)
My kids want to join the party.
speaker (31:54)
I swear I didn't request it.
And then some takeaways here. Our structure. So structure is our external executive function. want to, so schedule those meals so you don't have to, you know, we don't forget, you know, keep the unhealthy, tempting foods out of the house. Put the healthy stuff that you want to eat, that you want your kids to eat visible.
helps set up that foundation for good sleep because without that, as humans, don't do anything very well.
Pills aren't skills, so we oftentimes we need both. And one of my favorite things, is you know, particularly in obesity, because weight management is just hard and annoying and it's just progress over perfection. You know, it's a lot of things. There can be a lot of challenges, sometimes all at once. And so, you know, get that perfectionism out of the way and just
Just make progress each day. Again, like I said, this is all I do and it took me a couple years to clean up some of the food in my own house for my own kids. So be graceful with yourself.
And if you need help, need a second opinion, we're here at MOKAN Weight Loss and Metabolic Health. Me, I love this. I help manage ADHD and binge eating in addition to obesity and kind of the metabolic stuff that comes with it. ⁓ We have Dr. Beck, who's particularly this
Also kind of a wheelhouse of hers over the years. Julie Vandal, our dietitian, all three of us, we work together at Mad Children's Mercy and feel very blessed that they've joined me because they're rock stars. And we offer behavioral therapy for ADHD, binge, the medical nutrition therapy. And if you feel like want to discuss meds or kind of need to...
Just like second opinion, feel free to reach out. can text us at our business number. Read a little bit more about us at mocanweightloss.com.
I left a little time for questions here.
speaker-1 (33:51)
Anyone has questions and doesn't feel comfortable asking, then you can put them in the chat and either Sara or I will get to those.
One thing that I thought of when you were talking about sleep and the melatonin, you mentioned like our slower metabolisms in the evening. There are all kinds of diets out there proposing like long fasts overnight and things like that. I don't know if that is too big of a question to ask with this, but if you could just maybe touch briefly on is there value to not eating after a certain time at night or something like that.
speaker (34:21)
Yeah, that's a really good question. First, I'll make a point about just intermittent fasting because that's...
I feel like that is messed up every time someone comes in and asks about it. There are plenty of benefits of intermittent fasting.
it's one it's a matter of is it right for you right so so if you have if you have a know history of binge eating troubles with portions etc you have ADHD anxiety man I don't love don't love intermittent fasting and and particularly you know all of the data says
speaker-2 (34:53)
when
speaker (34:57)
that it is best when we kind of think just like eat by the sun, right? So you break fast, do a little earlier, and then in your eating window is kind of when it starts to get dark. I'd be happy to nerd out about like all the reasons why that's the ideal way. But of course, everyone does it opposite, right? So everyone's just like,
kind of intermittent fasting, like, you know, I skipped breakfast and don't eat until like lunch and then I, you know, I'm done at like eight or nine. Man, that is not, you know, in general, not the way to do it. And again, as I think as we, you know, kind of laid out here, definitely doesn't work well for the ADHD brain anxiety. So there's so there's that, that piece I just see wrong every single time.
To your specific question though about, you know, is there a good time that like we should probably stop eating? Yeah, I mean it's kind of as close to when it's getting as dark as possible. So is that, you know, changes throughout the season. So it's not, you know, it's not a single time, you know, knowing that for, you know, for our patients with or for our families here with with kids.
Man, it's tough to do for a lot of families. But what I would absolutely take away from that question is, the kind of the earlier you can have dinner and shut it off, the better. So from like a weight and our metabolic health, that kind of stuff, definitely better to be having kind of a smaller meal.
a smaller meal for dinner and a little bit earlier.
speaker-1 (36:33)
We have lots of questions in the chat all of a sudden. So I'm going to start reading these out. First, is it worth going to a sleep clinic once a child has been diagnosed with ADHD or does ADHD make a sleep clinic visit moot since so much is already known about the relationship between ADHD and sleep?
speaker (36:37)
I'll be quicker then.
⁓ love that. No and no. So it is not, yeah, definitely not an automatic referral to a sleep clinic. You know, whoever made the diagnosis.
Surely will and should be if they're following up for years should be monitoring asking about sleep, sleep habits, stuff like that. And if there's a you know, looks like a real sleep disorder that is just not being addressed, not getting better than than sure. But yeah, not not an immediate not an immediate referral. And and yeah, you know, just knowing that they are friends.
doesn't mean that they can't be helped. So it's really just being alert that like, they're buddies and we want to be alert about some sleep issues, maybe not necessarily a terrible, untreatable sleep disorder. But just being aware that there some sleep issues and typically there's lots we can do.
And sometimes a sleep specialist will be a part of that story.
speaker-1 (37:46)
I'm going to combine two of the questions because they kind of go together. What are your thoughts on vitamins and supplements such as magnesium to support sleep or others for anxiety when you have ADHD? And then part two of that related question is what would the maximum milligram of melatonin for adults be?
speaker (38:02)
I'm going to give a vague answer for the magnesium. In general, this setting, I kind of like it. You know, there's some potential benefit with anxiety, can help with sleep, but...
But with that said, there are times where you would not want to give it. So I would definitely not say no. It's a fairly reasonable thing to look into with your doc.
as far as like random, you know, other supplements, generally, generally, you know, recommend people just be really careful about spending too much on kind of bogus claims. So something someone tells you that it fixes everything, it fixes almost nothing. And and and I mean, you know, people have gone broke, half broke, trying to
you know, trying to help their weight when like, I look in their initial questionnaire in two minutes, I can see, okay, you've had multiple family members with have had bariatric surgery and diabetes. I found your answer.
So just go to someone that you trust to manage these things and you've got a good rapport and just be careful you don't throw your money down the trash and I know a lot of people we all mean well but there's a of people out there want to sell you stuff that's not to your benefit. Max dose for melatonin
I mean, you know, understanding I am not a sleep specialist, but I am not aware of the like any data to say like, you know, over five milligrams is beneficial. And even five is quite super physiologic. It's a pretty big dose. So I don't know. I don't even know how 10 is out there. I don't know, Dr. Stuppi, if you have...
Any thoughts?
speaker-1 (39:44)
I'd
say less is more. Yeah. Yeah. Yeah. With some good sleep hygiene, which basically means having all of the... Or setting the stage for sleep.
speaker (39:51)
Amen.
speaker-1 (39:55)
All right, then there is a statement with question. ⁓ don't believe specifically I have issues with eating too much, consistency is definitely an issue. Are these tips applicable to that as well?
speaker (40:05)
Yeah, yeah, I would say so. mean, it doesn't, you know, we don't have to have, you don't have to have obesity. You don't have to have like binge eating to, to still get the benefits of just these small healthy meals throughout the day. Just kind of balance, balance your blood sugar. You know, make sure you're getting the right nutrients. So yeah.
speaker-1 (40:25)
Alright, and you just commented that you're not a sleep specialist, but lot of these questions are about sleep. Do you have any tips for adjusting an out of place sleep schedule from 3am to 11am?
Or is that for another time? For adjusting.
speaker (40:37)
I'm trying to figure out the question. We're trying to move like if it's currently 3 a.m. to 11 a.m. so yeah I will I'm gonna I'm gonna take a little leap here and assume that we're saying hey we're currently sleeping from 3 to 11 I'd like to sleep at 11 a.m.
I the low hanging fruit here is the thing to remember, it's really hard to move back in your sleep schedule. So if you're at three and you're like, yeah, you know, tonight I'm gonna go to bed at 9 p.m. That's gonna be tough.
speaker-1 (41:12)
it
speaker (41:13)
I think tip like what I typically hear, you know, and again, can remember hearing from, you know, like sleep specialist is like, I mean, you're almost like going forward. Yeah, please. If that is just like your natural sleep schedule and you. You want to try to get out of that and you have some insomnia, please go see your physician to talk about that. That's a big. That's a pretty big lift.
To be honest.
speaker-1 (41:34)
All right, here's another eating one. with all these questions about sleep, I had no idea that sleep was going to be such a big question for you. We might have to search for someone to talk about sleep medicine. This is like a big, big thing with lots of you guys. ⁓
speaker (41:45)
I'll connect to you.
But
another eating... I'll throw out a shout out for Dr. Haley Martens. She's new to the area, she does adult and pediatric sleep and she's a great doc, wonderful human. So if any of you need a good ⁓ resource, she's Dr. Haley Martens at Remedy Sleep.
kind of like College Boulevard in Antioch. She's great, great doctor.
speaker-1 (42:13)
Can I drop your name when I reach out to her to see if she wants to talk to this group?
speaker (42:16)
please. Yeah. Yeah.
speaker-1 (42:18)
Then let's get back to eating. Do you have an opinion about the intuitive eating movement that some people advocate for ADHD?
speaker (42:24)
Yeah, I love. ⁓ man, I love this question. It is loaded. So.
So the intuitive eating, this makes, I'll tell you, so this makes sense if your biology and your hunger and satiety signals are working normally.
When I mean, I would almost say that that is almost obsolete. And the problem and the reason there is we have had companies engineering food for the last how many decades to be more palatable. You want to eat more. And literally trying to hack our biology.
And they've been very successful with it. then, then, you know, eventually then, you know, we get, so develop obesity and, and like, not to get two in the weeds, but we can develop insulin resistance. And so, which is like kind of on that spectrum of like pre-diabetes, diabetes. We normally think of insulin acting out as like the, like the rest of our body, but it's, it's also a
a fullness signal and we can get insulin resistance at the level of our brain. so, okay, so now we're not working on the even playing field. Like our biology is, it's no longer intuitive. This food, this lack of sleep, because we're all on our phones, mean, it's all of us.
I'd say for the vast majority of people right now.
I don't think that's appropriate. Specifically for ADHD, again, you know, my first question would be like, okay, are you on stimulants? Okay, now, so we just gave you medicine that's dropping your appetite. We no longer meet the qualifications for intuition. We're changing your biology and changing your hunger.
So yeah, there's my opinion.
The intent of it is phenomenal. And if we were in the right environment, it's absolutely what we should be doing. It's just, yeah, my argument is it doesn't fit our current environment of...
such an obesogenic environment.
I'd say there's a small subset of patients that sure, go nuts if you're just like a vegan, whatever, vegetarian, but a very healthy diet. You've got no fast food, no processed stuff around you. Your sleep is amazing.
⁓ But for the most most for ADHD and 70 % of the population with overweight or obesity, I wish it was, but I don't think it is.
speaker-1 (44:37)
All right, well that is the last question in the chat and we did run over by a few minutes, but this was fabulous. So much information. Does anybody have any parting questions? Quick question.
Cause if not, we'll let you all get back to hopefully not dinner. Hopefully you've already had your Which I know. Young, but.
speaker (44:54)
Thank you all for sharing your evening with us. Feel free to reach out with any questions. We've got free discovery calls if you'd like to just chat and see if we fit for you. Otherwise, yeah, count speed. It's been a pleasure.
speaker-1 (45:07)
Alright, thank you everyone.
speaker (45:08)
Thanks.
speaker-1 (45:09)
enough.
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