MAHA Report: 3 Takeaways for the ADHD Community

May 23, 2025

The anticipated MAHA Commission report released yesterday misrepresents ADHD causes and care in the U.S., misinterpreting studies and disregarding compelling new research and patient voices to suggest that ADHD is contributing to a “crisis of overdiagnosis and treatment” in American children.

The MAHA Report, spearheaded by Health and Human Service (HHS) Secretary Robert F. Kennedy, Jr., equates ADHD with obesity, heart disease, and diabetes in calling these harmful contributors to the “childhood chronic disease crisis” in the U.S. It disregards the genetic underpinnings of ADHD to suggest it is solely caused by environmental factors and foods, twists data to stoke fear over rising diagnosis rates, and excludes a wealth of studies that link stimulant medication use to improved health outcomes.

It assumes ADHD is a disease caused and cured by environmental factors. And it suggests that curing ADHD will “make America healthy again.” We disagree, and so does the research.

Should the U.S. government take a long, hard look at the impact of ultra-processed foods, environmental chemicals, and declining physical activity on American children? Absolutely. Should it invest in programs to provide healthy foods, affordable health care, and screen-free activities for all children, regardless of socioeconomic status or means? Yes. Do we support efforts to eliminate toxins from our kids’ food, water, and air? To protect them from unhealthy screen use? To help them live longer, healthier lives? 100%.

Will any of these efforts “cure” ADHD, as the MAHA Report suggests? No, the research does not support that notion. But these efforts, if undertaken by Kennedy, do stand to improve quality of life for many children, and so they should be seriously considered by HHS through investment in the FDA, CDC, and NIH.

Do you know what else improves quality of life for kids? Less stigma and shame, and more investment and solutions. The MAHA Report, sadly, increases ADHD stigma by claiming the condition is overdiagnosed and disparaging its treatment as ineffective without any credible evidence to support these claims. On the flipside, it makes no mention of the proven, life-saving benefits of ADHD treatment or the risks associated with undiagnosed, untreated ADHD. It makes no mention of behavioral parent training, cognitive behavioral therapy, dialectical behavior therapy, or classroom interventions for ADHD, all of which are shown to improve outcomes for individuals with ADHD. Instead, the report’s “solutions” for ADHD suggest more scrutiny of and restricted access to stimulant medication.

Finally, it is notable that the commission included few scientists or experts in pediatric health care. The commission conducted no new research and it apparently did not seek comment or insight from the American Professional Society of ADHD and Related Disorders (APSARD), the American Academy of Pediatrics (AAP), or the World Federation of ADHD regarding the established science on ADHD causes and treatments. No patients were interviewed for or quoted in the report.

The next steps outlined in the report are vague and we expect the commission to propose more detailed strategies in August, but here are three takeaways from the May 22 MAHA Report that may impact the ADHD community.

#1: The Report Misrepresents the Causes of ADHD

ADHD is a highly genetic condition, as confirmed by brand-new research that identified measurable genetic traits that essentially act as biomarkers for ADHD. Lifestyle factors such as nutrition, exercise, and sleep exert epigenetic changes on DNA that influence how strongly or weakly ADHD genes are expressed. However, diet, physical activity, sleep, or screen use alone do not cause — and have not been shown to “cure” — ADHD.

Scientific research has established no causal link between consumption of sugar, food additives, or food dyes and ADHD, though some studies show a heightened sensitivity among children with ADHD to these foods, which may exacerbate existing symptoms. Likewise, scientific research has established no causal link between excessive screen time, video game play, or social media use and ADHD.

Despite clear evidence to the contrary, the MAHA Report claims that ADHD is caused by all of the following, but it never mentions genetic factors:

• Antibiotics: The report cited as evidence a study that “could not disentangle the effects of antibiotics from those of the underlying conditions” and “could not verify adherence to antibiotic prescriptions.” Other recent studies have found gut microbiome alterations in children with ADHD but no causal link between antibiotic use and ADHD in humans.
• Food additives: Research shows that food dyes may worsen symptoms of inattention or hyperactivity in children with ADHD, however there is no evidence of a causal relationship.
• Environmental toxins: This article by Joel Nigg, Ph.D., contains a thorough overview of all existing research on environmental toxins and ADHD, but the bottom line is this: “Genes and environments work together to shape development of the brain and behavior throughout life, but especially — and most dramatically — in very early life. ADHD, like other complex conditions, doesn’t have a single cause. Both nature and nurture influence its development.”

#2: The Report Casts Doubt on the Validity of an ADHD Diagnosis

The MAHA Report claims that “research shows ADHD has the strongest evidence of overdiagnosis,” however no such research is cited in the report. Perhaps that is because there is no definitive evidence that ADHD is overdiagnosed in America today. ADHD diagnosis rates have increased over the last few decades, however this may be a result of any of the following, and other factors:

• The high diagnosis rate cited in the report comes from a problematic and misleading CDC study that is “terribly designed to assess the prevalence of the disorder,” says Russell Barkley, Ph.D., a leading authority on ADHD. “In this survey, there is one question about ADHD: ‘Has a doctor or other healthcare provider ever told you that this child has ADD or ADHD?’ That could be anybody associated with the healthcare profession who has no training in ADHD… and there is no effort in this study to follow up to see if these children were, in fact, diagnosed.” Barkley goes on to say that meta-analyses of better-conducted studies that apply diagnostic criteria to their research populations find that the prevalence of ADHD among children ranges from 5 to 8 percent, not 10 to 11 percent.
• Revised diagnostic criteria published in the DSM-5 changed the age of onset from 7 to 12 and added the first-ever qualifier symptoms for ADHD in adulthood
• With ongoing research and clinician training on ADHD, education and symptom recognition have improved
• Twenty years ago, ADHD was viewed as a disorder that affected young males. As research on females began to take hold, girls and women were able to secure ADHD evaluations for the first time
• Likewise, as mental health stigma dissipates within time, historically underserved populations are seeking care for the first time

The report further suggests that “the harms associated with an ADHD diagnosis may often outweigh the benefits” without naming those supposed harms or acknowledging the many health risks associated with undiagnosed ADHD. Research shows that undiagnosed and untreated individuals face a higher risk for fatal car accidents, unwanted pregnancies, serious injury and hospitalizations, job loss, academic interruptions, self-harm, anxiety, depression, eating disorders, and more. The harms associated with undiagnosed ADHD are too severe to ignore, yet the MAHA Commission does just that.

#3: The Report Misrepresents the Efficacy and Risks of ADHD Medication

The MAHA Report draws faulty conclusions from the ​​Multimodal Treatment of Attention-Deficit/Hyperactivity Disorder (MTA) study to argue that ADHD medication use offers no benefits “in grades, relationships, achievement, behavior, or any other measure” after 14 months of use. This is untrue.

In reality, the MTA study ended after 14 months, so the control group members with ADHD who did not initially receive medication were free to seek it out after 14 months. As many of the controls began treating their ADHD symptoms with medication, the differences between the control and treatment groups faded because the control group members began to improve on medication, not because the treatment group began to do worse. It is wrong and irresponsible to suggest that no patients experienced benefits from ADHD medication use after 14 months.

“The groups became very contaminated after that 14-month follow-up,” Barkley says in a video on his YouTube channel. “Therefore, we can’t make comparisons at years 2, 3, or 4 between or among the treatment groups and draw any conclusions about them because the treatments were mixed up among all the groups.”

The report claims that stimulants, “when stopped, often lead to disabling and prolonged physical dependence and withdrawal symptoms.” This is untrue. The research cited in the report was a study of antidepressants, not stimulants. There is no evidence to support this assertion regarding stimulant medication. In addition, we know that half of teens and adults with ADHD stop taking stimulant medication within one year of starting it, often due to stigma or access problems. This suggests that it is not addictive. In fact, stimulant medication has been used safely and effectively for nearly 100 years — more than enough time for long-term adverse outcomes to come to light, yet none has.

Finally, the report’s claim that stimulant medication use does “not improve outcomes long-term” is also false.

Research dating back more than 40 years has documented the positive impact of ADHD treatment on specific symptoms like inattention and hyperactivity, and on life expectancy overall. Recently, a Swedish study, published in JAMA Network Open, documented these findings:

• ADHD medication use reduced overall risk of death by 19%. Among people with ADHD who did not receive medication, there were 48 deaths for every 10,000 people, contrasted with 39 deaths per 10,000 people within the medicated cohort.
• ADHD medication use reduced the risk of overdose by 50%. Medication use also reduced the risk of death from other unnatural causes, including accidental injuries, accidental poisoning such as drug overdoses, and suicide.
• ADHD medication use reduced the risk of death from natural causes, such as medical conditions, for women.

People with childhood ADHD are nearly twice as likely to develop a substance use disorder as are individuals without childhood ADHD. However, research suggests that patients with ADHD treated with stimulant medications experience a 60% reduction in substance use disorders compared to those who are not treated with stimulant medication. Considerable evidence also suggests that children taking ADHD medication experience improvements in academic and social functioning, which translates to improved self-esteem, lower rates of self-medication with drugs or alcohol, and decreased risk of substance abuse.

Given all of the above, it’s difficult to view the increase in stimulant medication use flagged by the MAHA Report as anything but positive. “Why isn’t that evidence of improvement in good public mental health?” Barkley asks. “The fact that there is a rise in the occurrence of a particular treatment does not provide prima facie evidence that there is something bad, wicked, evil, wrong going on here; it simply means that, over time, we are getting closer and closer to identifying conditions that produce harm in individuals, and that we try to alleviate that harm and suffering.”

The Threat to ADHD Care Access

The MAHA Commission plans to release its recommended strategies in August, but it’s easy to see the writing on the wall now. The arguments presented in Thursday’s MAHA Report, based largely on outdated or poorly interpreted research, suggest that Kennedy may seek to restrict access to ADHD care and that he’s building a foundation of doubt and misinformation now to support that action.

We fear efforts to dissuade physicians from diagnosing and treating ADHD may be forthcoming from the Drug Enforcement Administration (DEA) with support from the CDC, which Kennedy oversees. Of course, we hope we are proven wrong. We hope that, instead, HHS chooses to fully restore funding for ADHD research efforts through the National Institutes of Mental Health, for mental healthcare initiatives through the CDC, and for nationwide nutrition assistance programs through the FDA.

ADDitude supports an investment in unbiased research into the root causes of and effective treatments for ADHD to support, not ‘cure,’ individuals living with neurodivergent brains. We welcome the opportunity to engage in transparent dialog with the MAHA Commission and to introduce the voices and viewpoints of individuals and families living with ADHD, which were excluded from this report. And we hope that this administration will fund initiatives to improve food quality and access, eliminate harmful food additives, provide mental health services to all children, and crack down on the industries and companies contributing toxins to our environment.

We also stand ready to defend the legitimacy of the robust library of credible, science-backed research studies that confirm ADHD’s genetic underpinnings, that validate its diagnostic tools, and that confirm the benefits of its uninterrupted treatment.

Reactions from the ADHD Community

Mark Bertin, M.D., PLLC, of Developmental Pediatrics

“Lifestyle changes that promote child health are a wonderful idea. However, the MAHA paper ignores the reality of ADHD, a common medical disorder with genetics nearly as strong as the inherited trait of height. Undertreated ADHD is a public health concern that affects school performance, relationships, and driving; increases the risk of substance abuse; and shortens lifespans. Research and clinical experience show clear benefits to ADHD medication, which has been used for a century without evidence of chronic side effects. Supporting individuals with ADHD requires more understanding, not less, while making medical, educational, psychological, and health-related supports affordable and easily available. The MAHA document completely misrepresents ADHD in ways that are judgmental, demeaning, and will be harmful to individuals, our health care system, and society.”

Russell Barkley, Ph.D.

The ADHD Evidence Project, Founded by Stephen Faraone, Ph.D.

“ADHD is one of the most discussed neurodevelopmental disorders in the MAHA Report, but many of its claims about ADHD are misleading, oversimplified, or inconsistent with decades of scientific evidence, much of which is described in the International Consensus Statement on ADHD, and other references given here.”

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