Before we start: If you or someone you know is struggling with ADHD and eating disorders, please immediately consult your doctor, who will refer you to relevant healthcare professionals. Remember, seeking help and support is a courageous and essential step towards recovery.
Here are a few resources that may help:
- Eating Disorders Australia
- Eating Disorders Families Australia
- National Eating Disorders Collaboration
- The Butterfly Foundation
Over the past three months, the Australian ADHD Helpline volunteers have been fielding more and more complex enquiries from our ADHD community, seeking direction and support. Many of these calls relate to the connection between eating disorders and ADHD. This article has information that may be helpful to those wanting to learn more about the relationship between these two conditions.
Types of Eating Disorders
- Bulimia nervosa: A person with this eating disorder will binge on large amounts of food in a short space of time and then “compensate” by exercising excessively or purging, which may involve vomiting or using laxatives.
- Binge eating disorder (BED): This is similar to bulimia, but people do not engage in compensatory behaviours.
- Anorexia nervosa: People with anorexia nervosa, known as anorexia, severely restrict their food intake, and they may rely on a limited number of “safe” foods.
ADHD and Eating Disorders Overlap
For patients with ADHD and an eating disorder, clinicians must understand the interplay between conditions and actively treat both.
ADHD commonly overlaps with eating disorders, in part due to traits like impulsivity, executive function deficits, low dopamine production, and more. Research shows a link between ADHD and certain eating disorders, such as bulimia and BED. ADHD does not appear to have an association with anorexia.
This may be due to the fact that overeating is an impulsive behaviour, while undereating is a restrictive behaviour.
Biological and Genetic Factors
The ADHD brain produces insufficient dopamine, a neurochemical implicated in reward, which may cause individuals to seek satisfaction through food. ADHD brains have lower levels of GABA, a neurochemical implicated in inhibition.
Purging can be a euphoric, almost addictive form of stimulation that increases dopamine levels. Restrictive behaviours can build up reward sensitivity – individuals may purposely restrict food so that when they do eat, it is much more rewarding to them.
Dopamine receptors could overlap with obesity, binge eating, and ADHD. ADHD brains take longer to absorb glucose than non-ADHD brains, which could lead to higher sugar and simple carb consumption.
Individuals with ADHD, like those with eating disorders, have poor interoceptive awareness, which affects the ability to understand hunger and satiety cues. Planning and decision-making around food can be difficult, which can contribute to impulsive eating or even restriction to avoid the executive task of preparing food.
Individuals with ADHD may also struggle with self-regulation and have difficulty resisting the temptation of high-calorie foods or strict diets, leading to overeating or other unhealthy eating behaviours.
A 2022 mini-review found that children with ADHD may be more likely to engage in impulsive behaviours such as binge eating, which can lead to weight gain and further exacerbate their eating disorder symptoms later in life.
Poor sleeping habits can dysregulate the metabolism, while poor impulse control and irregular eating schedule can contribute to overeating, and issues with self-regulation can make it difficult to know the quantity eaten.
A 2013 study found that certain traits of ADHD were more strongly associated with eating disorder symptoms than others. Predominantly inattentive presentations reported more severe eating disorder symptoms than those with hyperactive/impulsive leading traits.
This is echoed by Murray et al. in a 2013 study that found inattention symptoms were more strongly associated with disordered eating risk in females, while impulsivity symptoms were more strongly associated with disordered eating risk in males.
Emotional Factors and Self-Esteem
Food can also be a relief from anger, sadness, anxiety, and other difficult emotions, a way to cope and feel in control. Boredom could also be a major predisposing factor to binge eating.
This may also cause a struggle with low self-esteem and negative self-talk, which can contribute to developing an unhealthy relationship with food.
There may also be an increased risk for eating disorders in girls with ADHD who particularly feel the social pressures of comparison, body image sensitivity and peer approval.
A 2009 study by Wentz et al. showed that girls with ADHD were significantly more likely to develop eating disorders compared to, control girls, with a 6-fold increased risk.
The link between ADHD and eating disorders might be more prevalent in females, where a 2008 study found that one in five women seeking treatment for an eating disorder had six or more signs of attention-deficit hyperactivity disorder (ADHD).
Social anxiety is common in men and women with ADHD of all ages. When looking at disordered eating behaviours, it’s important to consider that they are often intrinsically linked to how we feel about our place in social structures and if we feel accepted.
Other Support Services
In combination with treatment from qualified healthcare professionals, here are some other supports:
Nutritional Counselling can provide individuals with ADHD with education and support around healthy eating behaviours, which can help them to make more informed and deliberate food choices.
Mindfulness Practices, such as meditation and yoga, can help individuals with ADHD to increase their self-awareness and develop greater control.
Support Groups can provide individuals with ADHD a safe and supportive space to share their experiences and connect with others who are going through similar struggles.
Reach out to the ADHD Helpline
This service is provided to help you find ADHD solutions and assist with ADHD Referrals. You can just head to the website ADHD Helpline here to register your interest.
Recommended Resources for ADHD and Eating Disorders
Find additional research on additudemag.com
Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). ADHD and eating disorders in childhood and adolescence: An updated minireview. Eating disorders, 19(4), 408-422.
Halmi, K. A. (2013). Perplexities of treatment resistance in eating disorders. BMC Psychiatry, 13(1).
Murray, K. E., Byrne, M., Rieger, E., & Touyz, S. W. (2013). Associations between inattention and impulsivity ADHD symptoms and disordered eating risk in a community sample of young adults. International Journal of Eating Disorders, 46(8), 758-763. Link: cambridge.org
Wentz, E., Lacey, H., Waller, G., & Råstam, M. (2009). Are girls with ADHD at risk for eating disorders? Results from a controlled, five-year prospective study. Journal of Psychosomatic Research, 66(5), 369-376.
William R. Yates MD, Brian C. Lund PharmD, Craig Johnson PhD, Jeff Mitchell MD, Patrick McKee MD. (2008) Attention-deficit hyperactivity symptoms and disorder in eating disorder inpatients. International Journal of Eating Disorders, 42(4), 375-378.