Research on ADHD and Related Eating Disorders
During the last decade, researchers have begun to discover connections between ADHD and various eating disorders, including:
- Anorexia nervosa – Inadequate food intake leading to a weight that is too low.
- Binge eating disorder – Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting.
- Bulimia nervosa – Frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting.
Commenting in US News & World Report, Ari Tuckman, a clinical psychologist with a private practice in West Chester, Pennsylvania, cites research indicating binge eating is the most common disorder. “Anorexia is negatively associated with ADHD; if someone has ADHD, they’re less likely to have anorexia. Obesity is more positively associated with ADHD.” A colleague, Roberto Olivardia, who has a psychotherapy practice specializing in ADHD and eating disorders, concurs and explains that anorexia is typically associated with compulsive behaviors, whereas binge eating typically deals with impulsive behaviors, which tend to be a struggle for those with ADHD.
Factors Behind ADHD Related Eating Disorders
According to Crystal Karges, MS, RDN, IBCLC, the link between ADHD and eating disorders can be due to multiple factors. Many of the characteristics of ADHD are known to influence some disordered eating behaviors. These include:
Sensory processing problems – Individuals with ADHD often exhibit problems with how the brain interprets signals and cues from the rest of the body. This includes cues about thirst, hunger, pain, etc, which may be distorted. These misinterpreted signals about the body’s basic needs can lead to abnormal eating behaviors. For example, a child who is unable to recognize when they are hungry and full may under-eat, overeat or develop food aversions.
Food allergies and sensitivities -Individuals with ADHD can be highly sensitive to scents, textures, flavors, and foods. As a result, they may not readily accept certain foods, and these behaviors can manifest as restricting, rejection, etc.
Inattention and impulsiveness – These are common characteristics associated with ADHD. They can make it difficult for the affected individual to maintain a healthy diet or eat adequately. For example, a child who is restless at the dinner table may avoid eating out of anxiousness or restlessness.
Specialists in the field of eating disorders linked to ADHD are quick to point out that there are generally no “one size fits all” treatments. As Roberto Olivardia writes in ADDitude magazine, “Eating disorders are complicated. Treatment requires a team—usually a psychologist, nutritionist, physician, psychiatrist, and, most often, a family/couples therapist. When a sufferer also has ADHD, seeing treatment through an ADHD lens is essential. Knowing how the eating disorder is affected by ADHD symptoms, and how it, in turn, affects ADHD symptoms, must be central to treatment. Not managing the ADHD usually leads to treatment failure. If the eating disorder therapist is not an ADHD expert, add an ADHD therapist to the team.”
In addition to therapy, Olivardia says medications can be an important component of treatment. Stimulants are a first-line treatment for ADHD symptoms, but they are not typically used for certain eating disorders, since they suppress a patient’s appetite. Research has shown, however, that using stimulants for patients with ADHD and bulimia promotes impulse control can prevent binge eating. Stimulants also help the person with ADHD and an eating disorder execute the treatment plan. SSRIs may also be effective in treating bulimia nervosa by easing mood, anxiety, and obsessive-compulsive symptoms. At this time, no medication has been found effective for anorexia nervosa.
The key to overcoming ADHD linked eating disorders is to get professional help.