ADHD and eating disorders
If you’re on social media (and who isn’t these days!), you’ve probably noticed an increase in conversations around ADHD, particularly in adult women. But did you know that girls with ADHD are almost four times more likely to develop an eating disorder?1
Keep reading to learn more about the overlap between the two disorders and how ADHD can be used to your advantage in recovery.
what is adhd and who experiences it?
ADHD, or attention-deficit/hyperactivity disorder, is a neurodevelopmental disorder that affects the way a person thinks and functions on a day-to-day basis.
Males are three times more likely to be diagnosed with ADHD than women.2 However, this is not because women are less likely to experience ADHD, but instead is due to differences in presentations between genders and non-inclusive diagnostic criteria.
In good news, diagnosis rates of ADHD in females are on the rise due to increased awareness, decreased stigma and greater access to health care3 - how great is that?!
what causes adhd?
The exact cause of ADHD is not yet known, but scientists believe there are a combination of factors including genetics, environment and brain development.
While there’s no specific known cause of ADHD, we do know that neurotransmitters are involved in the way an ADHD brain functions.
Neurotransmitters are chemicals in the nervous system that allow communication between the brain and body. Norepinephrine and dopamine are two neurotransmitters that are altered in people with ADHD. Treatments for ADHD tend to work by altering the levels of neurotransmitters in the brain.
Dopamine
Dopamine is related to our sense of pleasure and reward. When dopamine is in short supply (as it is in people with ADHD), there is an increased urge to seek out highly stimulating activities and increased difficulty controlling impulses.
Norepinephrine
Norepinephrine is related to focus and information processing. The low levels of norepinephrine experienced by people with ADHD leads to issues with concentration, memory, interoception and organisation.
How does adhd relate to disordered eating?
ADHD can play a role in both undereating and overeating, and is particularly associated with Bulimia Nervosa, Binge Eating Disorder and Anorexia (Binge/Purge Subtype).4 Even in the absence of a clinical eating disorder, research suggests that adults with ADHD are more likely to experience impulsive, dysregulated, and disordered eating behaviours.5
Here’s how:
Undereating or irregular eating
Norepinephrine is a major factor at play when it comes to undereating or irregular eating in people with ADHD. Its role in the brain can cause:
Hyperfocus on other tasks, distracting the person from eating
Forgetting to eat or struggling to assess how long it has been since the last meal
Becoming distracted while eating or preparing food
Difficulty with organisation and planning related to shopping and meal planning
Poor motivation to organise meals, decreased appetite from ADHD medications
Poor awareness of internal cues, such as hunger, fullness and satiety
Stimulant medications for ADHD, such as Ritalin or Adderal, can also effect appetite by increasing dopamine and sending signals of premature satisfaction to the brain, decreasing the drive to eat.
Overeating or binge eating
The role of dopamine has a significant influence on overeating or binge eating by contributing to:
Poor impulse control related to eating
An increased response from the reward system in the brain from food
Increased desire to overeat, especially high calorie, “reward” type foods
Not only can undereating increase the likelihood of binge eating, but it can also worsen ADHD symptoms. This is due to starvation of the brain, causing heightened irritability, poor concentration and memory, and an increase in impulsivity. This in turn increases the likelihood of engaging in disordered eating behaviours - and the cycle continues!
Ways to manage ADHD and find food freedom
With all this talk about how ADHD can contribute to disordered eating behaviours, you might feel a little disheartened if this is resonating with you.
But don’t despair!
There are strategies that you can use to manage your ADHD symptoms and find food freedom. Here are just a few to get you started:
Use alarms to remind you of meal times – and change the alarm sound regularly to prevent getting used to them!
Place snacks in visible places if you are prone to forgetting to eat
If you struggle with organisation around food, dedicate an hour a week to meal planning – decide on your meals, check what ingredients are necessary, and make a grocery list
Consider online grocery shopping if you find yourself getting distracted or overwhelmed in the brick-and-mortar store
Learn YOUR hunger cues – these look different for everyone, particularly those with ADHD! An embodiment-focussed dietitian can help you build your interoceptive skills to understand more about how your body is communicating with you.
Try meditating! You might be thinking that you couldn’t possibly quiet your mind or focus long enough to meditate, but that’s not really the point! This article by Dr John Fleming outlines the benefits of meditation for an ADHD brain: http://drjohnfleming.com/adhd-meditation
If this resonates and you feel you would benefit from more individualised support, Ari offers one-to-one coaching through her Re:Align Programme that might be right for you! Learn more about the program and apply here: https://www.arianarodriguez.com/one-to-one-coaching
Karli Battaglia, APD
References
1. Biederman J, Ball SW, Monuteaux MC, Surman CB, Johnson JL, Zeitlin S. Are girls with ADHD at risk for eating disorders? results from a controlled, five-year prospective study. Journal of Developmental & Behavioral Pediatrics. 2007;28(4):302–7.
2. Attention-Deficit/Hyperactivity Disorder (ADHD) NIMH; Available from: https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd
3. Chung W, Jiang S-F, Paksarian D, Nikolaidis A, Castellanos FX, Merikangas KR, et al. Trends in the prevalence and incidence of attention-deficit/hyperactivity disorder among adults and children of different racial and ethnic groups. JAMA Network Open. 2019;2(11).
4. Svedlund NE, Norring C, Ginsberg Y, von Hausswolff-Juhlin Y. Symptoms of attention deficit hyperactivity disorder (ADHD) among adult eating disorder patients. BMC Psychiatry. 2017;17(1).
5. Reinblatt SP. Are eating disorders related to attention deficit/hyperactivity disorder? Current Treatment Options in Psychiatry. 2015;2(4):402–12.