ADHD AND EATING DISORDERS
What is the link?
This is an area where we have seen a lot of new data lately. The connection between ADHD and eating disorders is not difficult to understand. Just because you have ADHD does not guarantee that you will develop disturbed eating behaviours.
However, it is easy to see how ADHD puts someone at a disadvantage given the difficulty with impulse control which is the central underlying attribute.
Eating disorder or disordered eating?
One study focused on overeating and eating disorders (Quinn & Nadeau, 2015). It found that women with ADHD tend to eat a lot of carbohydrates and they eat for stimulation. It seems that there is not a high incidence of anorexia nervosa or active bulimia (overeating and purging), but they did report a high incidence of binge eating and compulsive overeating.
Many women described a pattern of ‘comfort food’, sweets and starchy snacks in the evening not only as a means of reward, but also for self calming or self-medication.
Those with ADHD tend to overeat for many reasons i.e. when they are bored, overwhelmed, feeling that they are out of control or stressed. They also have lack of impulse control or impulsivity. Once they start eating, they can’t stop. Many times they have a lack of awareness of how much or why they are eating. They seem to go on auto-pilot. Mindful eating won’t make you thin, but it can be a self-regulating tool to help pay attention to your eating cues.
ADHD and weight issues
Weight management can be difficult and more so for those with ADHD. It is harder to lose weight and to sustain dietary and lifestyle changes for longer than a few weeks. It appears there is a sub-population of people with disordered eating who can’t maintain weight loss because their ADHD behaviors do not allow them to stay with a dietary plan for very long.
The implication is for the ADHD to be successfully treated so their weight reduction program may be successful.
How can it be overlooked?
ADHD and eating disorders share several key characteristics. These are impulsivity, low self-esteem and depression. In the past, most of the research focused on males and children, instead of young adults and all adults with ADHD. Another study found that adolescent girls with ADHD: Combined Presentation, showed more eating pathology. It is the symptom of impulsivity that seems to be related to ADHD and eating disorders. Other factors included peer rejection and strained parent-child relationships (Hinshaw et al. 2008). There is more variability in how it shows up in adults i.e. lifestyle choices, eating as a coping mechanism, using food in the context of addiction, etc.
What treatment helps?
There needs to be a multi-factorial approach to treat co-existing ADHD and eating disorders. The stimulants used to treat ADHD by themselves decrease the urge to binge. The symptom of binge eating may result from impulsivity, therefore decreasing the impulsivity in bulimia after the use of ADHD medication can potentially decrease binging and purging.
Secondary, the appetite suppression is noted. Effectively treated individuals will more likely sustain healthy eating habits.
Sources:
Dukarm, C. (2015). Pieces of the Puzzle: The Link Between Eating Disorders and ADD. Washington DC: Advantage Books.
Hinshaw, S.P. et al (2008). Eating pathology among adolescent girls with ADHD. Journal of Abnormal Psychology, Feb; 117(1):225-235.
Roché Herbst, M. A. R. Psych.
