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Attention deficit hyperactivity disorder (ADHD) and eating disorders are both complex mental health conditions impacting the day-to-day life and functioning in some very similar but also very different ways. When these two disorders exist together, or comorbidly, it’s important to understand and establish what these differences and similarities in presentation can look like for an effective treatment plan to be developed. Here, we’ll do a quick dive into ADHD, eating disorders, and how these disorders are connected to each other from a psychological standpoint.
What is ADHD?
ADHD often presents as challenges with attention, hyperactivity, and impulsivity, and these symptoms often impact things like academic and work performance, socializing, and performing other daily tasks. Something especially interesting about ADHD though, is that it usually doesn’t present as an isolated disorder. Oftentimes it is diagnosed with another mental health or developmental disorder, such as an eating disorder. In fact, individuals with ADHD are thought to be about three times more likely than the general population to develop an eating disorder. When it comes to eating disorders and ADHD, though, binge eating disorder (BED) and bulimia nervosa (BN) are the ones that most commonly occur alongside ADHD. It’s important to remember that ADHD doesn’t cause the development of an eating disorder such as BN or BED, but it can contribute to the development of disordered eating behaviours. But why is this?
The Links Between Disordered Eating and ADHD
It’s important to understand the shared mechanisms between eating disorders and ADHD and how they influence one another, especially since ADHD co-occurring with an eating disorder can cause the symptoms of one to influence the symptoms of the other. A few of the shared mechanisms between ADHD and eating disorders are the reward system, inattention, and impulsivity.
The Reward System
The dopamine reward pathways in our brain are thought to be implicated in both the presentation of ADHD and disordered eating. This pathway is what allows us to regulate our emotional responses, and typically dopamine transmission levels are higher in individuals with ADHD compared to the general population, meaning the effects don’t last as long1. This is what causes challenges with motivation, planning, impulse control, and other important executive functions. But how does this relate to disordered eating?
Certain activities or behaviours can activate dopamine transmission in the brain, like shopping, drinking alcohol, spending money, having sex, or even eating. Food, then, can act as an easy way to trigger the dopamine pathways in the brain and fire up that reward system, which makes us feel positive emotions. This coupled with the dysregulated function of dopamine in the brain of someone with ADHD means that binge-eating behaviours can trigger the feel-good response through the dopamine pathway, causing that “out of control” feeling around food. This reinforces the binge-eating behaviours, causing it to become habitual and challenging to work through as a result.
Inattention and Impulsivity
Other shared mechanisms between ADHD and eating disorders are inattention and impulsivity. Inattention in ADHD can often manifest as an inability to tune into hunger and fullness cues, resulting in either under- or overeating. Impulsivity, on the other hand, can cause challenges with planning, organization, task prioritization, and time management, which can lead to choices that might not be the most balanced when it comes to eating behaviours. A lack of planning and organization with regards to grocery shopping, for example, might lead to binge eating on snacks rather than cooking a balanced meal for dinner due to a lack of planning, organization, or even time management.
Coping Mechanisms and Strategies
Understanding the interaction between ADHD and disordered eating is critical in determining a course of treatment in therapy when these two things present at the same time. Now that we’ve done a quick dive into a few of the mechanisms that drive both disorders simultaneously, let’s talk about coping strategies. There are so many helpful coping strategies out there to help you manage your ADHD, eating disorder, or both. Mindfulness and meditation practices can help to draw attention inward to help with noticing signals like hunger, fullness, and appetite, for example. Having a routine, structure, and making lists can also help with ensuring you’re eating at regular intervals throughout the day to avoid that inattention and eventual binge when you realize it’s 3pm and you haven’t eaten anything yet today. Even methods of distraction can be helpful in breaking that reward cycle response with food, such as fidget toys, hobbies, or even gentle stretching. Therapy and medications can also be useful tools for addressing ADHD and its resulting symptoms.
Working with a therapist is helpful in discovering the areas in which your ADHD and disordered eating intersect, allowing us to come up with a collaborative plan that involves some, all, or maybe even none of these strategies to ensure that we’re tackling the problem head on and helping you reach your personal goals. If you’re looking for support with ADHD, an eating disorder, or both, we’re here for you!
References
1 Ptacek, R., Stefano, G. B., Akotia, D., Raboch, J., Papezova, H., Domkarova, L., Stepankova,
T., & Goetz, M. (2016). Attention deficit hyperactivity disorder and disordered eating behaviors:
Links, risks, and challenges faced. Neuropsychiatric Disease and Treatment, 12, 571-579.
2 Marson, G., & Keenan-Miller, D. (2023, May 4). What role does ADHD play in eating disorder
treatment? Psychology Today. https://www.psychologytoday.com/ca/blog/the-binge-eating-
prevention-plan/202305/what-role-does-adhd-play-in-eating-disorder-treatment
3 El Archi, S., Cortese, S., Ballon, N., Reveillere, C., De Luca, A., Barrault, S., & Brunault, P.
(2020). Negative affectivity and emotion dysregulation as mediators between ADHD and
disordered eating: A systematic review. Nutrients, 12(11), 3292.
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