Is there a link between ADHD and eating disorders?

On the surface, attention-deficit hyperactivity disorder (ADHD) and eating disorders seem like two completely distinct mental health conditions with few, if any, commonalities. One affects your focus and energy, and the other affects your eating patterns. And while it’s true that these are separate conditions, they actually have more in common than you might think.

If you live with ADHD, you might have noticed that you’re vulnerable to binge eating and other unhealthy eating behaviors. Researchers have found that this could be because of the way ADHD affects impulse control. They’ve also found that ADHD and eating disorders have some neurobiological links (see below for an explanation).

How ADHD can affect your eating habits

To understand the complex relationship between ADHD and eating disorders, it’s helpful to first look at how ADHD can affect your relationship with food in general. ADHD is a neurodevelopmental condition that begins in childhood and often continues to affect adults. It causes symptoms like: 

• Chronic restlessness or feeling like you’re driven by a motor
• Difficulty focusing or easily getting distracted
• Impulsive behaviors

These ADHD symptoms can affect your eating habits in many ways. First, many people with ADHD have trouble managing their impulses. For some people, this could mean they have a hard time managing impulses to eat. This can lead to binge-eating behaviors, where you can’t stop eating large quantities of food even when you’re full.

People with ADHD can also be more likely to experience emotional dysregulation. This means they may have trouble managing strong emotions. If you live with ADHD, you might go through emotional or angry outbursts or engage in unhealthy coping mechanisms as a way to deal with uncomfortable emotions. One of these unhealthy coping mechanisms could be emotional eating, which could also contribute to binge eating.

In addition, some studies suggest that people with ADHD may have lower awareness of their internal hunger and knowing when they’re full. If you live with ADHD, you might get so distracted or hyperfocused on whatever you’re doing that you don’t pay attention to when your body is hungry. The reverse may also be true: You don’t notice when you’re full, so you continue eating. You might also forget to eat, leading to intense hunger pains and a tendency to overeat later in the day.

Can ADHD cause an eating disorder?

The causes of eating disorders are complex and multifaceted. In other words, there’s no one cause of eating disorders. People develop eating disorders for many reasons, and for most people, it’s because of a combination of factors. 

With that being said, some research suggests that ADHD can increase your risk of developing an eating disorder. In one review of more than 50 studies, the authors found that up to 16% of people with ADHD also had an eating disorder. Only around 3% of the general population (without ADHD) has an eating disorder, so it’s clear that having ADHD can increase your risk.

Again, it’s important to clarify that these links don’t mean that ADHD causes eating disorders. It’s more likely that both ADHD and eating disorders share some common traits and even neurobiological characteristics, which means that if you’re at high risk for one, you’re also at high risk for the other.

On top of having ADHD, some of the other risk factors for eating disorders include:

• Genetics and family history: If you have a family member with an eating disorder, you are more likely to have one as well. 
• Perfectionism: Having perfectionistic tendencies can make you more likely to develop an eating disorder.
• Body image dissatisfaction and frequent dieting: Often, eating disorders develop out of chronic dissatisfaction with your body shape or size. If you frequently diet, then you may be more likely to develop an eating disorder.
• Other mental health conditions: Living with other mental health conditions, including depression and anxiety, can increase your risk of developing an eating disorder.

ADHD and binge eating disorder

Specifically, research has found strong links between ADHD and binge eating disorder (BED). BED is a condition that causes you to eat large amounts of food quickly, followed by periods of guilt and shame. 

BED is often related to difficulties with impulse control. People with ADHD also have a hard time with impulses, so this could be why these two conditions are so closely linked.

ADHD and bulimia nervosa

Research has also found some overlap between ADHD and bulimia nervosa, an eating disorder that causes cycles of binging and purging. Purging involves trying to get rid of calories in unhealthy ways, like self-induced vomiting or taking laxatives. In one 2007 study, girls with ADHD were over five times more likely to have bulimia than girls without ADHD. 

Like binge eating disorder, bulimia is related to a difficulty with controlling impulses. If you live with bulimia, you likely find it hard to stop binge-eating and purging, even when you know it’s unhealthy.

ADHD and anorexia nervosa

Some studies have also found a link between ADHD and anorexia nervosa, an eating disorder that causes severe restricting of calorie and food intake. People with the binge-purge subtype of anorexia in particular are more likely to have ADHD. One review found that up to 17% of those with purging-type anorexia also had ADHD.

Neurobiological links between ADHD and eating disorders

Research has found neurobiological similarities between ADHD and eating disorders that could explain why these two conditions appear together so frequently. Specifically, both of these conditions are linked to executive functioning deficits in the brain. 

Executive functions are a set of complex tasks that the brain is responsible for, including impulse control, judgment, and problem solving. Both people with eating disorders and those with ADHD have deficits in the same area of the brain, which is responsible for executive functions: the front-striatal networks. These executive functioning deficits explain why people with eating disorders and ADHD have such a hard time with impulse control and managing unhealthy behaviors.

In addition, people with both ADHD and eating disorders often have problems in the reward circuit of their brains. Neuroimaging studies have shown that ADHD and eating disorders cause differences in chemicals, like dopamine and norepinephrine, in the brain. Because of these differences, people with these conditions have a harder time feeling a sense of reward after eating, causing them to overeat.

Eating disorder treatment approaches for patients with ADHD

If you live with both ADHD and an eating disorder, it’s critical to address both conditions in your treatment. Unfortunately, when you live with any other mental health condition on top of ADHD, it becomes more likely for your ADHD to be misdiagnosed. The symptoms of your eating disorder may mask your ADHD symptoms, which can lead your provider to miss the signs.

Some treatments can address both eating disorders and ADHD. These approaches include:

• Cognitive-behavioral therapy (CBT) can help you address unhelpful thinking patterns that can make symptoms worse. Both eating disorders and ADHD can negatively affect your self-esteem, and you might have developed some core beliefs about yourself (like “I’m not good enough”). Through CBT, you can identify and change these thoughts.
• Medications to treat co-occurring conditions can improve your mood, which can make it easier to address other symptoms.
• Mindfulness is a holistic approach that has been proven to be helpful for a wide array of mental health problems, including ADHD and eating disorders. Using mindfulness, you can learn to be more intentional with your eating behaviors and pay closer attention to the present moment.

If your eating disorder symptoms are severe, you may also need to go through nutritional counseling and other interventions to make sure your physical health is stabilized first. Eating disorders, specifically anorexia, are the most fatal mental health conditions, so your provider might want to prioritize treating your eating disorder first. Talk to your provider if you have questions about your treatment plan.

Find care with Rula

Life with ADHD and a co-occurring eating disorder can be tough. But you’re not alone, and treatment can help you manage both of these conditions. Rula makes it easy to find affordable, quality, in-network therapy. Book an appointment with a therapist in as few as three minutes, and meet with your new therapist from the comfort of your home as soon as tomorrow.

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