ADHD and Eating Disorders

Contributor: Staff at Timberline Knolls Residential Treatment Center

When someone is suffering from a mental health disorder, it is not uncommon for them to experience symptoms of one or more co-occurring disorders. However, two types of disorders that are not frequently discussed as occurring together are attention-deficit/hyperactivity disorder (ADHD) and eating disorders. Yet, there are theories regarding why and how the symptoms of these conditions overlap.

Similarities Between ADHD and Eating Disorders 

Attention-deficit/hyperactivity disorder is a mental health condition characterized by struggles related to attention, focus, hyperactivity, behavior regulation, and impulse control.

There are multiple types of eating disorders, including binge-eating disorder, anorexia nervosa, and bulimia nervosa, and a number of symptoms of these disorders mirror those of ADHD.

People who suffer from binge-eating disorder, for example, struggle with impulsivity and behavior regulation. Binge-eating disorder is a condition that causes people to lose control over the amount of food they eat, often finding it difficult to stop eating once they’ve started.

Some people who have ADHD turn to food as a means of coping with the daily struggles they often face. In a sense, they find comfort in food.

An article published in Duke Research Blog states that approximately 30% of people who have binge-eating disorder also have ADHD [1]. In addition to having similar symptoms, people who have an eating disorder like binge-eating disorder have a greater sensitivity to how food can impact the brain’s reward system. When someone’s reward system is triggered, it means that the levels of dopamine, which is the primary chemical in the brain that controls feelings of pleasure, have increased [2]. In this sense, food can be used as a coping mechanism for dealing with distress.

People who have ADHD typically face daily struggles in terms of successfully functioning in an appropriate manner at school, at work, or in social settings. This can lead to immense feelings of stress and anxiety, and some may find that eating makes them feel better. However, the impulsivity and inability to regulate behavior that are hallmarks of ADHD can cause these people to lose control over the amount they eat, ultimately tying in the symptoms of binge-eating disorder.

Binge-eating disorder is not the only eating disorder linked to ADHD. Anorexia, which is an eating disorder that centers on restricting food intake to the point that a person becomes dangerously underweight, has been linked to ADHD in terms of how people who have either of these disorders tend to struggle with setting boundaries. Bulimia, an eating disorder characterized by binge eating and purging, shares similarities with ADHD because people who have bulimia struggle to control their impulse to eat excessively in the same way that people who have ADHD struggle to control their impulsivity.

An additional similarity between eating disorders and ADHD is the feeling of guilt and shame that can accompany the behaviors people who have these disorders engage in. Acting impulsively and being unable to regulate one’s behaviors and emotions can cause people who have ADHD to feel ashamed. Likewise, people who have eating disorders often feel an immense sense of guilt and shame after engaging in disordered eating behaviors.

Treating ADHD and Eating Disorders

For a person to heal from the symptoms of attention-deficit/hyperactivity disorder and a co-occurring eating disorder, they must receive comprehensive treatment that addresses all their symptoms. While ADHD and eating disorders may share similarities, they are not the same, and they cannot be treated as though they are.

Treatment professionals will use different types of therapies when treating someone who has ADHD and an eating disorder. Cognitive behavioral therapy (CBT) is one of the most common treatment modalities used because it focuses on confronting and addressing negative thought patterns and problematic behaviors. As people begin to identify their thoughts and behaviors and recognize the ways in which they are negative or distorted, they can work with their therapist on learning how to redirect their thoughts and control their behaviors. In doing so, they are also able to begin developing various coping mechanisms. Ultimately, this can change the way these people feel about themselves, increasing their confidence in their ability to regulate and control their actions [3].

Dialectical behavior therapy (DBT) is another type of treatment method that can be used with patients who have ADHD and eating disorders. DBT focuses on acceptance and change. The American Journal of Psychotherapy identifies the four skills modules included in DBT as mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance [4].

Individual, group, and family therapies can also be beneficial when treating patients who have eating disorders and ADHD. Individual therapy gives patients time to talk with a therapist in a confidential, one-on-one setting. Group therapy allows people to have an opportunity to engage in open discussions with other individuals who may have had similar experiences and struggles. In family therapy, family members can become educated about the disorders themselves while also learning ways to help the patient outside of the treatment setting.

Psychotropic medications are often used in the treatment of ADHD and eating disorders. Whether or not a person should take medication, however, is something that needs to be discussed with a psychiatrist.

References

[1] Haurin, S. (2018, March 13). Understanding the link between ADHD and binge eating could point to new treatments. Duke Research Blog. https://researchblog.duke.edu/2018/03/13/binge-eating-disorder/

[2] Guy-Evans, O. (2021, July 8). Brain reward system. SimplyPsychology. https://www.simplypsychology.org/brain-reward-system.html

[3] Sherman, C., Ramsay, J.R., & Barrow, K. (2021, August 24). How CBT dismantles ADHD negativity: cognitive behavioral therapy overview. https://www.additudemag.com/cognitive-behavioral-therapy-for-adhd/

[4] Linehan, M.M., Wilks, C.R. (2018, April 30). The course and evolution of dialectical behavior therapy. The American Journal of Psychotherapy. https://psychotherapy.psychiatryonline.org/doi/10.1176/appi.psychotherapy.2015.69.2.97