Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition. Research has shown a link between ADHD and certain eating disorders.
For instance, a 2018 study in Psychiatry Research reports links between ADHD and both bulimia nervosa and binge eating disorder (BED).
Eating disorders are a type of mental health condition that can have serious negative consequences on a person’s mental and physical health. People with eating disorders display harmful behaviors and attitudes in relation to food, eating, and body image.
Keep reading to learn about the link between eating disorders and ADHD, including who is at risk and the treatment options.
Research suggests that there is a link between ADHD and some, but not all, eating disorders.
There are various types of eating disorders, including:
Bulimia nervosa: A person with this eating disorder, known as bulimia, will binge on large amounts of food in a short space of time and then “compensate” by exercising excessively or purging, which may involve vomiting or using laxatives.Binge eating disorder (BED): This is similar to bulimia, but people do not engage in compensatory behaviors.Anorexia nervosa: People with anorexia nervosa, known as anorexia, severely restrict their food intake, and they may rely on a limited number of “safe” foods.
The authors of the previously mentioned 2018 study report links between ADHD and both bulimia and BED. They conclude that the links between ADHD and eating disorders could be due to the presence of other psychiatric disorders. The study did not show a link between ADHD and anorexia.
Experts say that ADHD’s link to bulimia and BED may be a result of similarities between the conditions.
The hallmarks of ADHD include hyperactivity, impulsivity, and inattention. Both bulimia and BED involve binge eating, which people consider an impulsive behavior.
People with ADHD may also overeat because they are seeking stimulation.
When someone has ADHD, their brain may be lacking dopamine, a neurotransmitter that plays a role in reward and motivation. Therefore, they may sometimes use food to achieve a dopamine hit.
Problems arise when regular overeating causes feelings of self-loathing, distress, and an inability to control the behavior. When this occurs, the behavior can develop into an eating disorder.
ADHD often presents with symptoms similar to those of other conditions, such as sleep disorders, anxiety, depression, and some learning disabilities.
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) outlines the diagnostic criteria for a wide range of mental health conditions. It lists the criteria for an ADHD diagnosis as:
five or more symptoms of hyperactivity and impulsivity, inattention, or both, lasting at least 6 monthsseveral inattentive or hyperactive-impulsive symptoms before the age of 12 yearsseveral symptoms in two or more settings — for example, at home and at school or workthe symptoms interfere with or reduce the quality of social, school, or work capabilitiesthe symptoms do not meet the diagnostic criteria for another mental health condition
In children aged up to 16 years, six or more symptoms of inattention and hyperactivity must be present for at least 6 months.
According to the National Institutes of Health (NIH), symptoms of bulimia and BED — the two eating disorders associated with ADHD — include the following.
Bulimia nervosa
The symptoms of bulimia include:
eating unusually large amounts of food in a discrete perioda sense of loss of control during the eating episodes harmful compensatory behaviors, such as vomiting, excessive exercise, or laxative misuse self-criticism of body shape or weight
Additionally, the physical signs of bulimia can include:
chronically inflamed and sore throatswollen salivary glands in the neck and jaw worn tooth enamel and increasingly sensitive and decaying teeth due to stomach acid exposureacid reflux disorder and other gastrointestinal problemsintestinal distress and irritation from laxative abusesevere dehydration from purging fluidselectrolyte imbalance — meaning excessively high or low levels of sodium, calcium, potassium, and other minerals — which can lead to stroke or heart attack
Binge eating disorder
The symptoms of BED include:
eating unusually large amounts of food in a specific periodeating even when full or not hungryeating quickly during binge episodeseating until uncomfortably fulleating alone or in secret to avoid embarrassmentfeeling distressed, ashamed, or guilty about eatingfrequently dieting, possibly without weight loss
Females have a higher risk than males of eating disorders. Due to the link between ADHD and eating disorders, females with ADHD could be more likely to develop eating disorders.
However, this does not mean that eating disorders cannot affect males, who are less likely to seek a diagnosis and treatment.
For example, BED affects males and females at relatively equal rates. Overeating is more prevalent than restriction in people with ADHD, so males with ADHD may be at a higher risk of binge eating.
Healthcare professionals commonly prescribe stimulants to treat ADHD. About 70–80% of children with ADHD experience fewer ADHD symptoms when taking these medications.
Some medications can treat both ADHD and eating disorders.
For instance, lisdexamfetamine dimesylate is a type of stimulant medication that the manufacturer originally marketed for the treatment of ADHD. The Food and Drug Administration (FDA) has since approved the drug for use in treating moderate or severe BED in adults.
Most treatment protocols for mental health conditions include both mediation and psychotherapy. Cognitive behavioral therapy (CBT) is a popular and effective form of talk therapy that may be helpful for people with eating disorders and ADHD.
In a 2018 study in the Journal of Attention Disorders, researchers found that CBT could reduce ADHD symptoms, improve executive function, and ease symptoms of anxiety and depression. These benefits continued for at least 5 months after stopping therapy.
A 2019 study in Psychiatric Clinics of North America confirmed that CBT is the first-line treatment for BED and bulimia.
Research shows a link between ADHD and certain eating disorders, such as bulimia and BED. ADHD does not appear to have an association with anorexia.
This may be due to the fact that overeating is an impulsive behavior, while undereating is a restrictive behavior.
Alongside talk therapy, the drug lisdexamfetamine dimesylate can help treat ADHD and BED. If a person has symptoms of ADHD or an eating disorder, they should contact a doctor.
