Research shows that individuals with ADHD face a heightened risk of developing an eating disorder (3 to 6 times the average), particularly Bulimia Nervosa & Binge Eating Disorder. It also shows that eating disorder symptoms grow in severity alongside ADHD symptoms.
ADHD can predispose an individual to developing an eating disorder due to:
- Genetic/behavioural factors such as:
- Reward Deficiency Syndrome – The ADHD brain produces insufficient dopamine, a neurochemical implicated in reward, which may cause individuals to seek satisfaction through food,
- GABA deficit – ADHD brains have lower levels of GABA, a neurochemical implicated in inhibition,
- Purging behaviours – Purging can be euphoric and can be a form of stimulation that increases dopamine levels; and
- Restrictive behaviours can build up reward sensitivity. Individuals may purposely restrict food so that when they do eat, it is much more rewarding to them.
- Executive function difficulties:
- These difficulties can impact eating and preparing food as decision-making can be challenging. This can lead to impulsive eating or restriction to avoid the executive functioning task of preparing/planning food, and
- Some individuals with ADHD can have poor interoceptive awareness, which can make it difficult to recognize hunger and satiety cues.
- Behavioural factors such as:
- Poor impulse control,
- Poor sleep habits,
- Irregular eating schedule/medication effecting ability to eat; and
- Poor self-regulation.
- Emotional factors and self-esteem:
- Boredom can be a major predisposing factor to binge eating,
- Food can be a relief from anger, sadness, anxiety, and other difficult emotions: and
- Low self-esteem can result in food becoming a way to cope and feel in control.
So, what does that mean for eating disorder treatment?
Research shows how important it is to treat both the eating disorder and ADHD at the same time. Recommended treatments include Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Acceptance & Commitment Therapy, and executive function skills training. For further information see the sources listed below.
Do you recognise some of these symptoms in yourself or someone you know? Get in contact with BodyMatters Australasia for support
Sources:
Hartmann et al., (2012). Laboratory snack food intake, negative mood, and impulsivity in youth with ADHD symptoms and episodes of loss of control eating. Where is the missing link?
Nazar, et al., (2016). The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis.
Curtin et al., (2013) The association between ADHD and eating disorders/pathology in adolescents: A systematic review.
Biederman et al., (2007). Are girls with ADHD at risk for eating disorders? Results from a controlled, five-year prospective study.
Seitz et al., (2013). The role of impulsivity, inattention and comorbid ADHD in patients with bulimia nervosa.