“Food is my heroin,” said Haley, 28, comparing her ADHD and binge eating disorder with drug problems. “It sounds dramatic, but it’s true. Although I’m trying to prevent overeating, like the same pothole that blows out the tire every day.” It’s a view that can be echoed by any of the more than 30 million Americans who will experience an eating disorder at some point in their lives. This feeling is combined with a shared diagnosis of attention deficit and ADHD.
About 22 million Americans live in ADHD, a condition characterized by attention regulation, impulse control, and executive functions (e.g., planning organization and managing time). These characteristics can complicate a person’s relationship with food. According to the National Institutes of Health (NIH), people with ADHD have a chance of developing an eating disorder as high as 12%. In particular, studies have confirmed the association between ADHD and binge eating disorder, which suggests that 26% of ADHD patients also have binge eating disorder behavior, while two percent of those without ADHD account for two percent.
For patients, this can translate into a more complex lifestyle than a lifestyle without any diagnosis. Especially a 35-year-old patient (pseudonym Alex), who believes the only thing that can lift him out of the confusion of ADHD is food. On some nights, Alex may consume four hamburgers, four large fries, a pizza, two bags of chips, two gallons of ice cream and twelve cupcakes. For more than a decade, after every party, he told himself that he would never overeat again.
For Fernando, 44, who has been fighting bulimia and ADHD since he was 15, controlling his weight is like his only success. For those with bulimia, food can be misunderstood as a way of self-treatment when they feel anxious, stressed, angry, or bored.
There are many behavioral, psychological, neurochemical and biological factors that help why people with ADHD tend to develop eating disorders. Treatment through lens observation of ADHD disease is essential and must be the core of treatment.
There is a link between the two diseases
According to the National Library of Medicine, up to 80% of adults with ADHD develop another mental illness. Although ADHD does not cause eating disorders, due to the high rate of eating disorders in this group, it is necessary to monitor children and adolescents with ADHD.
There are some ADHD characteristics that cause you to suffer from eating disorders.
People with ADHD often suffer from emotional disorders, which may make them more likely to use food as an emotional coping mechanism. Impulsivity is another feature often found in people with ADHD, which can lead to inconsistent eating habits and can lead to meat eating, skipping meals, purification and other disordered eating habits. Some people with ADHD may experience difficulties in structured routines, which can make the essential treatment parts of eating disorders, such as prescription meal plans. Finally, sensory processing issues involve increased sensitivity to taste, sound, light and other stimuli, which can also affect their experience in food. These problems can lead to avoidance/restricted intake disorder (ARFID), a diet disorder characterized by a higher sensitivity to the texture of the food and lead to a narrower diet and inadequate nutrition.
Coordinated ADHD and eating disorders can enhance each other’s symptoms. Impulsiveness can lead to overeating or clearing, and emotional disorders can make coping with difficult life challenges. Simultaneously addressing ADHD and eating disorders can best exercise the path to recovery and healthy coping.
Together to treat ADHD and Eating Disorders
With the right intervention and support, recovery can be done. These strategies are part of an effective treatment plan:
- Customized meal plan – Structured but flexible meal planning helps meet nutritional needs, in addition to bringing balance and predictability to the meal This looks like a written plan, where built-in options and flexibility can be adjusted to how recovery progresses.
- Dialectical Behavior Therapy (DBT) – DBT provides tools to manage emotional responsiveness and impulsiveness, which are common in ADHD and eating disorders. DBT focuses on learning and practicing mindfulness, enduring tolerance and emotional regulation skills, which can help reduce impulsive behaviors around food. Practicing with DBT skills and tools can benefit the entire family to help manage the unpredictability of these conditions and lead to progress in recovery.
- Cognitive Behavioral Therapy (CBT) – CBT helps identify and transfer disordered mindsets and build healthier behaviors while addressing ADHD-related challenges, including impulsive decision making and difficulty in starting tasks. CBT can also help improve body image and self-esteem.
- Drug Supervision – Stimulating drugs for ADHD must be carefully managed to ensure that the drug does not suppress the patient’s appetite and interfere with their recovery goals. Non-irritating drug options for ADHD should also be considered more strongly for those suffering from eating disorders or who are prone to developing eating disorders. Medication treatment options must be carefully coordinated with patients’ prescription medical resources, and close communication is key.
- Execute functions – Patients who build planning, organization and time management skills tend to have easier outcomes as well as lasting habits and routines.
Recovery is possible
This can be difficult when eating disorders and ADHD coexist, but loved ones can help a lot by creating space for open and judgment-free conversations about emotions, daily experiences, and food choices. With compassion and patience, loved ones can support predictable daily work.
Tools like visual scheduling or timers can also help provide structures around meals, snacks, schools, work, activities and much-needed rest. By staying close to the care team, loved ones can better understand the challenges faced by their patients and help them celebrate their progress.
Addressing an eating disorder that coexists with ADHD requires desire and dedication, professional treatments and programs, and support from families and caregivers at home. With all this integration, there is no reason why an individual cannot achieve his or her recovery goals and enjoy a healthier life.
Photo: Things, Getty Images
Brad Smith, MD, DFAPA, is Chief Medical Officer of the Accanto Health Emily Program, oversees the clinical orientation of the Emily Program and collects behavioral health. With nearly 25 years of experience in psychiatry and medical leadership, he is committed to providing high-quality, patient-centered care for people with eating disorders.
Dr. Smith, who has been board certified in adult and forensic psychiatry, has developed innovative, evidence-based treatment plans in his career. Prior to joining Accanto Health, he directed clinical services at all levels of care in Rogers’ behavioral health Eating Disorder Recovery Service. He is recognized for his leadership in improving clinical outcomes and expanding care for those in need.
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