ADHD And Eating Disorders: Are They Connected?

Medically reviewed by Corey Pitts, MA, LCMHC, LCAS, CCS
Updated November 4, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

According to research published in 2021, the lifetime prevalence of eating disorders is approximately 1.89% in Western countries. Some people living with eating disorders also experience attention-deficit/hyperactivity disorder (ADHD), which can exacerbate eating disorder symptoms in some cases. It’s thought that the impulsivity associated with ADHD may play a role in behaviors associated with anorexia, bulimia, and binge eating disorder. Therapy is often beneficial for those living with both ADHD and eating disorders, and some individuals who have experienced physical health impacts due to disordered eating may require medical care as well.

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Are you experiencing ADHD and an eating disorder?

What is ADHD, and how does it affect the brain and behavior?

According to the American Psychiatric Association, ADHD tends to be one of the most common mental health disorders among children, who may be diagnosed by a specialist in developmental and behavioral pediatrics. However, this disorder can also affect adults. Individuals may experience the inattentive type, the hyperactive/impulsive type, or a combined presentation. 

Inattentive type

With the inattentive type of ADHD, individuals tend to experience difficulty paying attention. They may have difficulty focusing during classes or meetings and experience challenges concentrating during conversations. These symptoms can contribute to personal and professional relationship challenges. Individuals with this type of ADHD may also have trouble staying organized, which may affect their time management skills and ability to manage deadlines. 

Hyperactive/impulsive type

Individuals with the hyperactive/impulsive type of ADHD may experience excessive energy and have difficulty sitting still. This may manifest as a tendency to fidget or frequently get up during classes or meetings. Those who experience this type of ADHD may also experience the urge to talk often and take over projects on which others are working. 

Combined type

As the name suggests, those with a combined presentation typically have symptoms of both other subtypes of ADHD. 

Those with any type of ADHD may experience comorbid mental health disorders, including eating disorders, but these may be more common in people living with the hyperactive/impulsive type of attention-deficit/hyperactivity disorder.

What are eating disorders?

The American Psychiatric Association states that eating disorders “are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions.” Some of the most common eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. 

Anorexia nervosa

Anorexia nervosa is a disorder primarily characterized by calorie restriction via limiting one’s food intake. A person living with anorexia nervosa may experience a fear of gaining weight, which can lead to behaviors that seriously affect their weight and overall health. People living with anorexia nervosa may not understand how serious the disorder can be for their physical and mental health.

Bulimia nervosa

Bulimia nervosa is usually characterized by binge eating, which generally consists of consuming large quantities of food in a short time, followed by purging behaviors to prevent weight gain. Purging may involve self-induced vomiting or the use of laxatives. Individuals living with bulimia may attempt to hide their behavior out of fear or embarrassment. Their behavior is often motivated by concerns related to weight and body image. 

Binge eating disorder

Like bulimia, binge eating disorder typically involves eating large quantities of food quickly. However, individuals with binge eating disorder don’t usually engage in purging behaviors.

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How commonly do eating disorders and ADHD co-occur?

Eating disorders and ADHD can co-occur in some cases. The following are a few statistics about the comorbidity of these disorders, taken from a study published in Current Treatment Options in Psychiatry:

The possible role of impulse control difficulties

In some eating disorders, such as bulimia and binge eating disorder, individuals often experience an impulse to engage in binge eating. Impulsive behavior may also be seen in some people living with ADHD. Some researchers have posited that impulsiveness in those with ADHD may lead to disordered eating behaviors. 

According to the study mentioned above, even individuals with ADHD who don’t meet enough criteria to be diagnosed with an eating disorder may experience impulsive eating tendencies.

Does dopamine play a role in ADHD and eating disorders?

Research suggests that dopaminergic signaling likely plays a role in both ADHD and eating disorder behaviors. Dopamine is typically involved in a person’s reward processing system, which may explain, in part, why both addictive eating and substance use disorders can be common comorbidities of ADHD. 

Some researchers posit that comorbid disorders in those with ADHD can explain their eating behaviors. More research may shed light on the relationship between ADHD, eating disorders, and other comorbid disorders. 

Is there help for ADHD and eating disorders involving impulse control?

Individuals living with eating disorders can receive help regardless of whether they also meet the criteria for ADHD. Treatment often involves a combination of medical care and therapy. Some people may require hospitalization if they experience serious physical symptoms, as eating disorders can affect numerous body systems. 

In addition, a doctor may need to monitor recovery to avoid refeeding syndrome, which can occur when a person facing malnourishment begins to eat again. Refeeding syndrome typically results from changes in fluids and electrolytes and can involve symptoms like vomiting, nausea, lethargy, hypotension, and cardiac failure. 

In addition to medical care, people living with eating disorders typically receive talk therapy. Cognitive behavioral therapy, in particular, may help people identify and replace negative or inaccurate thoughts they have about themselves, which may lead to improved behaviors. 

CBT can also be helpful for those who have ADHD. This type of therapy may help them challenge unhelpful thought patterns that may be exacerbating ADHD symptoms. For example, some people may practice negative self-talk that leads them to believe they can’t do things correctly at work or school. A therapist may be able to help these individuals identify and replace inaccurate thoughts with more constructive ones, often resulting in more positive emotions and improved behavioral outcomes. 

Online therapy for anorexia nervosa, binge eating disorder, and ADHD symptoms

Individuals living with eating disorders may be hesitant to participate in traditional in-person therapy. Those who experience eating disorders may experience a sense of shame and low self-esteem, which may make it difficult to talk about their thoughts, feelings, and symptoms. In cases like these, online therapy may be a more viable option. 

With online therapy, individuals can be matched with a mental health professional who has experience treating eating disorders and ADHD. They can communicate with their therapist in a way that’s comfortable for them, such as audio, video, or live chat. Individuals can also reach out to their therapist at any time through in-app messaging, and the therapist will generally respond as soon as they can. This may be helpful if clients have questions about emotions or eating habits in between sessions. 

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Are you experiencing ADHD and an eating disorder?

Is online therapy effective for impulse control and eating disorder symptoms?

In recent years, research has demonstrated the effectiveness of online therapy for numerous mental illnesses. One study published in 2020 found that online therapy can effectively treat eating disorders, as well as anxiety, depression, and substance use disorders, and additional research supports the use of online therapy for ADHD treatment.

While online therapy can often be helpful for those with ADHD and eating disorders, some individuals with severe physical health impacts resulting from eating disorder symptoms may require in-person medical care. 

Takeaway

ADHD and eating disorders can co-occur. The relationship between these disorders may involve impulsivity, dopaminergic activity, and other factors. Regardless of the connection between ADHD and eating disorders, help is available for both conditions. Those who can’t access or aren’t comfortable with traditional in-office therapy might consider online therapy.
Healing from eating disorders is possible
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