The Connection Between Binge Eating & ADHD

Explore how ADHD affects the way we eat

Attention-Deficit/Hyperactivity Disorder, also known as ADHD, is one of the most common neurodevelopmental disorders. ADHD can affect both children and adults in many aspects of their lives, including school and/or work performance, social interactions, cognitive and executive functioning, and eating habits. 

Although the exact rationale is still unknown, people with ADHD are prone to dysregulation of behaviours and emotions, which likely increases their risk of adopting overeating or binge eating behaviours, especially in the presence of other life stressors, such as a stressful exam week or a busy workday. Interestingly enough, people with ADHD also seem to be more sensitive to criticism (1). Through my experience working as a counselling dietitian, I’ve seen many ADHD clients with good intentions struggle to start or stay on their healthy eating journey due to self-sabotaging and –criticizing. This may lead them to think that they “just don’t have the willpower” but fail to recognize that ADHD can have an impact on their overall eating. 

The Research Behind Binge Eating and ADHD

Emerging evidence has suggested links between ADHD and eating disorders and disordered eating behaviours. One national study in the U.S. has found that their ADHD participants were 2.8 times more likely to also struggle with an eating disorder, not only the binging and/or purging type (8.1 times more likely) but also the restrictive type (4.9 times more likely) (7). Another study in 2016 also revealed a higher prevalence of eating disorders and disordered eating behaviours in the ADHD population (a three-fold increase) and vice versa (a two-fold increase). The results were similar despite gender, age, and types of eating disorder, with only a slightly higher risk of Bulimia Nervosa among all types of eating disorders and disordered eating behaviours (6). Although the exact connection between the two conditions remains unclear, one population-based study has found that children with ADHD are at a moderately higher risk of body dissatisfaction as well as weight loss attempts, suggesting assessments and interventions to be taken to prevent the development of eating disorders (8). 

How ADHD impacts diet and common ADHD behaviours related to food  

As a dietitian with lived ADHD experience, I have the privilege of viewing things through both a professional and personal lens and hence would like to share a few connections I’ve discovered between the features of ADHD and eating challenges that people with ADHD tend to struggle with. 

Reward Processing  

Research suggests that people with ADHD may process rewards differently in their brains in terms of reward anticipation and receipt (2). A brain imaging study has found a weaker reward anticipation and a stronger reward receipt in ADHD participants (6). This has certainly occurred many times in my professional practice as well as my personal life. 

A very common struggle I often hear from my ADHD clients is: “I know healthy eating is good for me and I do want to eat healthier, but it just seems so boring to me, or I just don’t seem to have the interest or motivation to get things started.” Again, this may sound very much like an excuse to others if you don’t know much about ADHD, and I am sure many people with ADHD have received numerous negative comments because of this, such as “you just don’t want it then,” “you are too lazy,” or “it is because you don’t have the willpower.” Before I learned anything about ADHD, I internalized all sorts of negative remarks, thinking about many things in life such as “why should I even try if I just can’t do it myself?” Does this sound familiar to you with ADHD? 

One thing I was surprised to find out before I started to associate my life with ADHD is that people with ADHD often have something they are very interested in or passionate about. It will make more sense if you picture the “stereotype” of young boys with ADHD who can play video games with their full attention for hours and hours. So, this is how I interpret it from a reward processing perspective: if you can somehow associate whatever ADHD deemed as “boring” with things you truly love or care about, you still have a chance to take the lead. 

Response Inhibition 

Impulsivity is another common struggle for many people with ADHD. Response inhibition, one of the core executive functions, refers to one’s ability to resist temptations and/or discontinue unwanted behaviours (2, 4). Many of my ADHD clients have addressed their concerns about overeating as a habit they have developed over time, and it is not because they don’t want to change the behaviour, but it just doesn’t seem the results can last. Research shows 40-50% of children with ADHD exhibit response inhibition deficits, speak to your physician if you want to discuss this further and explore the potential of ADHD medications as brain imaging research has shown these can be effective (2). 

Emotion Dysregulation 

We all experience emotions daily, both positive and negative, and probably have regrets about things we did when the decision maker was our emotions. Emotion regulation refers to one’s ability to manage and respond to one’s emotions through appropriate, healthy behaviours (2, 5). Research suggests that deficits in emotional processing and regulation in children with ADHD may be related to functional abnormalities in the brain (2). My interpretation of this, from a dietitian perspective, is that people with ADHD may be at a higher risk of emotional eating, especially when food has been their main coping mechanism. What complicates the situation is when impulsivity co-exists, making it hard to think about and commit to the right decision or the desired behaviour. 

Inattention 

Although I didn’t come across any specific research study analyzing the relationship between inattention and one’s eating habits, some research has found positive associations between the two. One study investigates interoceptive awareness in ADHD participants and suggests that “the ability to monitor the momentary bodily state may be impaired in ADHD” (3). Over the years in my practice, I have encountered a number of clients with ADHD who have trouble connecting with their body cues, such as hunger, fullness, or satisfaction, which has led to several barriers in their healthy eating journey.  

A typical eating day may start with no breakfast as they may not feel hungry, especially if their appetite is suppressed by their ADHD medication. Moving into the day as they get busier, they may forget to take breaks, not to mention eating, even if their stomach was growling. By the time they get home, they are often exhausted and starving but somehow fail to recognize that they haven’t had any food yet after a long, tiring day. Then they start to eat, and eat, and eat, eventually stopping not because they are full and satisfied, but because it’s time to go to bed, if they didn’t get uncomfortably full before then. This cycle then can repeat day after day. 

5 Strategies to Manage Binge Eating if you have ADHD  

1. Maintain a regular, balanced eating routine

Based on what you just learned from the above, ADHD puts people at risk of unhealthy, disordered eating behaviours. To some people, it can be challenging enough to maintain a regular, balanced eating routine. If this sounds like you, please don’t give up yet as healthy eating can still be possible. In believe healthy eating comes in stages, and regular, balanced eating happens to be the very fundamental stage in healthy eating. You must match your goals and expectations to what makes the most sense in your busy life, even if it has to start with eating anything but three times a day or setting reminders for the three times that your body needs your attention. The more consistently your body is nourished from regular, balanced eating, the better you can regulate your emotions and behaviours as well as manage any unhealthy eating behaviours as the result. 

2. It is worth taking the time and effort to plan out your eating in detail

There is no doubt that people with ADHD tend to do better with routines, but the challenge is how they set up the routine in the first place. I know meal planning seems like a lot of trouble to you; it is to me too. However, if you want to be “lazy”, you better find a shortcut that allows you to stay “lazy”, and meal planning is the shortcut to healthy eating. The final plan doesn’t have to look fancy or be perfect, but it does need to work for you, meaning that if it takes an hour for you to get everything ready for supper, make sure that time is preserved in your day. 

3. Find the right motivation

I’ve given this advice to so many of my clients with ADHD. If you want to get something started but struggle with how to take the first steps, make it matter to you. Whether it is an annoying set of phone alarms that are only a minute or two apart, or rewarding yourself with things that you care about after you finish the “boring stuff” you intended to do. You know yourself the best, so be honest with yourself and be creative in ways that can grab your attention. 

4. Start your mindful eating journey sooner than later

Mindful eating is almost an unseparated part of healthy eating, especially in the case of ADHD. Often time, without proper guidance and practice, even if you may have noticed that your stomach is growling or uncomfortably full, you may not be able to register such feelings with the action of eating or stopping. It is also common that your ADHD brain tends to prioritize other important things over eating. Mindful eating may benefit many people with ADHD, which is a fine art of knowing and feeding your body with what and how much it is asking for. 

5. Set up your toolbox for efficient emotion regulation

All human beings have emotions which need to be acknowledged and handled. Emotional eating itself, as one of many ways to regulate emotions, is actually not a bad thing. It only becomes a problem if you have a lot of strong emotions you need to deal with, and food seems to be the only coping mechanism you have. There is a lot more we can do about our emotions. Laughing, crying, listening to music, watching a movie, taking a hot bath, walking… you name it. 

Wrapping it up 

As a dietitian with lived ADHD experience, I do understand eating can be a struggle.  The purpose of me writing this blog and sharing the why’s is to help you understand and know that there is nothing wrong with you; it’s just that our brain works differently compared to others. However, don’t let ADHD take advantage of this knowledge and “justify” the unhealthy eating habits and routines that you need and want to change. I know it is hard, but you don’t need to do this alone.  Reach out to our friendly Dietitian team for help so we can work with you in the right direction for your goals.  

If you or a loved one need assistance with common ADHD eating challenges such as meal planning, emotional eating, not eating enough, etc., our specialized dietitians are here to help. Learn more about virtual and in-person Nutrition Counselling or contact us directly to see how we can help.

Check out our other related blog posts below!

References 

1. https://www.psychiatry.org/patients-families/adhd/what-is-adhd 
2. Seymour, K. E., Reinblatt, S. P., Benson, L., & Carnell, S. (2015). Overlapping neurobehavioral circuits in ADHD, obesity, and binge eating: Evidence from neuroimaging research. CNS Spectrums, 20(4), 401–411. https://doi.org/10.1017/s1092852915000383 
3. Wiersema, J. R., & Godefroid, E. (2018). Interoceptive awareness in attention deficit hyperactivity disorder. PLOS ONE, 13(10). https://doi.org/10.1371/journal.pone.0205221 
4. Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64(1), 135–168. https://doi.org/10.1146/annurev-psych-113011-143750 
5. https://selfinjury.bctr.cornell.edu/perch/resources/what-is-emotion-regulationsinfo-brief.pdf 
6. Nazar, B. P., Bernardes, C., Peachey, G., Sergeant, J., Mattos, P., & Treasure, J. (2016). The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. International Journal of Eating Disorders, 49(12), 1045–1057. https://doi.org/10.1002/eat.22643 
7. Bleck, J. R., DeBate, R. D., & Olivardia, R. (2014). The comorbidity of ADHD and eating disorders in a nationally representative sample. The Journal of Behavioral Health Services & Research, 42(4), 437–451. https://doi.org/10.1007/s11414-014-9422-y 
8. Bisset, M., Rinehart, N., & Sciberras, E. (2019). Body dissatisfaction and weight control behaviour in children with ADHD: A population-based study. European Child & Adolescent Psychiatry, 28(11), 1507–1516. https://doi.org/10.1007/s00787-019-01314-8