David, 35, feels that the only thing that gives him relief from his ADHD chaos is food. He makes several stops on his way home from work. Along the way and later at home, he might order and eat four hamburgers, four orders of French fries, a pizza, two bags of potato chips, two gallons of ice cream, and a dozen cupcakes. His numbness after such a binge turns into frustration and disgust. Then he vomits. He swears he will never binge and purge again, something he has told himself for 10 years.
Approximately 20 million women and 10 million men suffer from a significant eating disorder at some time in their lives. Although eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, have been recognized for many years, their association with ADHD is relatively new.
As most of you know, anorexia nervosa (AN) is characterized by restricting food intake (sometimes to the point of starvation) leading to a low, unhealthy body weight. Anorexic individuals are fearful of gaining weight, especially in the form of body fat. Bulimia nervosa (BN) is marked by recurrent binge-eating episodes. A binge is defined as uncontrollably eating a large amount of food in a short period, compared with what most people eat. Due to feelings of self-loathing and anxiety after the binge, bulimic individuals compensate for it through self-induced vomiting, laxative use, excessive exercise, fasting, or the use of diuretics to prevent weight gain. Binge eating disorder (BED) is characterized by binge eating episodes without the purging behaviors that are present in bulimia.
Research has demonstrated that individuals with ADHD have a greater risk for developing binge eating disorder or bulimia nervosa than their non-ADHD peers. A study conducted at Harvard Medical School, in 2007, found that girls with ADHD were almost four times more likely to have an eating disorder than their non-ADHD peers. Another empirical study found that 11 percent of women with ADHD, compared to 1 percent of non-ADHD women, reported a history of bulimia nervosa.
On a Binge
Many people with ADHD have poor impulse control and find it hard to regulate their emotions. This combination sets the stage for binge eating. Haley, 28, compares it to an addiction. “Food is my heroin,” she says. “It sounds dramatic, but it is true. As hard as I try to prevent a binge, it is like driving over the same pothole that blows out your tires every day. I hate what binge eating does to my weight. It makes me feel worthless, which makes me turn to food again. It’s an abusive relationship.”
For bulimics, food is self-medication for anxiety, stress, anger, and boredom. Eating is stimulating, so when sufferers feel “empty” emotionally, food fills the gap. People with ADHD who feel inadequate and incompetent turn to food as a source of comfort. Eating is used as an unhealthy outlet to take control of their lives. Both binge-eaters and ADHDers have trouble heeding their internal cues of satiety and hunger.