Is There a Link Between Eating Disorders and Women with ADHD?
Disordered eating — in all its insidious forms — may be more common for women and girls with ADHD. Two experts weigh in on why this might be.
Although there is minimal research available specifically on women, girls, and eating disorders correlated with ADHD, there are studies that establish that obesity, bulimia and binge eating are more prevalent in those with ADHD due to poor self-control and impulsivity. We ourselves published a study that reviewed eating habits of 85 adult women with ADHD (no girls), who reported compulsive eating with some bulimia, but little or no occurrence of anorexia. Other clinical researchers have suggested that there are separate concerns for adolescent girls with ADHD, who like many girls in their age group may be preoccupied with body image and dieting, and are occasionally reluctant to take ADHD medications if they perceive them to interfere with maintaining that image.
In Understanding Women with ADHD, Dr. John Fleming and Dr. Lance Levy discuss the use of food in the context of obsessive behaviors. Dr. Fleming found that the women who were the least successful in losing weight in his eating disorders treatment program had a much higher incidence of undiagnosed ADHD than the general population. Upon interviewing these women, it was discovered that many ate out of boredom and need for stimulation. One of his approaches in working with them was to help them develop other better sources of stimulation.
Another pattern that was found in the questionnaires completed by women with ADHD in our survey was that food was calming for them. Many women reported a pattern of eating carbohydrates at night — snacks and desserts — as a means of self-calming. It is known that high carbohydrate intake can temporarily raise serotonin levels. Additionally, a dopamine deficiency often occurs with ADHD, which is also associated with disordered eating patterns and obesity. We can infer from these studies that women with ADHD may use food as a form of self-medication — one that is more socially acceptable than drug or alcohol use.
ADHD is often characterized by problems in self-regulation, and a lack of awareness of internal states such as hunger and fullness. Levy’s study reports subjects often miss meals due to lack of awareness of their hunger, and often miss the cue of feeling “full” while eating, and will overeat to the point of feeling “stuffed.”
Changing unhealthy patterns of over-eating or binge eating requires planning and consistency — two capacities that are compromised by the executive functioning challenges associated with ADHD. Medication is often critical for adult women with ADHD to manage impulsivity and poor self-regulation symptoms that lend to overeating or binging.