Mental Health & ADHD Comorbidities

Do You Think Your Daughter Has an Eating Disorder?

Adolescent girls with ADHD are especially prone to eating disorders like bulimia. If you’re worried about your daughter, stay vigilant and seek treatment.

Bulimia and ADHD: Is Your Daughter at Risk?
Bulimia and ADHD: Is Your Daughter at Risk?

Your daughter is getting better grades, and she no longer argues — every day, at least — about taking ADHD medication.

Life is good. But your parental radar has detected a potential problem: Lately, she seems to be eating more — a lot more — from soup and salad to dessert. She’s always loved potato chips, cookies, and cherry Twizzlers, but you’ve been noticing a few too many empty bags and wrappers in the kitchen garbage can. And yet, she isn’t gaining weight. You’re concerned.

Is there a link between the incidence of eating disorders and adolescents who have ADHD? Keep reading to see what research has shown, and learn at-home strategies for parents and daughters.

Bulimia Basics

A 2007 study conducted by Harvard Medical School reported that ADHD girls are 3.6 times more likely to have an eating disorder, compared to girls without ADHD. In 2008, researchers at the University of Virginia and University of California found evidence that bulimia nervosa — characterized by binge eating, followed by attempts to purge the food by vomiting or taking laxatives — was much more common in adolescent girls with ADHD than in girls without it. Impulsivity, not hyperactivity or inattention, was an excellent predictor of bulimia. Having ADHD without impulsivity does not seem to put girls at higher risk for the condition.

[Is There a Link Between Eating Disorders and Women with ADHD?]

The health problems stemming from bulimia include more than losing too much weight. They can range from stomach ulcers and tooth decay to hair loss and irregular menstrual cycles. Frequent vomiting depletes the body of potassium, which controls heart rhythm. A potassium deficiency could lead to sudden death.

At-Home Strategies
If you suspect your daughter is struggling with bulimia, make an appointment with her doctor (see Beating Bulimia at the end of this article). Along with the course of treatment the doctor and other professionals recommend, keep these at-home strategies in mind:

Ease Up

Parents who are overly critical or controlling are more likely to have a daughter with an eating disorder, says Stephen Hinshaw, Ph.D., professor of psychology at the University of California, Berkeley. Find ways to boost your daughter’s self-esteem.

Encourage her to do things she is good at — art, sports, dog-walking — and praise her for her accomplishments. If she struggles in school, hire a tutor. If she has trouble making friends, enroll her in a social-skills course.

Stay vigilant.
Be sure your daughter’s ADHD is properly treated. Finding the right medication to control impulsivity involves trial and error, but stick with it. Hinshaw’s research suggests that girls who are successfully medicated are at lower risk for bulimia.

Consider behavioral therapy.
Studies show that a combination of medication and behavioral therapy work better than either strategy alone for helping girls with ADHD.

[How Cognitive Behavioral Therapy Works]

Keep Healthy Foods Around

Binge eating usually involves high-calorie foods, such as candy, cookies, cake, ice cream, and chips. Reduce the amounts of those foods you buy while increasing your supply of fresh fruits and veggies. Bulimics are less likely to binge on apples than they are on apple pie.

Have her take a multivitamin.
If she is bingeing on junk foods, a daily multivitamin will offset nutrient shortfalls. Also, consider giving her a zinc supplement (12 mg. is the RDA for adolescent girls).

Research published in the Journal of Clinical Psychiatry and in the Journal of the American College of Nutrition reports that zinc deficiency is common in bulimics. This may be due to impaired zinc absorption, vomiting, or bingeing on low-zinc foods.

Don’t expect your daughter to overcome bulimia quickly. But with loving support from you, along with a treatment plan from a team of professionals, she can do it.

[How Do We Know the Treatment Is Working?]

Beating Bulimia

Bulimia often starts as a way for adolescent girls to control weight, but it may lead into a way to deal with stress and frustration. Working with your doctor is essential to overcoming the condition. Here’s what to expect when you do:

  • The doctor will examine your daughter and talk with her about eating disorders.
  • Blood may be drawn to test for levels of potassium, zinc, and other nutrients that may be depleted because of vomiting.
  • If your daughter isn’t taking a stimulant for ADHD, one may be prescribed. The doctor may also check for signs of a mood disorder, and prescribe an antidepressant, if he makes a diagnosis.
  • She will be referred to a psychologist or psychiatrist, who can help your daughter identify triggers of binge eating.
  • She may be referred to a registered dietician, who can help your daughter develop a healthy eating plan. A team approach to treating bulimia is the most effective.