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The Relationship Between ADHD and Binge Eating Disorder

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Attention deficit hyperactivity disorder (ADHD) and binge eating disorder (BED) often occur together. While the relationship between ADHD and binge eating is complex, they both share similarities in the pathways in the brain for reward processing, impulsivity, and emotional regulation. (1,2)

The Relationship Between ADHD and Binge Eating Disorder

ADHD Symptoms, Binge Eating Patterns and Common Traits

ADHD is a neurological disorder characterized by an executive functioning developmental delay, attention dysregulation, emotional dysregulation, and hyperactivity. It is a common risk factor for binge eating disorder, and high rates of binge eating have been found in those with ADHD. (2) In fact, research has found more than thirty percent of people who have eating disorders also have ADHD symptoms, and up to thirty percent of those who have ADHD exhibit disordered eating patterns. (3)

Research has also found several core ADHD symptoms are directly related to binge eating and restrictive eating patterns. In addition, both ADHD and binge eating have some neurological similarities. (2,4)

People who have ADHD can be easily distracted, impulsive and hyperactive. So they may not pay attention to what they are eating and may overeat. They may get immersed in a task and forget to eat, realize they’re ravenous, then binge eat. Those with inattentive ADHD especially may not be aware of hunger and fullness cues, eating when not hungry and past the point of fullness.

Managing emotions and transitions are hard for people who have ADHD. So they may turn to food to deal with difficult emotions and change. They can also have what is called poor executive functioning, which includes planning, organization, and time management skills. This may play a role in shopping for food, meal planning, timing, and eating. 

As a result, people with ADHD may get frustrated easily and feel bad about themselves. And others get frustrated with them, often labeling them as lazy, stupid, or stubborn, because they don’t understand the ADHD brain is wired differently. Interpersonal challenges are also common in those who have ADHD. This can contribute to low self-esteem. 

Those who have ADHD and BED also tend to have similar personality traits, such as obsessive-compulsiveness and perfectionism. (5)

All this, in turn, can have a cumulative effect for people with ADHD and lead to anxiety and depression, both of which also commonly occur with eating disorders. Because the reward pathways in the brain are the same in people with ADHD and BED, they have the same increased response to food and other rewards. So they may turn to food to make themselves feel better in response to many negative emotions. They may also restrict their food intake to lose weight and feel better about themselves.

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Treating ADHD and Binge Eating Disorder

The presence of any two or more co-occurring conditions can make treatment especially complicated. A comprehensive treatment plan must consider all underlying conditions and risk factors. More research is needed to inform the relationship between ADHD and binge eating disorder and the most effective treatments. (1) But methodologies are available that have had some success to date. 

Stimulant Medications

ADHD is generally treated with stimulant medications, which increase dopamine levels in the brain and reduce hyperactive and impulsive behaviors. (7)

Some research has found stimulants, such as amphetamine, lisdexamfetamine, methylphenidate, and phentermine, to be effective for some eating disorders. (6,7) Methylphenidate combined with cognitive behavioral therapy (CBT) in one study helped patients reduce the number of binges and cravings they had. (7)

But some risks are associated with stimulants, too. They may cause heart attacks, increase blood pressure, reduce appetite, and cause weight loss. (6) At this time, no one really knows the impact of these stimulants on the loss of control eating in youth with ADHD. (6)

Mindfulness

Mindfulness-based meditation training has been found to reduce ADHD symptoms and decrease binge episodes by strengthening areas in the brain that regulate emotions and attention and improve cognitive functions. (8,9) Mindfulness is the practice of bringing your attention to the present moment and cultivating an objective awareness of your experiences and surroundings in that moment without an immediate reaction or judgment. 

A mindfulness-based approach to eating addresses the core challenges of BED, which are managing responses to emotions, increasing awareness of hunger and fullness cues, and cultivating self-acceptance. Sometimes called mindful, intuitive, or attuned eating, this approach has been found to decrease binge episodes, improve self-control, and reduce depressive symptoms. (8)

Likewise, mindfulness-based training has demonstrated improvement in attention regulation, emotional regulation and executive functioning skills. Even just 20 minutes a day resulted in improved attention, reduced reactivity, better working memory functioning, better visuo-spatial processing, and less mind wandering. (9)

Our clinical care team at Within Health provides attuned care for eating disorders, and their co-occuring mental health disorders, like ADHD. If you are looking for help for binge eating, or any other eating disorder, we are here to help.

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Frequently asked questions

Resources

  1. Cortese S, Bernardina BD, Mouren MC. Attention-deficit/hyperactivity disorder (ADHD) and binge eating. Nutr Rev. 2007 Sep; 65(9): 404-11. https://pubmed.ncbi.nlm.nih.gov/17958207/ 
  2. Seymour KE, Reinblatt SP, Benson L, Carnell S. Overlapping neurobehavioral circuits in ADHD, obesity, and binge eating: evidence from neuroimaging research. CNS Spectr. 2015 Aug;20(4):401-11. https://pubmed.ncbi.nlm.nih.gov/26098969/
  3. Svedlund, N.E., Norring, C., Ginsberg, Y. et al. Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among adult eating disorder patients. BMC Psychiatry 17, 19 (2017). https://doi.org/10.1186/s12888-016-1093-1
  4. Kaisari P, Dourish CT, Rotshtein P, Higgs S. Associations between core symptoms of attention deficit hyperactivity disorder and both binge and restrictive eating. Front Psychiatry. 2018 Mar 29;9:103. https://pubmed.ncbi.nlm.nih.gov/29651258/
  5. Bleck, J et al. (2015). Underlying mechanisms and trajectory of comorbid ADHD and eating disorders: proposing an innovative systems framework for informing research. International Journal of Mental Health and Addiction, 14: 449-458. 10.1007/s11469-015-9593-7 
  6. Keshen A, Bartel S, Frank, GKW, et al. The potential role of stimulants in treating eating disorders. Int J Eat Disord. 2021 Nov 30. https://pubmed.ncbi.nlm.nih.gov/34846763/ 
  7. ADHD Medications. Help guide. https://www.helpguide.org/articles/add-adhd/medication-for-attention-deficit-disorder-adhd.htm
  8. Jean L. Kristeller & Ruth Q. Wolever (2010) Mindfulness-Based Eating Awareness Training for Treating Binge Eating Disorder: The Conceptual Foundation, Eating Disorders, 19:1, 49-61, DOI: 10.1080/10640266.2011.533605
  9. Mitchell, J.T., Zylowska, L., Kollins, S.H. (2015, May). Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions. Cogn Behav Pract. 2015 May; 22(2): 172–191. doi: 10.1016/j.cbpra.2014.10.002
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