Could your ADHD be affecting the way you eat? We explore the lesser-known link between ADHD and eating disorders

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Although research does suggest people with ADHD have higher rates of eating disorders, there are several reasons why the link isn’t spoken about so much – most notably because binge-eating and bulimia may happen in private, so the symptoms are not recognised by doctors. And because both ADHD and eating disorders can have similar traits, such as reward-seeking and impulsivity, the symptoms overlap.

The link between ADHD and eating disorders

To understand more about the link between ADHD and eating disorders, I spoke to nutritionist and eating disorders specialist Marcelle Rose, of Marcelle Rose Nutrition, and author of the ‘Binge Freedom Method book’.

In her work, Marcelle has seen a lot of clients with ADHD who either have, or believe they have, an eating disorder. In fact, to put that the other way round, she says approximately 70% of her clients who struggle with binge eating disorder either have a diagnosis or believe they have ADHD.

“I also see this with clients who have bulimia and more generally those who describe themselves as compulsive or emotional eaters,” she explained.

“I particularly see an overlap between ADHD and eating difficulties involving the loss of control around food. I also work with neurodivergent clients, with both ADHD and autism, who struggle with restrictive eating behaviours.

“Eating disorders are complex and usually involve a combination of biological, psychological and environmental factors. But certain ADHD traits may make an individual more vulnerable to developing or maintaining difficulties around food.”

The research that connects ADHD to increased eating disorders

There are several studies Marcelle points to that have revealed the link between ADHD and eating disorders, including the following:

“The most recent study is this one: Springer Nature Link which is a relatively small report of 120 adults receiving treatment for eating disorders. More than half of those studied met the diagnostic criteria for ADHD, despite only two having previously been diagnosed. ADHD was particularly associated with bulimia and binge-eating disorder.

“However, this isn’t the first study to find a connection,” she explained. “A systematic review and meta-analysis found that people with ADHD had around four times the odds of having an eating disorder compared with those without ADHD. The association was particularly strong for bulimia and binge eating disorder. The survey is here: National Library of Medicine

“And finally, a large Swedish population study involving more than 3.5 million people also found an increased risk of eating disorders in people with ADHD and observed a stronger genetic association with ADHD for bulimia and other eating disorders but less so with anorexia. The results are here: National Library of Medicine

Is ADHD and eating disorders more prevalent in women than men, and what are you seeing amongst your clients?

“Females are a particularly important group because ADHD have historically been under-diagnosed in women and girls. There is evidence of ADHD being associated with binge eating in both women and men so it’s not exclusively a female issue,” Marcelle explained. “Some population research has found higher rates of co-occurring diagnosed ADHD and eating disorders among women than men, although research looking at sex differences has produced mixed findings.”

In her London clinic, Marcelle particularly sees the connection between ADHD and binge eating or bulimia in women.

“I work with many women in their 40s and 50s, and perimenopause can provide the perfect storm. Some women have spent decades masking or finding ways to compensate for their ADHD traits and then find that these strategies no longer work during perimenopause. They often experience more difficulties with concentration, organisation, emotional regulation, anxiety, sleep and overwhelm.

“When life feels harder to manage, food can become one way of coping with stress, exhaustion or difficult emotions, particularly if that person already has a history of dieting, binge eating or emotional eating. And then we see body image challenges emerge during this life stage too, when women are more likely to gain weight and their body shape tends to change.”

What ADHD traits can become intertwined with difficulties around food?

There are several overlapping mechanisms, Marcelle explained. “Impulsivity is one, where it may be more challenging to step away from an intense urge to eat. ADHD also involves differences in reward processing, and food can provide an immediate source of reward or stimulation. .

“Planning meals, shopping, and preparing something before you’re extremely hungry all require organisation and people with ADHD tend to find this more of a struggle.

“Hyperfocus is common with women with ADHD, which can mean someone becomes so absorbed in an activity that they inadvertently miss a meal. Then, later in the day may find themselves ravenously hungry, increasing the risk of a binge eating episode.

“Medication can play a role too. Some stimulant ADHD medications reduce appetite, so a person may eat very little earlier in the day and then become extremely hungry later as the appetite-suppressing effects wear off. Regular, adequate nourishment is a particularly important part of the recovery process.

“Some people with ADHD have more difficulty noticing internal body signals, and this is also well documented across eating disorders. That can make recognising and responding to hunger, satiety and fullness signals, for example, more difficult.

“Living with undiagnosed or unsupported ADHD can be exhausting. Anxiety, overwhelm, feeling inadequate and masking are all likely to increase emotional distress. For some people, eating becomes a very effective short-term way of self-soothing, or numbing difficult emotions.”

How can ADHD affect eating? Is it common for it to lead to eating disorders, and why?

“I wouldn’t say ADHD inevitably ‘leads to’ an eating disorder, but having ADHD does appear to increase vulnerability,” explained Marcelle.

“Impulsivity, reward sensitivity, emotional regulation, executive functioning and interoception can all potentially play a part. Then you add environmental factors such as dieting and restriction.

How does binge eating work in people with ADHD? Is it that they have no control and gorge on food without even realising it?

“The definition of a binge doesn’t change if someone has ADHD. A binge-eating episode involves eating an unusually large amount of food within a relatively short period of time, together with a deep sense of feeling completely out of control – many of my clients describe it almost like an out of body experience. Eating is usually much faster than usual, until they feel uncomfortably full. Mostly a binge occurs in secret because individuals experience a great deal guilt, shame and distress surrounding the eating episode.

“Where ADHD may come into the picture is in understanding some of the vulnerabilities surrounding that binge. Impulsivity and difficulty inhibiting the urge may play a part. Food may provide stimulation or immediate reward. Emotional dysregulation may make eating an effective short-term coping mechanism. And irregular, chaotic eating is more likely to increase the risk of a binge.

“Rather than seeing the binge as a failure of self-control, I want to understand what has happened in the hours and days leading up to it. That’s often where we find the information that helps someone begin to change the pattern of behaviour.”