ADHD and Eating Disorders: Addressing the Overlap

August 3, 2022 by chrysalis

Both Attention-Deficit hyperactivity Disorder (ADHD) and Eating Disorders (EDs) are increasing in prevalence. There is documented overlap between the two and how the diagnoses interact with one another. Those with both ADHD and Ed will have unique experiences that will impact their interaction, with their disorder and with treatment.

ADHD is a disorder characterized by the presence and persistence of the core symptoms of hyperactivity/impulsivity and/or inattention. Hyperactivity is defined as constant movement in inappropriate situations. It can include things like fidgeting, always talking/frequently interrupting, or talking at an inappropriate volume. Impulsivity refers to hasty decision making without forethought, which can go alongside hyperactivity in social situations. Inattention, on the other hand, manifests as wandering from task to task, difficulty maintaining focus, and disorganization. Inattention is much less “visible” than hyperactivity and impulsivity, meaning that those with inattentive ADHD are easier to miss (American Psychiatric Association, 2013). ADHD is diagnosed in roughly a 2:1 ratio of males to females, but recent research suggests that this may be due in part to different presentations based on gender.

ADHD has a worldwide prevalence of about 5%(Polanczyk et al., 2007). Most of these diagnoses are made in boys below the age of 18. In the college age population, prevalence is estimated between 2-8%. Based on current research, it appears that approximately ~75% of ADHD symptoms from childhood will persist into adulthood (Biederman et al., 2010). These statistics are changing, however, because women are underdiagnosed with ADHD. Women/girls typically present with more inattentive behaviors, vs. men/boys who tend to present as more visibly hyperactive.

The worldwide prevalence of eating disorder is estimated at 8.4% for women and 2.2% for men. The estimated combined percentage of eating disorders has risen from ~3.5% between 2000-2006, to ~8% between 2013-2018. Prevalence of eating disorders in adolescents is estimated between 6-8% (Galmiche et al., 2019).

Recently, there has been an ongoing conversation about the way that ADHD symptoms can impact the development and progression of eating disorders. Symptoms such as inattention, poor impulse control, and poor executive function all support a link between ADHD and the manifestation of eating disorders. These symptoms may manifest as forgetting meals and snacks, poor awareness of hunger and fullness cues, and strong impulses to binge/purge. Other factors may include anxiety and mood disorders, both of which occur at higher rates in both those with ADHD and eating disorders (Levin & Rawana, 2016).

The research around this topic is new and ongoing, but by bringing attention to the possibility of a relationship between eating disorders and ADHD, the hope is that, over time, screening, and early intervention for those at high risk for either diagnosis will improve. If you or a loved one struggles with ADHD, an eating disorder, or both, you are not alone. Clinicians at Chrysalis treat these disorders both individually and when they co-occur.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association.

Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402-1413.

Levin, R. L., & Rawana, J. S. (2016). Attention-deficit/hyperactivity disorder and eating disorders across the lifespan: A systematic review of the literature. Clinical Psychology Review, 50, 22-36.

Polanczyk, G., M.D., Silva de Lima, M., M.D., Horta, B. L., M.D., Ph.D., Biederman, J.,M.D., & Rohde, L. A., M.D., Ph.D. (2007). The Worldwide Prevalence of ADHD:A Systematic Review and Metaregression Analysis. American Journal of Psychology, 164(6), 942-948.

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