When we talk about ADHD and eating patterns, there's often an oversimplified focus on binge eating. However, research tells us that the relationship between ADHD and eating is far more nuanced. Recent studies have shown that ADHDers experience higher rates of all types of eating disorders and eating differences, not just those involving binge eating.
A 2016 systematic review and meta-analysis but Nazar et al. revealed that people with ADHD are nearly four times more likely to develop an eating disorder. Conversely, when looking at individuals with diagnosed eating disorders, they were more than twice as likely to have ADHD. This relationship exists across different eating disorder presentations and throughout the lifespan.
50-70% of autistic identifying individuals are also ADHDers and both autism & ADHD are a spectrum, so when considering which strategies to use with the client, clinicians should reflect on what each clients reported strengths and difficulties are and what strategies might best fit their presentation (rather than just the identification as autistic or ADHDer).
For many ADHDers, the challenge isn't just about appetite or food choices – it's about executive functioning. Think of executive functioning as your brain's secretary, managing organisation, planning, and memory. When this system is under-resourced, as it often is in ADHD, it can create unique challenges in accessing, preparing, and consuming food.
Rather than viewing these differences as deficits, we can understand them as natural variations in how brains work and develop creative solutions that work with, rather than against, ADHD traits.
While stimulant medications can affect appetite, it's crucial to take a balanced approach. The impact on appetite needs to be weighed against potential improvements in executive functioning and overall quality of life. This isn't about choosing between medication and adequate nutrition – it's about finding strategies that support both.
Some practical approaches include:
One often-overlooked aspect of ADHD and eating is the role of dopamine. ADHDers typically have lower dopamine levels, which can affect focus, concentration, and motivation. Food can be a source of stimulation and dopamine release. Although commonly demonised by diet culture, eating for stimulation isn't inherently problematic – it's a valid way that some ADHDers meet their needs for stimulation and regulation. However, it can be helpful to explore additional sources of stimulation with ADHDer’s especially if they are finding they are regularly overeating
Neurodivergent burnout is a real phenomenon that requires understanding and accommodation. During these periods, focusing on accessible nutrition options and reducing demands becomes crucial. This might mean:
Exercise often plays a crucial role in managing ADHD symptoms, but it's important to look beyond traditional assumptions that in the case of eating disorders exercise is always ED driven. When working with ADHDers who exercise, we need to:
Supporting ADHDers with eating differences requires moving beyond one-size-fits-all approaches. Instead, we need to:
The goal isn't to make ADHDers eat like neurotypical people – it's to support them in finding sustainable, enjoyable ways to meet their nutritional needs while honouring their neurodivergent experiences.
Our free resource provides practical strategies for implementing these principles in your practice: Essential Tips for Supporting ADHDers with Eating Differences
For a neuroaffirming adaptation to the RAVES model - SAFETY
For online on demand training - A Neuroaffirming Approach to Working With Eating Disorders
References
Hours, C, Recasens, C, Baleyte, JM. (2022). ASD and ADHD Comorbidity: What Are We Talking About? Front Psychiatry Vol 28
Nazar, B.P et al. (2016). The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Int J Eat Disord. 49(12) p1045-1057
Nickel, K et al (2019). Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Front Psychiatry. 10(708)
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