For as long as I can remember, my eating habits have been atrocious. What I didn’t know is that my struggle to manage my weight is an ADHD thing.
ADHD impacts every part of a person’s life and it will impact your eating. The key is identifying the how so that you can do something about.
Show me the numbers: ADHD, eating disorders, and obesity
We’ve only just begun discovering the connection between ADHD and our eating habits. It turns out, so far, the numbers are pretty shocking.
The Link Between ADHD and Eating Disorders
ADHD and Bulimia Nervosa
These two disorders share an unfortunate correlation. One thing they sometimes share is the feeling of being out of control. Those with Bulimia struggle with feeling out of control around food and purging behaviors. Those with ADHD often struggle with feeling out of control with thoughts and impulses. That connection of shared feeling may, in part, show us why they are so connected. And connected they certainly are.
In one study, girls with ADHD were 3.6 times more likely than their peers to have an eating disorder and over 5 times more likely to have Bulimia.
1% of Women have a history of Bulimia vs. 12% of women with ADHD.
In one study, 9% of women inpatient for Bulimia also had ADHD.
Bulimia symptoms, among girls with ADHD, were most prevalent in the combined type presentation, followed by the inattentive type.
ADHD and Binge Eating
Binge Eating Disorder (BED) is the newest eating disorder in the DSM 5. It’s characterized by eating excessively large amount of food on a consistent basis. Those who have BED often feel out of control when it comes to food and experience shame and guilt that leads to another binge.
Some experts say that approximately 30% of people with Binge Eating Disorder have co-occurring ADHD. That represents the strongest link between ADHD and eating disorders. Some researchers are calling for screening all individuals with BED for possible ADHD.
Binge Eating (often associated with obesity) has the highest correlation with ADHD of any eating disorder.
The Link Between ADHD and Obesity
Those of us with ADHD are much more likely to be on the heavier side. In fact, some studies have shown that adults with ADHD are 70% more likely to be obese than neurotypicals. When trying to lose weight, the people who struggle the most are more likely to have ADHD.
Several studies have reported on the prevalence of ADHD among those who are overweight or obese and the findings are surprising. One 2005 study found that 58% of morbidly obese teens had ADHD (and 60% were undiagnosed before the study). Another showed that 1/3 of patients getting gastric bypass had ADHD Inattentive type. In that same study, of the participants with a BMI over 40, half of them had Inattentive ADHD.
With all of this, it seems clear that we ADHDers struggle to regulate our eating habits.
Why do ADHD Adults Over Eat?
Several different factors show in the research on the link between ADHD and overeating. It’s really interesting that different presentations of ADHD appear to be more associated with eating disorders and obesity than others. In particular, the ADHD combined type has the strongest connection in the literature, followed by the Inattentive type. As you look at the various reasons why we tend to over eat or have a disordered relationship with food, see if you can identify why.
Your Impulsivity impacts Eating Habits
Even so, impulsivity seems to have the strongest impact on the connection between ADHD and Bulimia Nervosa. It is primarily the combination of impulsivity and other executive functioning problems like inattention, self-regulation (particularly with stimulation), planning, etc… that connects ADHD to Binge Eating and Obesity.
With ADHD, we tend to get a wild hair to do something, buy something, say something, eat something and we struggle to stop ourselves from engaging with that impulse. That can look like eating the whole bag of cookies because it just tastes so good that your mind can’t stop thinking about needing another one until they are gone. But you didn’t really think about the potential consequences of eating the entire bag of cookies until after you already ate them.
Or it can look like the impulse to eat a cookie. And a bag of chips. Then the fast food commercial makes you run out and grab that burger without thinking. Before long, you’re feeling the impuse to eat that donut and blended coffee someone gave you. Oh, more chips! Then there’s that ice cream in the freezer… And before you know it, you’re entire day has been high sugar, high fat. And most of your days may be the same unbalanced mixture of foods because we struggle to inhibit our impulses.
Your Inattention impacts Eating Habits
Inattention is a common presentation of ADHD, especially in women. It often makes us unaware of cues about hunger and fullness and sometimes it creates a negative effect on our mood. When we are inattentive, we are more likely to eat more than we intended to and much more than our body needed from us.
We may pay less attention to the type of food we are eating and be more inclined to think, “oh, I never eat banana pudding so I can eat it now and still have a balanced diet.” But forget that we’ve said that about 50 other high sugar things in the last week. (Because we ADHDers tend to like our sugar.)
“The inattentive symptoms of ADHD were associated with decreased awareness of internal signals of hunger and satiety, and in turn these deficits were positively associated with disordered eating, particularly binge/disinhibited eating,” one study wrote.
The connection between ADHD and unhealthy eating habits and disorders often involves a combination of impulsivity and inattention. So, we may get the impulse to eat the cookies in the pantry, then continue eating them as our ADHD brain misses the signals telling us we’ve had enough.
You are Eating for Stimulation
Reaching the right level of stimulation provides the human brain with better alertness and makes it more receptive to information and learning. It helps us to be engaged and function well. Neurotypical brains can self-regulate stimulation normally. The ADHD brain is on a continuous quest for optimal stimulation and arousal. Just as we struggle to regulate ourselves in just about any other capacity, our brain struggles to regulate stimulation.
Dopamine is a neurotransmitter that is highly involved in the internal reward system of the brain and in getting the “right amount of stimulation.” For adults with ADHD (or kids), Dopamine is a tricky thing. For one, we struggle to regulate it appropriately as well. For two, the reward system is chronically under-active for us. But activities that reinforce Dopamine in the brain are more gratifying to ADHD brains. In other words, we experience those activites as much more rewarding than others do.
As you may have guessed, eating is a form of stimulation. Sugar or simple carbs with high fat content tend to create a surge of dopamine that the ADHD brain finds even more pleasurable. The cookies, cupcakes, fast food burgers and fries, chips, etc…those foods we often reach for are the ones that give us the highest dopamine rush. Plus, adults with ADHD are less sensitive to the taste of sugar so we tend to eat more of it.
These foods can feel like the answer to the search for stimulation and keep us coming back for more. It’s really interesting that this dopamine process is similarly indicated in Binge Eating Disorder.
Your Struggle with Executive Function Impacts Eating Habits
Starting and maintaining healthier eating habits require skills that ADHD adults often struggle with. Many of these skills fall under the umbrella of ‘Executive Functions.’ Planning, organizing, task initiation, following through, problems solving, managing impulses (and others) are examples of executive function skills that are necessary in our ability to create and sustain healthy eating habits.
Memory is one of those skills that we have a hard time with. And it often impacts our eating. We forget to eat until our stomach is angrily protesting. It’s at that time that we are at risk for eating whatever we can find, eating it fast, and eating a lot of it.
Adults with ADHD struggle heavily with executive functions like the ones listed above and may heavily impact our ability to change what and how we eat.
Your Overwhelming Emotions Impact Eating Behaviors
Many people can relate to the struggle with emotional eating. We know that comfort food increases Dopamine in the brain. Dopamine in addition to stimulation we mentioned earlier, is also responsible for giving us a sense of wellbeing which may explain why we reach for food when we are upset.
Those of us with ADHD may experience a greater struggle with emotional eating because we:
- Experience more rejection and criticism than others
- Tend to be more sensitive to both rejection and criticism than others
- and the ADHD brain, which struggles to self-regulate in general, becomes flooded when we experience difficult emotion and is unable to regulate it efficiently
ADHD experts believe that children with ADHD (just in school) will experience up to 20,000 more critical statements than other kids by the age 10. Those of us with ADHD are more likely to experience rejection from our peers in childhood. The criticism and social ostracism create intense emotional pain that links to disordered eating.
We are also more likely to misinterpret boredom or emotions with being hungry. The combined total of these challenges push us to reach for food when our bodies aren’t asking for food.
Strategies to Manage Weight with ADHD
Thankfully, there are strategies we can use to find balance with our diet and develop healthy eating habits.
Practice Intuitive Eating
Dieting has a negative relationship with managing our weight. The more we diet, the more likely we are to gain weight. Restriction may also increase our likelihood of developing an eating disorder. Ultimately, we do our best when we change our focus to achieving balance with our eating habits, nourishing our bodies, and being mindful of what our bodies need.
Intuitive eating is a healthy way that we can begin to change our relationship with food and improve our health. It is based on 10 principles that helps us find balance with food.
If you are interested in learning more about Intuitive eating, check out this home course to fix your relationship with food.
Exercise to Improve Execute Function (and health)
Few natural strategies for ADHD have research supporting evidence of benefit on executive function or other related challenges. The exception to that is exercise. We’ll just add that little tid bit to the long list of things exercise seems to help with.
Exercise helps us regulate dopamine, which is particularly helpful in enhancing our sense of well being, regulating our impulses and emotions, and improving our concentration and attention.
If you struggle to get yourself to exercise, I’ve found it helpful to find things I’m interested in that require me to move. I’ve always wanted to learn how to do a handstand and a back walkover and it turns out that learning to do that is great exercise. Walking with a friend or learning yoga are other ways I can usually get myself to exercise and even enjoy it. The key is to look for ways to make exercise more interesting. If all else fails, find ways to make yourself move while your doing your favorite activities. A yoga ball always helps me with that!
If you are interested in yoga, but you’re worried about being a total newbie, this class is for you.
Make it Harder to Eat Compulsively
You can find many ways to make it harder to act on your impulse to eat when you aren’t hungry. Here are some ways that I’ve found that help me.
Don’t keep food you tend to binge on in the house.
If you do have it in the house, try to keep it to an individual portion. So, instead of a whole box of cookies, buy just one. Rather than a big bag of chips, get a small bag. Controlling impulses are hard enough passing temptations in the grocery store. Keeping large amounts of binge worthy food in the house with the constant temptation it brings might just be impossible (at least, for me).
When foods you binge on ARE in the house, make eating it a multi-step process.
I’ve never been able to keep cupcakes in the house because I eat them until they are gone. I’ve recently realized though, that it helps if I don’t pre-emptively ice the cupcakes. Instead of being able to run the kitchen and grab a yummy cupcake, I have to find the icing, get a knife, stir the icing, ice the cupcake, put everything up….That little bit of extra effort helps it be a little less impulsive.
Reduce Impulsive purchases in the grocery store.
Grocery stores are designed to make impulsive purchases a persistent problem. You’ve noticed the individual candy bars and sodas at the check out right? They’re banking on your impulses getting the best of you.
One thing I’ve realized is that by paying a little extra money to have someone else grocery shop for me, I actually save money. Why? I’m less susceptible to impulse buying. Some grocery stores have their own employees who shop for you, which can save you money. They don’t mark their food up when you purchase it online, there’s no monthly subscription or tip needed…just an assembly fee. I often shop at Harris Teeter because they have this option.
If you like other stores that don’t have this option, you can check out companies like Instacart or Shipt. The extra fees can add up if you aren’t careful–food is slightly more expensive, there is a delivery fee, and your grocery shopper needs a tip so make sure you consider those extra fees to make sure it’s worth it. Depending on how expensive your impulse buys usually get, this option may still be cheaper for you in comparison.
You can always try only bringing a set amount of cash with you to the store and leave your debit/credit cards at home. That pushes you to buy what is necessary and consider what you take home since your funds are limited.
Treat Your ADHD
It’s exciting to find that the link between ADHD and obesity is increased only among those of us who are unmedicated. When we are treated for ADHD, our likelihood of obesity lowers by at least 40%. In this study, appetite suppression for stimulant medication vanished at the 2 month mark. Meanwhile, participants maintained weight and healthy eating habits at 15 month follow up.
This shows that medication for ADHD helps us learn to manage our weight, rather than taking our appetite away. Medication helps us overcome the road blocks we have in developing executive function skills. We still have to learn how plan, organize, self-regulate, prioritize, etc…but with medication we are able to learn. Part of good treatment, besides medication, will mean putting effort into developing those skills we lack like getting organized (mentally, physically), Being productive, and other strategies that make ADHD work for you.
This is another exciting benefit that comes from treating ADHD. If you are on the fence or fearful about medication for ADHD for yourself (or your children) make sure you read this.
Learn and Practice Meal Planning
Meal planning is difficult for us, don’t get me wrong. We often struggle to make decisions on what to make and we already know that ADHD and planning don’t easily go together. But, when we put that ADHD mind to the task, fabulous things can happen.
Start with a list of meals you enjoy. Meals you’ve made or meals you like to get at restaurants. List as many as you can think of. If you are not the person who enjoys cooking, cross anything off the list that will take more than 30-60 minutes to make or involve difficult processes. Try to identify enough dinner ideas for 10 days. That keeps you from eating the same thing over and over.
Now for breakfast and lunch ideas. If you need or want a lot of variety in what you eat, follow the same steps you took in identifying dinner ideas above. If you are like me, and don’t mind repetition with these meals, this is a little easier. For lunch, I usually stick to easy stuff like sandwiches, soups, or salads. That makes it easy to make and simple to plan. Breakfast can be easy–oatmeal, eggs, cereal–whatever you prefer. Just make sure you have enough of whatever breakfast/lunch foods you will need until your next shopping day.
If you still struggle to choose what to make from the dinner ideas, you can turn it into a game. Write them out on index cards and flip them over, face down. Pick the number you’ll need until your next shopping day. Whichever random choices you end with are your dinners for the week. You can “pick a card, any card” each day to determine what you are eating that night.
Pursue Healthy Forms of Stimulation
Many times, we eat out of boredom and the natural fix to that is to get yourself engaged in things you are interested in and excited about. Get involved in that creative pursuit you’ve been missing. Learn a new skill or try a new hobby. Look for things that you’d feel excited about doing and run with them. Doing that gives your brain that dopamine boost it’s looking for without the unnecessary food intake.
It starts with a question. If you could do anything without anything standing in your way, what would it be? Now start doing that or working toward doing that.
Other Healthy Eating Habits to Help
The biggest challenge I’ve had in my eating habits is the tendency to eat too quickly. We’re more likely to miss our body’s cue that we’ve had enough when we eat too fast. By the time it catches up to us, we’re usually miserable because we’ve eaten too much. Chew thoroughly and rest your fork between bites. I found this practice irritating before I was medicated because I felt too impatient. But now it’s easier to do, it just takes practice to be consistent.
Drink plenty of water. Many times that we think we’re hungry, we’re actually thirsty. Many with ADHD forget to get their H20 (I’m definitely guilty there). Grab a water bottle that you LOVE. Or one that’s fun to drink out of. It makes drinking water more likely when you have ADHD. If you’ve eaten but find yourself still hungry, grab a glass of water and wait a little bit to see if it was really thirst in disguise.
Practice Mindful Eating. It sounds fancy and complicated but it’s pretty simple. Pay attention to every detail of your food as you eat. Pay attention to the smell, the texture, the subtle tastes you experience. I like to see if I can isolate the taste of individual spices. If I’m not the one who made it, I like to try to figure out what ingredients the chef used. Mindful eating is hard, but a class like this can help.
When you eat slowly and mindfully it’s much easier to recognize your body’s cue that it’s satisfied. I tried mindfully eating a fast food french fry once. It’s funny the things you notice when you slow down your eating. I love fries. I LOVE fries. But when I slowed it down and mindfully ate one, it was DISGUSTING. Weird right?
Other Important and Healthy Habits
Get good sleep. Not prioritizing healthy sleeping habits leads to overeating. It also makes functioning with ADHD infinitely harder. So make sure you get your sleep.
Learning mindfulness in general can be really helpful in helping us practice it with food. It’s also a helpful strategy for managing ADHD symptoms. It’s really hard for those of us who battle 50 thousand thoughts a minute, but there are ways to make it easier when you have ADHD.
If you have physical pain or unexplained aches, or your emotions are making life challenges, make sure you treat those. Not only is it important for your quality of life, it also helps reduce our vulnerability to acting on impulses. If you think you might have additional anxiety, depression, something wrong physically, or any other related issue, make sure you are talking with your doctor about those things as well.
Practice your self care. Taking care of yourself and not overextending yourself all the time helps reduce stress which makes us more vulnerable to compulsive eating. Learn to engage your emotions in healthy ways that don’t include food.
Get Help for Eating Disorders
If you’ve realized that your relationship with food fits one of the disorders we talked about earlier or food feels like it’s outside of your control, start working with a therapist that specializes in eating disorders. It’s really common for people to think that they “aren’t sick enough” to get help but that Is. Not. True. Eating disorders are serious business and they need clinician attention as soon as possible. Early intervention can save lives. If you need help finding a therapist, I generally recommend people start with Psychology Today. You can search in your area, with your insurance, and by the eating disorder specialty. Get the help you need and deserve.
Connect with Us
The connection to overeating and disordered relationships with food may be strong for us but there are ways that we can overcome. What areas do you struggle with the most?
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