While eating disorders are complex enough to navigate on their own, research shows that most people with eating disorders are also dealing with at least one other co-occurring condition. For instance, anxiety disorders are common among adults with eating disorders—affecting some 48% of those with anorexia, 81% of those with bulimia, and 65% of those with binge eating disorder (BED)—and the risk of depression is also higher for people affected by eating disorders, especially those with BED or bulimia. More recently, research has also drawn a link between ADHD and binge eating.

Attention-deficit/hyperactivity disorder, or ADHD, is one of the most common neurological disorders in children, but it can also affect adults. And while people with any type of eating disorder might also have ADHD, there does seem to be a particularly strong link between BED and ADHD. Read on to understand why binge eating and ADHD often go hand in hand, and how to find the most effective treatment for lasting recovery.

What the research says about ADHD and binge eating

While not every person with ADHD experiences eating issues, research has shown that the odds of having a clinical eating disorder are higher among the ADHD population. One study found that those with ADHD are more likely to experience binge eating and purging behaviors and to restrict food intake, and several studies have indicated a specific correlation between ADHD and binge eating.

“There is evidence that there are greater rates of binge-spectrum disorders, including both bulimia and BED, in people with ADHD, compared to people without ADHD,” says Equip’s Director of Program Development, Tana Luo. She cites one sample that found that 8.3% of adults with ADHD had BED, as compared to a prevalence rate of 2.6% for the general population. And according to some estimates, she says, up to 30% of people with BED experience ADHD symptoms, compared to 5% for the general population.

How do the symptoms of ADHD relate to binge eating?

There are a multitude of symptoms associated with ADHD, but some of the most common and universal include persistent patterns of:

• Inattention (i.e. not being able to focus on or complete a task/listen/pay attention, etc.)
• Hyperactivity (i.e. having an unusually high level of excitement or activity)
• Impulsivity (i.e., acting on sudden feelings, ideas, or desires).

“People with ADHD tend to struggle with executive functioning, things like planning ahead, prioritizing, and managing time,” Luo explains.

Meanwhile, BED is characterized by recurrent episodes of binge eating, in which a person consumes a large amount of food while feeling like they can’t control their compulsion to do so. Though the overlap with ADHD may not be immediately obvious, Luo points out that both conditions share some characteristics, which may make someone more prone to one if they’re actively experiencing the other.

“It’s possible that the symptoms of ADHD increase risk of binge eating behaviors,” Luo says. “For example, it could be that challenges with executive functioning make it hard for people with ADHD to stick to a regular plan of eating. And we know that skipping meals, whether intentional or unintentional, increases vulnerability to binge eating later in the day. Furthermore, some people with ADHD struggle with awareness of their hunger and satiety cues, and this could also lead to disrupted eating patterns.”

It’s not your fault, and you’re not alone. Get the support you need to manage ADHD and stop binge eating.

Schedule a consultation

How the brain might explain the ADHD-eating disorder link

Like all mental disorders, ADHD doesn’t have one single cause, nor can we point to a clear reason why it correlates with binge eating. There are, however, some theories around the connection between ADHD and binge eating in certain brain processes.

“There are a few different hypotheses as to why there’s a link between ADHD and binge eating,” Luo says. “It may be that ADHD contributes to binge eating, or vice versa. Or that certain comorbidities in ADHD, like depression, increase risk of binge eating disorder. And finally, it’s possible that ADHD and binge eating share the same underlying neurobiological vulnerabilities.”

One study found that both ADHD and binge eating involve similar processes in the brain. Specifically, both groups had dopamine systems (the reward circuit in the brain) that reacted more positively to food when in a heightened emotional state, and both also showed higher scores for impulsivity and more difficulty processing and regulating emotions.

It’s also worth noting that there’s some evidence to suggest a connection between ADHD and anorexia, but Luo explains that this association isn’t as well understood.“While there is evidence to indicate co-occurrence between ADHD and bulimia and BED, the relation between ADHD and anorexia has been shown to be mixed,” she says. “With that being said, people with ADHD tend to experience difficulties regulating their emotions. And, oftentimes, disordered eating behaviors serve as a way to regulate painful emotions. People with ADHD may also experience interoceptive differences, meaning they may have trouble detecting, accurately interpreting, or attending to their body’s cues, including hunger and fullness cues. Challenges with interoception may increase overall risk for developing an eating disorder.”

How to treat ADHD and binge eating together

When it comes to treating binge eating, a variety of therapeutic strategies, like cognitive behavioral therapy (CBT), integrative cognitive-affective therapy (ICAT), and dialectical behavior therapy (DBT) can be effective, as can certain medications. For ADHD treatment, the standard protocol typically combines medication, skills training, education, and counseling. And importantly, with the right care, it’s possible—even preferable—to treat both conditions at the same time.

“Non-pharmacological treatments for ADHD include both behavioral and cognitive-behavioral approaches, both of which can work very well alongside eating disorder treatment,” Luo says. “For example, both family-based therapy (FBT) and enhanced cognitive behavioral therapy (CBT-E) teach patients skills like emotion regulation, mindfulness, identifying triggers and high risk times, meal planning, and structuring home/school/work environments to support regular eating. Many of these skills also apply to symptoms of ADHD.”

When people come to Equip with both binge eating and ADHD symptoms, their multidisciplinary care team works collaboratively to create an effective, evidence-based plan of action to address both conditions. “At Equip, providers work with each patient and their loved ones to identify how the patient’s specific symptoms of ADHD may be impacting eating disorder symptoms,” Luo says. “This understanding then informs how different strategies are applied to address eating disorder symptoms. For example, someone with ADHD may benefit from additional tools, like setting alarms or reminders to eat, coming up with a detailed plan of eating before a big event, and extra focus on certain distress tolerance and emotion regulation skills.”

Regardless of whether you or a loved one has been diagnosed with ADHD or BED, if you’re worried about specific symptoms or patterns, it’s important to seek immediate expert support. With the right team and plan, both conditions can be effectively treated, making a healthier, happier future possible.