When Attention-Deficit/Hyperactivity Disorder (ADHD) and eating disorders co-occur, the recovery process can become more complex. The interplay between these conditions—each with its own challenges—can make the journey to healing feel daunting. ADHD, which is marked by symptoms like impulsivity, emotional dysregulation, and difficulties with executive functioning, can worsen disordered eating behaviors. Understanding how these conditions affect one another is crucial to providing effective, compassionate care. At The Emily Program, we specialize in personalized treatment tailored to the specific needs of individuals managing both ADHD and eating disorders, helping them achieve comprehensive and lasting recovery.
The Link Between ADHD and Eating Disorders
ADHD frequently occurs alongside other mental health conditions, including eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder (BED). While ADHD doesn’t cause eating disorders, research from the National Institutes of Health indicates that certain ADHD traits may increase the risk for eating disorders due to the way that ADHD influences eating habits and behaviors. For individuals living with both ADHD and an eating disorder, the recovery process can feel especially challenging. Understanding how these conditions overlap is not just beneficial; it’s an essential first step toward healing.
ADHD is characterized by difficulty with attention regulation, impulse control, and challenges with executive functioning (which includes planning, organization, and managing time), all of which can complicate a person’s relationship with food.
- Impulsivity: ADHD can make it hard to pause before acting, leading to impulsive decisions around food, such as restricting, eating large amounts of food in a short period (as seen in compulsive overeating and binge eating disorder), or skipping meals entirely. These behaviors often feel automatic and difficult to control.
- Emotional Dysregulation: Strong, fluctuating emotions may lead people with ADHD to use food as a way to cope with stress, sadness, or overwhelm. This emotional dysregulation can contribute to disordered eating habits.
- Difficulty with Structure: Organization and time management challenges, common in ADHD, can make it hard to follow consistent meal plans or routines around balanced nutrition—essential components of eating disorder recovery.
When these ADHD traits overlap with an eating disorder, they can intensify each other. For instance, impulsive food decisions may trigger disordered eating episodes, and emotional dysregulation can make it harder to build and sustain healthy coping mechanisms. However, it’s important to know that recovery is possible. Addressing both ADHD and eating disorder symptoms in tandem is necessary for breaking this cycle.
How Malnourishment Affects ADHD in Recovery
Malnutrition caused by an eating disorder can complicate treatment for ADHD. When the body lacks proper nutrition, it may lead to issues that can look similar to ADHD symptoms.
As Amanda Barnhardt, LCSW, CCS, Clinical Director of The Emily Program’s RTP-Durham, NC center, explains, “During the weight restoration process, clients commonly experience brain fog marked by slower processing speeds and difficulty concentrating. It can be difficult to discern what symptoms may be due to ADHD and what is caused by inadequate nutrition to support brain health.”
Focusing on restoring weight helps stabilize these overlapping symptoms. Once a client’s nutritional health improves, ADHD symptoms can be more accurately assessed and treated.
Stimulant Medications in Eating Disorder Recovery
Managing ADHD with stimulant medications during treatment for ADHD and eating disorder recovery requires close collaboration between psychiatric providers and dietitians. Stimulants, often prescribed for ADHD, can suppress appetite, which may interfere with weight restoration.
As Amanda explains, “Stimulant medications are typically reduced until a client’s body weight is stabilized, after which the medication may be reintroduced in collaboration with the care team.”
Once a client reaches weight stability, the care team works together to determine if and when ADHD medications can be safely reintroduced. This collaborative approach ensures that the client’s mental and physical health is carefully balanced, closely monitoring any adjustments to medication and meal plans. A similar process is followed when reintroducing exercise during recovery.
Treatment Strategies for Co-Occurring ADHD and Eating Disorders
At The Emily Program, we understand the unique challenges of treating both ADHD and eating disorders together. Our individualized approach is designed to address how ADHD can influence eating behaviors and how, in turn, disordered eating impacts ADHD symptoms.
Our multidisciplinary care team uses evidence-based treatments that are tailored to meet each client’s specific needs. These treatments for managing co-occurring ADHD and eating disorders include:
- Individualized meal plans: Personalized to be structured but flexible, considering attention difficulties and creating realistic strategies for consistent nourishment.
- Dialectical Behavior Therapy (DBT): Teaches clients to manage impulsivity and regulate emotions, both of which are often heightened in ADHD. DBT also incorporates mindfulness, helping clients stay present and reduce impulsive reactions to food or emotional triggers.
- Cognitive Behavioral Therapy (CBT): Helps clients reframe disordered thoughts and behaviors, focusing on both eating patterns and ADHD-related challenges like impulsive decision-making and task initiation. CBT is also key in addressing body image concerns and building self-esteem.
- Careful medication management: Ensures that ADHD medications, particularly stimulants, do not interfere with recovery by suppressing appetite. The care team works collaboratively to balance mental health and nutritional needs.
In addition to these therapies, we emphasize psychoeducation on ADHD, helping clients and their loved ones better understand the condition in a compassionate, nonjudgmental way. This education highlights the strengths that come with an ADHD brain, fostering greater self-awareness and empowerment during recovery.
A crucial part of our approach is executive function training, which addresses skills like planning, organization, and time management—areas often affected by ADHD. Clients may work on using tools like calendars or apps to plan meals, set reminders for self-care, and build routines that support recovery. These skills help clients stay on track during treatment and provide a foundation for confidently navigating life in recovery.
Recovery is Possible
While managing ADHD and an eating disorder together can feel overwhelming, it’s important to remember that recovery is absolutely possible with the right support. Treating both conditions simultaneously improves treatment outcomes and helps individuals regain balance in their eating habits and lives. At The Emily Program, we offer personalized, compassionate care that addresses the unique challenges of ADHD and eating disorders, empowering individuals to achieve lasting recovery and lead healthier, more fulfilling lives.
To dive deeper into ADHD and eating disorders and gain insights on differentiating between disordered eating behaviors and ADHD symptoms, join our upcoming continuing education presentation, “Distracted and Disordered: Understanding the Overlap Between ADHD and Eating Disorders,” led by Kelly Pertzsch, LPCC, on Thursday, December 12, 2024. Register here for this free virtual event.
If you, a loved one, or a patient is struggling with ADHD and an eating disorder, The Emily Program can help. Our team of experts provides individualized, compassionate care to support recovery every step of the way. Contact us today by completing our online form or calling 1-888-364-5977 to start the journey toward recovery.