ADHD and Binge Eating Disorder
We need to have more discussions on the relationship between eating disorders, disordered eating, body dysmorphia, and ADHD. Something I’ve noticed is there is a huge disconnect between this part of the clinical world and neurodivergence. However, professionals in the ADHD world have entire nutritionists and support pages dedicated to people who struggle with all the above. How do they connect, you ask?
Let’s start by breaking down ADHD.
ADHD andbinge eating have the most overlap and can commonly exist at the same time. The primary neurological issue for people with ADHD is their brains do not make enough dopamine. Why is dopamine important? It’s commonly known as the “pleasure” hormone, but more importantly, dopamine oversees motivation. When ADHD is untreated and undiagnosed it creates a slew of issues, especially for women. The majority of female ADHDers are not diagnosed until their 30-40s. Because of the biases in our society both clinicians and physicians incorrectly diagnose and focus on the outcomes of undiagnosed ADHD in women for almost their entire lives; this includes binge eating disorder or disordered eating, depression,anxiety, insomnia or restless leg syndrome, and even addiction.
You may be thinking “well, how is it missed so often and misdiagnosed?”. When a person lacks the brain chemical for satisfaction and pleasure in life, their mood will present as low most of the time. When there are no motivation juices in the brain it can be hard to get out of bed, shower, maintain a social life, get out of the house, clean, and achieve the simplest tasks in the day. ADHDers have impaired executive functioning which allows for planning, focus/attention, impulse control, remembering instructions, and multitasking.
Not everything is as it seems.
Someone on the outside looking in will assume this person has depression because the behaviors and mood align with it, or even worse, they will mislabel the neurodivergent (aka neurologically different than the average person) as “lazy”. A person who is sad and can’t meet their own basic needs with a foggy memory and inability to focus—it’s understandable how it can be missed even by the most experienced clinicians and physicians. It is not a common practice to be knowledgeable about ADHD and how it can present in female patients and different cultures. Hell, in grad school they went over ADHD for less than 10 minutes before moving on to other topics.
Even as a therapist with ADHD, I was not educated on how important it is to keep it in mind when seeing female clients. Another reason it is missed is how women are diagnosed with autism later in life, us gals are great at masking. Masking refers to when a person behaves or portrays themselves in a way that is not true to their reality. Women with ADHD are secretly in a constant state of overwhelm and deep shame for needing help. Women already struggle with the fear of being viewed as incompetent, and asking for help in academic or professional settings could come off as “weak” or “not good enough”. Silent suffering is ingrained in us from a young age which further contributes to late diagnoses.
It doesn’t stop there.
Another common misdiagnosis or coexisting diagnosis is binge eating disorder. Most people could define eating good food as a pleasurable experience. We even have a term for people who truly enjoy food as a big part of life—“foodies”. Remember how I mentioned dopamine is the vessel of pleasure and people with ADHD have a deficit in it? Well, one way the brain tries to compensate for it is to seek out pleasure in various forms: thrilling activities (sky diving, bungee jumping, speeding while driving, etc.), sex, drugs, and food.
Addiction is one of the outcomes when severe ADHD goes undiagnosed and untreated over a lifetime.
Google the statistics and prepare to be shocked. In order for the brain to get this chemical it desperately needs food jumpstarts the production of dopamine. Food can be more accessible and socially acceptable, so immediate gratification becomes an endless cycle. On a neurological level, a person with ADHD is going to binge eat or have an eating disorder until finally getting the proper treatment for what is causing the behavior. The root of what needs treatment is not the pleasure-seeking behavior, but the very reason the seeking even exists which in this case is Attention Deficit Hyperactive Disorder.
Boys are diagnosed early in life (and overdiagnosed) because the hyperactivity is seen as “bouncing off the walls” whereas hyperactivity presents differently in girls through fidgeting and restlessness. Insomnia or restless leg syndrome are other common comorbidities an ADHDer struggles with. The sleep-wake cycle is wired differently from everything else mentioned. Not to forget emotional dysregulation (which is another symptom of the brain being wired differently) requires some sort of self-soothing. Lack of sleep and inability to regulate emotions will create changes in eating habits and self-soothing techniques. The most well-known feature is the complicated relationship between task completion and time management. When delaying task completion food then becomes “procrastinating” morphing into a binge. It becomes a subconscious coping mechanism to avoid overwhelm to then only create more.
Overwhelmed or underwhelmed, something needs to change.
Stimuli is a main component of ADHD, if a person is over-stimulated in an environment with lights, sounds smells, and crowds then they become overwhelmed and need an isolated space with total silence. When a person feels under-stimulated (which is often for ADHDers) this is where behaviors start to become telling. This could happen when a person is bored with a necessary task or work. If there is no sense of novelty and no other stimuli to make the experience enjoyable, then pleasure-seeking and impulsive behavior take the reign. Food is a go-to source of stimuli; it offers a beautiful visual, alluring smell, interesting texture, and dopamine-boosting taste—especially if it’s sweet. It’s something that can keep fidgety hands busy, and it acts as an oral fixation.
When we understand what is actually happening in our brains then the correct treatment and support can lead to a new life. One where the lack of a hormone doesn’t take control of coping and daily behaviors. Women can go their entire lives without knowing their brain functions differently and suffer the consequences. Let’s start changing those statistics and biases in healthcare. Let’s start asking more questions knowing there is an answer out there that can change everything.
A special mind calls for a specialist.
The first step towards figuring out if you have ADHD and BED or disordered eating is meeting with the right professionals. Although medical doctors are helpful for many health concerns, if they do not specialize in either of these then you won’t get the proper diagnosis or care. There are ADHD specialists in the mental health field and professionals who are thoroughly trained in the proper assessments. Their whole career is helping people who have been struggling in a world that’s not set up for neurodivergence. Similar to eating disorders, it’s another niche in the neurological and psychological world. Please see a clinician who lives and breathes working with their passion population. They. Will. Know. More. Do not turn away from the very people who could help you the most. You can change your own life by seeking out needed answers and proper treatment.
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Trauma can have lasting effects physically and mentally, but you don’t have to struggle alone. Our team understands the time it can take to navigate the ways you can heal from trauma using your body. This is why we are happy to offer in-person and online services across Philadelphia. You can start your therapy journey with Revive Therapy by following these steps:
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About Revive Therapy Services
At Revive Therapy Services, we help adults heal fromtrauma, PTSD, Complex PTSD, childhood trauma, attachment wounds, anxiety, and chronic stress through evidence-based, trauma-informed care. We offer online therapy throughout Pennsylvania and Colorado, as well as in-person therapy in Philadelphia and Colorado. Our services include:
EMDR Therapy: Helps reprocess distressing memories, core beliefs, and emotional patterns that continue to affect you in the present.
IFS (Internal Family Systems Therapy): Helps you understand and heal the different parts of yourself with greater self-compassion and inner connection.
Ketamine-Assisted Psychotherapy (KAP): Combines ketamine treatment with therapy to support deeper emotional processing and new perspectives.
Eating Disorder Treatment: Provides individualized support for binge eating, restriction, emotional eating, body image struggles, and other concerns around food and your body.
If you’re ready to stop simply coping and start addressing the root of what’s keeping you stuck, schedule a consultation today. We’d love to help you find an approach to therapy that fits your needs.
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