On the Struggle for Women with Eating Disorders to be Diagnosed with ADHD

Medical research and care has always been focused on the health of men, typically white men. This fact is based on reams of research over decades focused primarily on this cohort. Many seminal medical articles solely about men remain the foundation of treatment. Subsequent research in many specialties rely on the original research as a springboard for further exploration and growth.

Although there has been some change in this truth of medicine, it’s difficult to overcome decades of work built upon the well being of one cohort of our population. Women’s health is often either sidelined or reliant on insufficient data.

One great example is hormone replacement therapy (HRT) for women in menopause. Flawed studies that showed a higher incidence of cancer from HRT led to decades of misled doctors shying away from HRT. Finally, years later, the benefits and minimal risks of HRT are evident, and care for menopausal women has been transformed, but at the cost of many women’s well being.

Eating disorder treatment falls into the same category. Eating disorder patients are primarily women, and research has been limited in many ways. Treatment is often run by finance companies, and research into new, more effective treatment is either unhelpful or often irrelevant.

A recent change in eating disorder treatment is the frequent combination of eating disorders and Attention Deficit Hyperactivity Disorder (ADHD). The overlap of these two diagnoses turns out to be very common, and treating ADHD improves eating disorder treatment for many patients.

The driving force for this new revelation is women on social media sharing their experiences and gradually recognizing their common concerns. Clinical care has been slow to catch up with many providers still believing that a patient with an eating disorder who mentions ADHD is seeking risky medications rather than asking for help.

ADHD historically has been diagnosed largely in boys. Girls often are overlooked due to a lower incidence of hyperactivity which is a red flag for teachers to recommend an evaluation. Girls often get by in school and do well enough by finding ways to compensate for the challenges of ADHD in an academic environment.

These adult women with ADHD seeking help were often overlooked as children and now find that modern psychiatry is not prepared to help either. There is no valid way to assess ADHD in adult women. The standard testing is for children. Treatment guidelines for adults are not clear either.

This one example, among many, shows how medicine frequently fails women. At least for now, psychiatrists need to find ways to diagnose women with ADHD and start treatment and education.

In eating disorder treatment, diagnosing and managing ADHD will improve outcomes and recovery significantly. The inattention, racing thoughts and struggle to complete tasks are all often triggers for eating disorder behavior. Treating these symptoms can help someone find their way to recovery a lot more easily. As a field, the eating disorder treatment world will do better for their patients by recognizing that ADHD diagnosis and treatment are critical for success.