The Cautionary Tale of ADHD and Eating Disorders

The shift in diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD) in the last ten years for people with eating disorders strikingly shows how underlying bias can affect clinical care.

Until about a decade ago people with eating disorders who thought they might have ADHD were immediately branded as drug seeking for stimulants like Adderall or Ritalin. These medications are known to suppress appetite and can cause weight loss at higher doses and when abused. In fact, as many people are aware, there is a black market for these medications not just for studying in school but for weight loss.

No clinician seemed curious to know if there was a link between ADHD and eating disorders.

Instead these patients became suspicious characters, untrustworthy and hopelessly lost in their illness and to losing weight.

As I have written about recently in several posts, social media and the subsequent communication of people with eating disorders spread the word about a possible and likely correlation between eating disorders and ADHD for some, if not many, people.

Girls are frequently more overlooked for ADHD as borne out in research. Subsequently, women with eating disorders may have never been screened or even considered to have ADHD. It was more difficult to find doctors who would diagnose adults with ADHD a decade ago so these people had to move ahead without more help.

Now, many women are much more likely to wonder about the diagnosis, seek testing and possible treatment. Many of these women do have ADHD. Recent research indicates that the anxiety and agitation caused by untreated ADHD can lead to eating disorder symptoms. The numbing and calming effect of an eating disorder often minimizes ADHD symptoms. Treatment with stimulants paradoxically leads to eating disorder recovery and not weight loss.

The story of suspicion and mistreatment of women with ADHD and eating disorders is cautionary. Clinical treatment sometimes follows bias or misunderstanding which can be harmful. Intellectual curiosity and the desire to help people recover needs to be the motivating force for medical care.

Clinicians of all types need to be open to new ideas linking various psychiatric and medical disorders. A variety of ways people with eating disorders may be coping often isn’t maladaptive behavior but indicative of a mode of treatment thus undiscovered.

Eating disorders are so universal and many people may fall into eating symptoms for a number of reasons. Assumptions about a person’s intent only interfere with an attempt to find wellness. Inherent biases are everywhere and awareness of misconceptions is the best way to avoid falling to that trap for any provider.