How ADHD and Eating Disorders Overlap
Kids with ADHD are three times more likely than their neurotypical peers to develop an eating disorder such as ARFID, anorexia, or bulimia. Here, an expert explains the most common eating disorders, to help with early identification and intervention.
Few parents are surprised to learn of the significant overlap between eating disorders and ADHD in adolescents. Numerous studies show that children with ADHD face three times the risk of developing an eating disorder compared to their peers without ADHD.
It’s important to diagnose and treat eating disorders early to prevent prolonged malnourishment and to improve a child’s prognosis.
Eating Disorders and Their Symptoms
Anorexia nervosa
The defining feature of this eating disorder is not actually being underweight or thin; it’s a fear of weight gain or becoming fat, so much so that people eat less and less throughout the day. A warning sign you might notice is that the person is skipping meals, or eating less than what is typical for them.
Atypical anorexia nervosa
This is a diagnosis of anorexia nervosa but in higher weight bodies. These individuals are at risk for going undetected with anorexia nervosa because of their physical appearance.
[Read: Eating Disorders in Children and Teens]
Avoidant/restrictive food intake disorder (ARFID)
This diagnosis is given to people who are not meeting their nutritional needs, but not because they fear weight gain, as in anorexia nervosa. Rather, they don’t prioritize eating. They might say, “I’m hungry, but I just don’t care enough to get myself something to eat” or “I can’t motivate myself to get up and make myself a meal.”
Sensory issues, such as the texture or smell associated with certain foods, may repel adolescents with ARFID, who start eliminating those foods from their diet to the point where they can become malnourished. Other people with ARFID have a fear-based reaction to food. Maybe they’re afraid of choking if this happened in the past, or perhaps they fear bad bouts of stomach upset.
One possible warning sign is a sudden refusal to eat anything but “safe foods” that patients and families feel certain they could eat day in and day out. Some folks with ARFID are very specific about how the food is prepared, or even specific brands and shapes.
[Self-Test: ARFID in Children]
Binge-eating disorder
This affects people who have repeated binge-eating episodes and feel out of control. They cannot stop eating once they’ve started, and they often feel guilty, ashamed, or disgusted with themselves afterward.
Bulimia nervosa
Bulimia involves binge-eating episodes paired with self-induced vomiting, abuse of laxatives or diuretics, and/or exercise to get rid of or make up for the calories that they’ve eaten.
Other specified feeding and eating disorder (OSFED)
This is the most common diagnosis for people who present with some but not all symptoms from several types of eating disorders.
ARFID, Anorexia & Bulimia: Next Steps
- Download: The Eating Disorders Associated with ADHD
- Read: “Foods Can’t Touch on My Plate:” On Life with ARFID and Food Aversions
- Watch: “Eating Disorders Comorbid with ADHD: What You Need to Know About ARFID, Anorexia, and Others”
Christine Peat, PH.D., is the Director of the National Center of Excellence for Eating Disorders (NCEED) and an Associate Professor of Psychiatry at the University of North Carolina at Chapel Hill.
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