Beruflich Dokumente
Kultur Dokumente
Katherine Mykytka
Dr. Zemel
Nutrition 302 Section 001
March 11, 2008
Over recent years, there has been much discrepancy over the relationship between
attention-deficit/hyperactivity disorder and binge eating. The popularity of research being done in
this area has increasingly grown in recent years. Often associated with behavioral and learning
disorders, ADHD has not been commonly linked to any type of eating disorder before now. While
some researchers still dispute this theory, the belief that there is a connection between ADHD and
ADHD is among one of the most common and impairing childhood psychiatric conditions.
hyperactivity that typically appear before the age of seven, while a large percentage of these
symptoms last well into adulthood. Patients with ADHD often have, “impaired
attention, and can be characterized into one of four ADHD types: predominantly inattentive,
well. In past research, patients suffering from ADHD have been shown to have oppositional
defiant disorder, conduct disorder, anxiety disorders, depressive disorders, and speech and
learning disorders, among others (Davis, C., 2000). Attention-deficit/hyperactivity disorder rarely
comes in a form by itself, but instead brings along many other problems and issues to additionally
deal with.
Throughout the past few decades, eating disorders have become one of the most prevalent
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medical problems in the world. An eating disorder can be categorized as any unhealthy behavior
or feeling involving food. Anorexia, bulimia nervosa, and overeating are all classified as eating
disorders. Common symptoms of eating disorders include refusal to maintain a normal weight
proportional to height and age, intense fear of weight gain, unrealistic or distorted ideas about
body image, withdrawing emotionally from people, anxiety around meal times, binging, or
purging. People with eating disorders need emotional support and psychotherapy, while
nutritional counseling and medications are commonly used (Liu, 2008). The specific disorder of
binge eating is classified by eating much more rapidly than usual, eating until uncomfortably full,
eating large amounts of food, even when not physically hungry, eating alone out of
embarrassment at the quantity of food being eaten, or by feelings of disgust, depression, or guilt
after overeating. Binge eating is also prevalent in bulimia, but is followed by either purging or
strenuous exercise.
Although overlooked in the past, a potential comorbidity between ADHD and binge eating
has been suggested by recent investigational evidence. Better insight into this potential connection
is of relevance for two principle reasons. The first is the contribution to the understanding of
possible pathological mechanisms underlying both ADHD and binge eating. The second are the
important implications for the management of patients with both ADHD and binge eating. Better
knowledge in this field could suggest potentially effective therapeutic strategies for when these
two conditions coexist. Before either of these matters can be considered, however, research
involving the relationship between attention-deficit/hyperactivity disorder and binge eating must
first be examined.
In a 2000 Minnesota Adolescent Health Survey, the rates of abnormal eating behaviors
among adolescents with and without chronic diseases were observed. While the sample size was
quite large, the authors found “subjects with attention-deficit/hyperactivity disorder were
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significantly more likely to binge than were subjects without the disorder” (Cortese, 2000, p.
409). The body sizes of the adolescents were also assessed. The prevalence of overweight and
obesity was significantly greater in the subjects diagnosed with ADHD than those not diagnosed
with the disorder. These results are of relevance because they show there is a basis for more
In a 2002 study by Saboya Mattos, adults that had been clinically diagnosed with ADHD
were observed. ADHD had two observable measures: retrospective recall of childhood ADHD
symptoms and current impulsivity traits. This assessment was critical in order to ensure adult
ADHD symptomalogy. The measured observations for overeating were comprised of binge
eating, emotionally driven eating, and eating prompted by external stimuli rather than hunger. Out
of the eighty-six subjects, 8.3% were found to have a binge eating disorder. This was the first
study that used a clinically structured observation method and proved a true comorbidity between
Another child-based study was done in 2006 by Amori Yee Mikami that consisted of
females ages six to twelve with and without attention-deficit/hyperactivity disorder. Mikami
hypothesized that girls with ADHD more commonly show distress through eating and
internalizing disorders and have impulsive personality traits central to binge eating. Through a
series of clinical tests and interviews, Mikami concluded that girls with ADHD in childhood are
at great risk for eating disorders later in life, particularly binge eating. Childhood impulsivity
symptoms were found to be the best predictors of adolescent eating pathology, as well as
inattention and hyperactivity. Overall, girls with ADHD had higher adolescent body mass indexes
than girls without the disorder. Mikami ultimately concluded that binge eating, as well as other
eating disorders should most definitely be incorporated into the risks and impairments among
That leaves the question of what is it that causes the relationship. Many hypotheses exist in this
area of study. Since clinical these subject studies indicate there being a correlation, investigators
have begun to take a better look at the physiological and neurological aspects of the comorbidity
Registered dietician Levitan Davis suggests that, “Deficient inhibitory control as well as
delay aversion, which are both expressions of the impulsivity component of ADHD, may
contribute to abnormal eating disorders, including binge eating. Deficient inhibitory control,
which manifests as poor planning and difficulties monitoring one’s behavior effectively, could
lead to over consumption when not hungry due to the relative absence of concern for daily caloric
intake. A strong delay aversion could favor the tendency to binge on ‘fast food’ with high caloric
content in preference to home cooked meals with lower caloric content, which take longer to
prepare” (Davis, L., 2005, 1218). The impulsiveness that comes along with ADHD can create
unwarranted desires. Commonly, these desires manifest themselves as food. The impulsivity is
then taken a step further and becomes an aspiration for large quantities of food in any form, most
Another possibility is that ADHD and binge eating are the expression of neurobiological
mechanisms. Insufficient dopamine levels are commonly linked to ADHD. This deficiency is also
immediate rewards such as gambling, risk taking, or inappropriate eating (Brown, 2000). Another
Depression is also often linked to eating disorders, and in these cases, significant weight gain is
seen more often than not. The overeating is seen by the patient as a way of “self-medicating” in
order to compensate for the hormone deficit. Therefore, lowered dopamine levels in a patient
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could be responsible for a myriad of disorders, most importantly, the concurrence of ADHD and a
eating has only been briefly researched. Individuals with ADHD, “show diminished activation in
the hippocampus when engaged in decision-making tasks that involve weighing the pros and cons
between small immediate rewards and large future rewards. Those with ADHD also tend to
respond more readily to immediate sensory stimuli than to engage in complex processing” (Davis,
C., 2005). This deficiency comes into play when considering binge eating tendencies. Patients
suffering from ADHD often want immediate food satiety due to their desire and responsiveness to
sensory activity. The deactivation in the hippocampus could very well be the cause of this
inability to process complex issues; however, there are many parts of the brain that contribute to
higher thinking. Therefore, it is not an absolute that the hippocampus is responsible for the
difficulty in decision making involved with ADHD and binge eating. More research would be
eating, treatment for one disorder may induce a medicating effect for the other. ADHD is most
commonly treated with drugs that elevate dopamine levels. These medications may be able to act
on the brain pathways involved in ADHD as well as those that cause abnormal eating behaviors.
Many trails have suggested that, “ADHD drugs may act on the synapses in the hypothalamus that
are thought to play a role in modulating satiety and feeding behavior” (Schweickert, 2007, 299).
Nevertheless, stimulant medications alone may not be sufficient to improve the disordered eating
habits of patients with ADHD. Alternatives such as behavior therapy focusing on attention,
organizational strategies, and response inhibition should also be considered. Since binge eating
may very well be an expression of the impulsiveness associated with ADHD, therapy dealing with
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frustration and anxiety difficulties could be quite beneficial. The fact of the matter is that if the
two disorders have a pathological connection, management and therapeutic strategies could be
drastically improved with more insight to their linkage. The unpleasant personal, social, and
nutritional implications associated with both ADHD and binge eating could be greatly improved
of recent interest, it is most definitely in need of greater attention and further research. Physicians
and dieticians have long overlooked this comorbidity, but emerging data from these studies
suggests that the rate of binge eating in patients with ADHD is higher than expected. Individuals
suffering from ADHD having a diminished ability to assess future adverse health consequences of
to wait for healthy food choices, and commonly indulge in the possibility of using palatable food
to satisfy sensory impulses. These characteristics likely foster the connection between ADHD and
binge eating. Better insight to this connection could greatly improve the nutritional status of so
With the United States at such an unfortunate current health standing, a breakthrough in
this comorbidity could get many overweight individuals back on the right path. America has made
it a challenge to maintain appropriate eating behaviors for a healthy lifestyle, so those with
already low inhibitory control have an even greater disadvantage. With fast food restaurants on
every street corner, temptation for the highly impulsive is difficult to avoid. The proper treatment
for individuals with ADHD and binge eating could be an enormous relief and an aid to recovery.
More research studies using clinically diagnosed ADHD patients, appropriate control groups,
controlled confounding variables, and scientifically sound methods are greatly encouraged by all
current researchers in the field. Only then will the medical and dietetic words be able to truly help
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those suffering with these disorders.
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References
7(2), 266-274.
Liu, Aimee. (2008). Gaining: The truth about life after eating disorders. New York: Wellness
Central.
Mikami, Amori Yee. (2006). Eating pathology among adolescent girls with attention-
Schweickert, Lori. (1997). Efficacy of methylphenidate in binge eating comorbid with attention-
21(3), 299-301.