From the Guidelines
Compulsive eating disorders are often associated with ADHD and other developmental disorders, requiring a multi-modal treatment approach that addresses both conditions simultaneously to improve morbidity, mortality, and quality of life. People with ADHD may experience impulsivity and difficulty with self-regulation, which can manifest as binge eating or other disordered eating patterns 1. The connection appears to involve shared neurobiological mechanisms, particularly in the brain's reward and executive function systems. Key considerations in the treatment of ADHD and compulsive eating disorders include:
- Medications like methylphenidate (Ritalin, Concerta) or amphetamine-based medications (Adderall, Vyvanse) at doses determined by a psychiatrist can help reduce impulsivity that contributes to disordered eating 1
- Lisdexamfetamine (Vyvanse) is particularly notable as it's approved for both ADHD and binge eating disorder, typically starting at 30mg daily and potentially increasing to 70mg daily as needed
- Cognitive-behavioral therapy specifically targeting both the eating behaviors and ADHD symptoms is essential, focusing on developing coping strategies, meal planning, and emotional regulation 1
- Nutritional counseling and establishing regular eating patterns are also important components of treatment
- Screening for comorbid conditions, including emotional or behavioral conditions, developmental conditions, and physical conditions, is crucial in the evaluation of a child or adolescent for ADHD 1
The relationship between ADHD, other developmental disorders, and eating disorders is complex, with executive function deficits, dopamine dysregulation, and emotional regulation difficulties serving as potential connecting mechanisms 1. A comprehensive treatment plan should prioritize the individual's specific needs, taking into account the severity of symptoms, age, and presence of comorbid conditions. A multi-modal approach that incorporates pharmacological and non-pharmacological interventions is likely to yield the best outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Compulsive Eating Disorder and ADHD
- Compulsive eating disorder is often associated with other developmental disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD) 2.
- Studies have shown that individuals with ADHD are at a higher risk of developing eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder 2.
- The association between ADHD and eating disorders is not fully understood, but research suggests that individuals with ADHD may be more prone to impulsivity and emotional dysregulation, which can contribute to disordered eating behaviors 2.
Treatment Options
- Cognitive Behavioral Therapy (CBT) is a commonly used treatment for eating disorders, including binge eating disorder and bulimia nervosa 3, 4, 5.
- CBT has been shown to be effective in reducing symptoms of eating disorders, including binge eating and purging behaviors 3, 4, 5.
- However, the effectiveness of CBT for individuals with ADHD and eating disorders is not well established, and more research is needed to determine the best treatment approaches for this population 2.
Comorbidity and Treatment Outcomes
- Comorbidity between ADHD and eating disorders can impact treatment outcomes, and individuals with both conditions may require more intensive and specialized treatment 2.
- Research suggests that combining CBT with medication, such as selective serotonin reuptake inhibitors (SSRIs), may be effective in treating individuals with ADHD and eating disorders 6.
- However, more research is needed to determine the most effective treatment approaches for individuals with ADHD and eating disorders, and to develop personalized treatment plans that address the unique needs of this population 2.