ADHD and binge eating in adults

Eating is one of the least discussed parts of adult ADHD. Some adults describe forgetting to eat until late afternoon, then eating quickly and a lot. Others describe eating when bored, or a pull toward food that is hard to stop once it starts. Research has found real links between ADHD, binge eating and weight. This article explains what those studies show, how binge-eating disorder is defined, and why it matters for treatment.

Nothing here is a way to diagnose yourself. Eating disorders are, as NIMH puts it, serious illnesses, and they deserve their own careful assessment.

What binge-eating disorder is

Binge-eating disorder is a recognized diagnosis, not a lack of willpower. NIMH describes it this way: people with binge-eating disorder regularly lose control of their eating and eat unusually large amounts of food. NIMH lists signs that include:

• Eating unusually large amounts of food in a short time, for example within two hours
• Eating rapidly during binge episodes
• Eating even when full or not hungry
• Eating until uncomfortably full
• Eating alone or in secret to avoid embarrassment
• Feeling distressed, ashamed or guilty about eating
• Frequent dieting, possibly without weight loss

Unlike bulimia nervosa, binge-eating disorder does not involve regularly purging or using other behaviors to prevent weight gain. NIMH notes that over time binge eating can lead to health problems including obesity, type 2 diabetes, cardiovascular problems, sleep problems and gastrointestinal symptoms.

How strong is the link with ADHD?

Several reviews have measured it:

The World Federation of ADHD's 2021 consensus statement lists eating disorders among the psychiatric conditions that often co-occur with ADHD. In the Nazar meta-analysis, the link was stronger when ADHD was diagnosed by clinical interview than by self-report questionnaire, a reminder that how a study measures ADHD affects what it finds.

Why ADHD and binge eating may overlap

The research does not yet explain the link fully. The authors of the Cortese meta-analysis started from the idea that the impulsivity and inattention of ADHD may increase food intake and, over time, weight. NIMH lists acting without thinking, trouble with self-control and choosing immediate rewards over future consequences among adult ADHD symptoms, which fits that idea. Inattention may also matter: someone absorbed in a task may miss hunger cues and then overeat later. That second idea is plausible but less studied.

Emotion may play a part too. Many adults with ADHD describe strong emotional reactions, discussed in emotional dysregulation in adult ADHD, and NIMH lists feeling distressed, ashamed or guilty about eating among the signs of binge-eating disorder. The broader topic of impulse control is covered in ADHD and impulsivity in adults.

The Vyvanse connection

One ADHD medication is also FDA-approved for binge-eating disorder. According to its current FDA label, Vyvanse (lisdexamfetamine) is a central nervous system stimulant indicated for ADHD in adults and children 6 and older, and for moderate to severe binge-eating disorder in adults. The same label states plainly that Vyvanse is not indicated for weight loss, that other sympathomimetic drugs used for weight loss have been associated with serious cardiovascular events, and that its safety and effectiveness for treating obesity have not been established.

This matters in two ways. First, when ADHD and binge-eating disorder occur together, a prescriber may weigh a medication with evidence for both. Second, it is not a reason to seek a stimulant to lose weight, and a clinician will not treat it as one. The meds guide article on Vyvanse for adults covers the label in more detail, including side effects and warnings. Other stimulants can lower appetite as a side effect, covered in ADHD medication, appetite and weight.

Other eating patterns adults describe

Not every eating difficulty is binge-eating disorder. Adults with ADHD sometimes describe irregular meals, forgetting to eat, eating out of boredom or relying on convenience food because planning meals feels overwhelming. These descriptions come from patient accounts more than from research, and none is a diagnosis. They are still worth mentioning in an evaluation, along with any history of restrictive eating, purging or excessive exercise, because the Nazar meta-analysis found raised rates of anorexia nervosa and bulimia nervosa in ADHD as well. The cooccurring-conditions article on ADHD and eating disorders covers those in more depth.

What to note before an appointment

Eating patterns are easy to describe vaguely and hard to describe accurately, especially when shame is involved. A week or two of simple notes gives a clinician much more to work with. Useful things to write down include:

• When you actually eat, including skipped meals
• Any episodes where eating felt out of control, with the time of day and what came before (boredom, stress, a long gap without food)
• How you felt afterward
• Current medications and supplements, and whether appetite changed when any of them started
• Past dieting, restricting, purging or excessive exercise, even if it was years ago
• Sleep, since NIMH lists sleep problems among the health effects of binge eating and NIMH notes that sleep problems are common in adults with ADHD

There is no need to bring this as a polished record. Rough notes are enough.

When to talk to a clinician

Talk to a clinician if you regularly feel a loss of control over eating, eat large amounts in short periods, or feel shame or distress about eating. Those signs deserve attention whether or not ADHD is involved. If you also have long-standing problems with attention, organization or impulsivity going back to childhood, an ADHD evaluation can look at both. Dr. Shershow's evaluation covers current symptoms, health history including medications and sleep, and other explanations or conditions that may be present alongside ADHD. It does not replace specialized eating disorder treatment when that is needed.

The free adult ADHD self-test can help you organize your symptoms first. It is a screener, not a diagnosis. To learn what a full adult assessment involves, see ADHD evaluation in New York City or ADHD evaluation in New Jersey. If eating or weight concerns ever come with thoughts of harming yourself, call or text 988 at any hour.