According to the National Institute of Mental Health, approximately 3 to 5% of school-aged children in America struggle with the hyperactivity, impulsiveness, and inattentiveness that characterize attention deficit/hyperactivity disorder (ADHD). These children face substantial social and academic problems, including poor grades and difficulty making friends, and research appearing in the current edition of the Journal of Abnormal Psychology indicates that some problems associated with ADHD may vary by gender. In studying teenage girls with ADHD, a team of researchers from the University of Virginia has found that this group may be at heightened risk for eating disorders.
Specifically, the researchers focused their investigation on the symptoms of bulimia and on body dissatisfaction, a characteristic common among most people with eating disorders. They looked for these symptoms in an ethnically and socioeconomically diverse group of 228 girls, 140 of whom had been diagnosed with ADHD. Among them, 93 fell within the combined subgroup of ADHD, which encompasses inattentiveness and hyperactivity/impulsiveness, while 47 had symptoms of inattentiveness only. The remaining 88 subjects were matched controls. The subjects were first assessed when they were between the ages of 6 and 12, and a second assessment occurred five years later. Girls within either subgroup of ADHD showed more symptoms of bulimia and body dissatisfaction than the controls, and girls within the combined subgroup showed more of these symptoms. The researchers also discovered that girls with ADHD were more likely to be overweight, to have been rejected by peers, and to have a poor relationship with their parents, and these factors may help explain the association between ADHD and eating disorders.
While the social and behavioral difficulties created by ADHD may play a role in associated eating disorders, one of the most prominent symptoms of ADHD may also contribute to eating disorders developed by these girls. As head researcher Amori Mikami points out in a press release, impulsivity can have a significant influence on eating habits: "As they get older, their impulsivity may make it difficult for them to maintain healthy eating and a healthy weight, resulting in self-consciousness about their body image and the bingeing and purging symptoms."
This research supports previous findings on the connection between ADHD and other psychiatric disorders, including eating disorders. Last August, a study published in the Journal of Developmental & Behavioral Pediatrics evaluated these associations in 125 teenage girls with ADHD and 100 controls. They found that girls with ADHD were more than three times as likely to meet the diagnostic criteria for either anorexia or bulimia. Additionally, the combination of ADHD and an eating disorder appeared to heighten the risk of developing another psychiatric condition. Compared with girls who had ADHD but did not have an eating disorder, girls with both conditions were more likely to also struggle with depression, an anxiety disorder, or disruptive behavior, all of which are common concurrent disorders for both boys and girls with ADHD.
The association between ADHD and eating disorders in girls is troubling and may be accompanied by distinct complications. As the researchers of this current study note, stimulant medications used to treat ADHD can suppress the appetite and could potentially be abused by someone wishing to lose weight. Further research is needed, and while future studies may want to investigate whether boys with ADHD are also more likely than boys without the disorder to develop an eating disorder, some research should focus specifically on girls. Boys are diagnosed with ADHD more often than girls, and the researchers surmise that many girls are not diagnosed and do not receive adequate treatment. With continued study on the specific concerns associated with ADHD and any concurrent disorder in girls, diagnosis may become more accurate and treatment may more effectively address their needs.
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