ADHD and Binge Eating Disorder

Attention Deficit Hyperactivity Disorder (ADHD) affects more than just focus and attention. For many people with ADHD, the challenges extend into daily habits, including how and what they eat.

Impulsivity, difficulty with emotional regulation, and problems with planning can all influence eating patterns. For some people with ADHD, these factors may contribute to irregular meals, impulsive snacking, or difficulty managing food intake. In some cases, this can develop into binge eating disorder.

Research shows a clear connection between ADHD and increased risk of binge eating. Understanding this link is important for recognising warning signs early and developing effective strategies to manage both conditions.

In this article, we'll explore the relationship between ADHD and binge eating, what the research shows, signs to watch for, and evidence-based approaches to managing both

What Is Binge Eating Disorder?

Binge eating disorder (BED) is more than occasionally eating too much. It's a recognised eating disorder with specific diagnostic criteria.

According to the DSM-5, BED involves recurrent episodes of eating large amounts of food in a short period (typically within two hours), accompanied by a sense of loss of control.These episodes occur at least once a week for three months and cause significant distress.

During binge episodes, people typically eat much more rapidly than normal, eat until uncomfortably full, eat when not physically hungry, eat alone due to embarrassment, and feel disgusted, depressed, or guilty afterward.

Unlike bulimia nervosa, binge eating disorder doesn't involve regular compensatory behaviours like vomiting or excessive exercise. The distress comes from the binge eating itself and its physical and emotional consequences.

How ADHD Affects Eating Patterns

ADHD affects everyday habits in ways that can influence eating patterns. Impulsivity—a core feature of ADHD—can show up as sudden cravings and spontaneous snacking, often on high-sugar or highly processed foods.

Difficulties with planning and organisation can lead to irregular meal timing. Over time, these patterns can contribute to weight fluctuations and emotional stress.

Emotional regulation is another important factor. People with ADHD often experience heightened emotional responses and may use food as a coping mechanism to manage anxiety, frustration, or boredom.

This behaviour is linked to the brain's reward system. Eating pleasurable foods can temporarily increase dopamine levels, offering short-term relief from negative emotions or low motivation. However, the relationship between dopamine and binge eating is more complex than simply "low dopamine leading to eating for a reward"—research shows altered dopaminergic function that varies by individual and context.

ADHD has different presentations based on whether symptoms are predominantly inattentive, predominantly hyperactive-impulsive, or combined.

While not firmly established by research, clinical observations suggest these presentations may influence eating patterns differently. People with predominantly inattentive ADHD may forget meals or eat inconsistently. Those with predominantly hyperactive-impulsive ADHD may be more prone to impulsive snacking and compulsive eating. People with combined presentation often show a mixture of both behaviours, making eating patterns unpredictable and difficult to manage.

The Link Between ADHD and Binge Eating Disorder

Multiple studies have consistently shown that people with ADHD are at higher risk of developing binge eating disorder compared to the general population.

Research indicates that adults with ADHD may have up to a four-fold increased risk of developing binge eating or bulimia compared to adults without ADHD. In children and adolescents with ADHD, studies show up to a three-fold increased risk of eating disorders, particularly BED and bulimia. Around 20% of children with ADHD may develop an eating disorder.

The exact prevalence varies significantly across studies. In some clinical samples, around a quarter or more of adults with ADHD may meet criteria for BED, but this isn't a universal figure and depends heavily on the study population. What's clear is that the rates are substantially higher than in the general population.

This connection comes from overlapping neurological and behavioural mechanisms, particularly impulsivity, poor self-regulation, and difficulties managing emotions.

Why ADHD Increases the Risk of Binge Eating

Several factors contribute to the increased risk:

Executive Function Difficulties

Executive functions include skills like planning, organisation, and self-control. In ADHD, these skills are often weaker, making it harder to plan regular balanced meals, recognise fullness and stop eating on time, and maintain consistent eating routines. Skipping meals or forgetting to eat during the day can result in intense hunger later, which often triggers overeating or binge episodes.

Emotional Dysregulation

Many people with ADHD experience strong emotions and have difficulty managing them effectively. Food often becomes a quick way to manage stress, boredom, frustration, or sadness. Research shows that emotional dysregulation in ADHD is very common—affecting 30-70% of adults with ADHD—and is associated with greater functional impairment. Binge eating is strongly linked to using food for emotion regulation and negative mood states.

Medication-related Appetite Changes

Stimulant medications commonly used for ADHD often suppress appetite during the day. This is a well-recognised pattern in clinical practice. When the medication wears off, some people experience rebound hunger and cravings in the evening or at night. This can create a cycle of under-eating during the day followed by overeating later. Being aware of these patterns can help in planning meals and preventing late-night overeating.

Impulsivity and reward-seeking

Impulsivity is a core feature of ADHD and can directly contribute to binge eating. People with ADHD may act on immediate urges to eat without considering long-term consequences, often reaching for calorie-dense or sugary foods. Difficulties with self-control and delayed gratification can make stopping a binge episode extremely difficult.

While the biology isn't completely understood, both ADHD and binge eating involve dopamine-based reward circuitry. Palatable, high-fat or high-sugar foods trigger dopamine release in the brain's reward pathway, contributing to pleasure and reinforcement.

Possible Role of Boredom and Novelty-seeking

ADHD is associated with novelty-seeking and boredom intolerance. While not firmly established by research, it's plausible that routine eating may feel dull, leading to snacking out of boredom rather than hunger, choosing highly palatable foods for stimulation, or eating impulsively without much thought. This should be understood as a theoretical link rather than a proven mechanism.

Co-morbid Conditions

Depression, anxiety, and substance use disorders are more common in people with ADHD and can intensify binge eating tendencies. For instance, someone struggling with both ADHD and anxiety may use food to self-soothe, leading to recurrent binge episodes.

Signs and Symptoms to Watch For

In people with ADHD, binge eating presents differently from occasional overeating. Compulsive eating tied to ADHD tends to be recurrent, impulsive, and linked to emotional triggers.

Common signs include:

Nighttime eating where people consume large amounts of food late in the evening or at night
Compulsive snacking throughout the day on high-calorie processed foods
Food hoarding, or an overwhelming urge to eat when stressed, bored, or fatigued.

These behaviours are often accompanied by a sense of loss of control and subsequent guilt and shame.

Red flags that can help identify binge eating disorder include eating rapidly, consuming food when not physically hungry, continuing to eat despite discomfort or fullness, eating in secret or hiding episodes from others, physical signs like weight fluctuations or digestive issues, and emotional signs such as irritability, anxiety, and low self-esteem.

Age-specific patterns with BED and ADHD

Children and teens with ADHD may display picky or selective eating, secretive snacking, or emotional eating often triggered by school stress or peer pressure. Studies show that children with ADHD have increased risk of various eating-related problems, including around 20% who may develop an eating disorder, primarily BED or bulimia.

Adults may exhibit more established patterns of binge eating and sometimes alternate between periods of restrictive dieting and uncontrolled eating.

Being aware of these signs allows for early intervention and support.

Strategies and Treatment Options for BED and ADHD

Managing binge eating in people with ADHD requires a combination of self-help strategies and professional support. While there's no single approach that works for everyone, combining behavioural techniques with medical and nutritional guidance can improve outcomes.

Self-help Approaches

Building Structured Eating Routines

One of the most effective ways to reduce binge episodes is establishing consistent meal and snack times. This helps prevent the extreme hunger that often triggers binge eating.

Practical steps include eating breakfast within an hour of waking, even if it's small, scheduling meals and snacks at roughly the same times each day (for example, breakfast at 8am, snack at 11am, lunch at 1pm, snack at 4pm, dinner at 7pm), and setting phone reminders if you tend to forget meals.

For people on stimulant medication, this often means eating a substantial breakfast before medication takes effect, having easy-to-eat snacks available during the day when appetite is suppressed (protein smoothies, yoghurt, cheese and crackers), and planning for increased appetite in the evening when medication wears off.

Meal planning and preparation can help reduce decision fatigue and impulsive choices. Try planning your week's meals on Sunday, preparing ingredients in advance (washing and chopping vegetables, cooking grains or proteins in batches), and keeping healthy grab-and-go options readily available.

Mindful Eating Practices

Mindful eating helps rebuild awareness of hunger and fullness cues, which are often disrupted in both ADHD and binge eating disorder.

Start with small changes: eat without screens or other distractions for at least one meal per day, put your utensils down between bites, notice the colour, smell, texture, and taste of food, and pause halfway through a meal to check in with your hunger level.

Rate your hunger and fullness on a scale of 1-10 before eating and during meals. This simple practice can help you become more aware of physical versus emotional hunger. Aim to start eating at a 3-4 (moderately hungry) and stop at a 6-7 (comfortably satisfied, not overfull).

Identifying and Managing Triggers

Keeping a food and mood journal can reveal patterns you might not notice otherwise. Record what you ate, when you ate, how hungry you were (1-10 scale), what you were feeling before and after eating, and what was happening around you (stress at work, argument with partner, boredom at home).

After a week or two, look for patterns. Common triggers include:

Time-based: Always bingeing after 9pm, or on Sunday evenings
Emotion-based: Bingeing after stressful work meetings, during loneliness, or when feeling overwhelmed
Situation-based: Bingeing when home alone, while watching TV, or after restrictive eating during the day
Physical: Bingeing when overtired, after skipping meals, or when medication wears off

Once you've identified your triggers, develop specific alternative coping strategies. For stress triggers, try a 5-minute breathing exercise, going for a walk, calling a friend, or doing something with your hands (knitting, drawing, playing an instrument). For boredom triggers, create a list of engaging activities you can turn to, keep hands-busy options available (puzzles, crafts, games), or schedule challenging tasks for times you're typically bored.

For fatigue-related triggers, prioritise sleep hygiene, take short rest breaks before hunger becomes extreme, and keep easy, nourishing foods available rather than relying on high-sugar quick fixes.

Managing the Home Environment

Your environment can either support or undermine your efforts. Consider keeping trigger foods out of the house initially, or storing them in opaque containers in less accessible places, stocking satisfying alternatives that meet similar needs (crunchy vegetables with dip instead of chips, frozen fruit instead of ice cream), and pre-portioning snacks into individual servings.

If you live with others who want certain foods in the house, designate specific cupboards or shelves for items you're trying to avoid, ask family members to eat trigger foods when you're not around during early recovery, and communicate clearly about what support you need.

Professional Support for BED and ADHD

Cognitive Behavioural Therapy (CBT) for BED

CBT is the first-line psychological treatment for binge eating disorder. It typically involves 16-20 sessions over 4-6 months, though this can vary.

In CBT for binge eating, you'll work on establishing regular eating patterns to break the restrict-binge cycle, identifying and challenging thoughts that trigger or maintain binge eating (such as "I've already blown it, so I might as well keep eating"), developing problem-solving skills for high-risk situations, and learning to tolerate difficult emotions without turning to food.

A key component is cognitive restructuring—learning to recognise unhelpful thought patterns. For example:

All-or-nothing thinking: "I ate one biscuit, so I've ruined everything and might as well eat the whole packet" → "One biscuit doesn't define my day. I can make my next choice a helpful one."
Should statements: "I should have perfect control over my eating" → "Recovery isn't about perfection. Progress matters more than perfect control."

CBT also involves behavioural experiments to test predictions and beliefs. For instance, if you believe "If I start eating chocolate, I won't be able to stop," you might practice eating a small, pre-portioned amount while using coping strategies, and observe what actually happens.

Dialectical Behaviour Therapy (DBT) Approaches

DBT-BED has strong evidence for binge eating, particularly when emotional dysregulation is central. DBT focuses on four skill areas:

Mindfulness: Learning to observe urges without immediately acting on them, practising being present during meals rather than eating on autopilot, and noticing thoughts and feelings without judgment.

Distress tolerance: Developing skills to ride out urges to binge without giving in. This might include using TIPP skills (Temperature change like splashing cold water on your face, Intense exercise like doing jumping jacks, Paced breathing, Progressive muscle relaxation), self-soothing using the five senses (listening to music, holding something soft, lighting a candle), and creating a distraction plan for when urges are strong.

Emotion regulation: Learning to identify and name emotions accurately, understanding what function emotions serve, and increasing positive emotional experiences to reduce vulnerability to negative emotions. This includes building a life worth living with regular pleasant activities, mastery experiences, and meaningful connection.

Interpersonal effectiveness: Communicating needs clearly, setting boundaries around food with family or friends, and asking for support when needed.

DBT is typically delivered in a combination of individual therapy and skills group sessions over 6-12 months.

Nutrition Counselling for ADHD and Eating Disorders

Working with a dietitian who understands both ADHD and eating disorders can be invaluable. They can help you develop flexible meal plans that account for medication effects, irregular schedules, sensory sensitivities, and executive function challenges.

A dietitian might help you understand how different macronutrients affect satiety and energy, identify nutritional gaps caused by erratic eating patterns, work through food rules or restrictions that may be contributing to binge cycles, and find practical solutions for barriers to regular eating (such as batch cooking, using meal delivery services, or keeping nutrient-dense convenience foods on hand).

Importantly, they'll help you move away from restrictive dieting, which often triggers or worsens binge eating, toward intuitive and flexible eating patterns that work with your ADHD rather than against it.

Medication Management

Lisdexamfetamine for Binge Eating Disorder

Lisdexamfetamine (Vyvanse) is currently the only stimulant medication approved specifically for moderate to severe binge eating disorder in adults. Clinical trials show it can reduce binge-eating days per week, with some people experiencing significant reduction or remission of binge episodes.

The typical starting dose is 30mg daily, increased gradually to 50-70mg based on response and tolerability. It's taken in the morning and effects last throughout the day.

Lisdexamfetamine works through dopamine and noradrenaline pathways, reducing impulsivity and potentially normalising reward-processing related to food. For people with both ADHD and BED, it may address both conditions simultaneously.

Side effects can include decreased appetite (which can be helpful for BED but requires monitoring), difficulty sleeping if taken too late in the day, increased heart rate and blood pressure, and dry mouth. Regular monitoring with your doctor is essential.

Adjusting ADHD Medications

If you're already on ADHD medication and experiencing binge eating, discuss with your doctor whether adjustments might help. Options include changing the timing of doses to better align with your eating schedule, adjusting the dose to minimise extreme appetite suppression during the day, trying a different formulation (short-acting versus long-acting), or adding a small afternoon dose to prevent evening rebound hunger.

Some people find that taking their stimulant medication slightly later in the morning allows them to eat breakfast first, or that adding a small booster dose in the late afternoon helps manage evening appetite surges.

Coordinating Care for BED and ADHD

The most effective approach often involves a team: a GP or psychiatrist managing ADHD and any medications, a psychologist or therapist providing CBT or DBT, a dietitian addressing nutritional and eating patterns, and potentially an eating disorder specialist if binge eating is severe.

Regular communication between providers ensures everyone is working toward the same goals and that treatments complement rather than contradict each other.

The Bottom Line

The relationship between ADHD and binge eating is closely linked. Impulsivity, emotional dysregulation, and difficulties with executive function all play a role in the development of disordered eating patterns. Understanding this connection is the first step toward managing both conditions effectively.

Research clearly shows that people with ADHD are at substantially higher risk for binge eating disorder than the general population. This risk comes from overlapping neurological and behavioural factors, particularly difficulties with impulse control, emotional regulation, and planning.

Effective treatments are available. These include structured eating routines, mindful eating practices, evidence-based therapies like CBT and DBT, nutrition counselling, and medication when appropriate. For children and teenagers, family support, consistent routines, and professional guidance are invaluable.

Making small, sustainable changes can be challenging, but can lead to meaningful progress. Seeking timely support—whether through healthcare professionals, support groups, or educational resources—empowers people to take charge of their eating habits and improve both physical and emotional health.

Resources and Support in Australia

If you or someone you care about is struggling with ADHD and binge eating, several Australian organisations provide specialist support:

Butterfly Foundation Butterfly's National Helpline provides free, confidential support for anyone experiencing an eating disorder or body image concern, including binge eating disorder.

Phone: 1800 33 4673 (1800 ED HOPE)
Webchat: Available 8am-midnight AEDT, 7 days a week
Email: support@butterfly.org.au
Website: butterfly.org.au

Butterfly also offers support programs, resources for families and carers, and information specifically about binge eating disorder.

InsideOut Institute InsideOut Institute is Australia's national institute for eating disorders research and clinical excellence. They provide:

eClinic: Free, evidence-based online therapy programs including Binge Eating eTherapy (BEeT) for people experiencing binge eating symptoms
GP Hub: Digital tools and resources to help GPs identify and treat eating disorders
National research: Leading Australia's eating disorder research and translation strategy
Website: insideoutinstitute.org.au

National Eating Disorders Collaboration (NEDC) NEDC provides evidence-based information, resources, and professional training to support the eating disorder sector across Australia. They've developed the National Eating Disorders Strategy 2023-2033, which guides policy and service development.

Website: nedc.com.au
Resources: Fact sheets, treatment information, and guidance for health professionals
Training: Free professional development courses for GPs and mental health professionals

This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment options..