[A note before we begin: What follows reflects my perspective as a nurse educator and women’s health advocate. This article is informed by the emerging research literature on ADHD and eating behaviors, and the personal experiences of the women I work with. These are complex issues that present differently in every person. For that reason, this is in no way a clinical prescription. Please take what resonates with you, leave what doesn’t, and bring any specific concerns you have to a provider or therapist who knows your particular situation. This is simply one informed voice, offered with the hope that some part of it may be of help.]
By Leigh Anne Hulva, BSN, RN— Women’s Health Educator
ADHD can affect eating in ways that may include forgetting meals, impulsive or reactive eating, difficulty noticing hunger, and fullness and appetite changes. This article explains why ADHD and eating can become complicated and offers practical strategies for adults in Nashville who want more consistent eating habits. (And, on a side note, Nashville of course is known as a town with many great restaurants).
Meet Bex
Bex works from home as a graphic designer. She loves her job. She loves living alone. She loves not being in a romantic relationship at 38, which bothers her mother but none of her friends. She loves the freedom of her wide-open days, when everything she does is up to her. Of course, having ADHD means she makes and maintains careful lists and reminders to stay on track workwise. It also means that her relationship with food (the timing of meals, what to eat, etc.) is entirely up to her.
Which means it is entirely chaotic.
On the kind of day when she is hyperfocused on her work, she can go from eight in the morning until maybe 4 in the afternoon without stopping for breath. The result of that kind of focus, however, is that by the time she realizes she might need to eat something, she is ravenous. She needs to eat now, and it hardly matters what. These are the days that Bex finds herself reaching for foods she knows aren’t good for her; they’re just there, and they’re fast, and they taste good.
This pattern of eating is something that she has mentioned to her counselor (who has a lot of experience treating adult ADHD), and she was reassured by her response. “This is one of the more common things I see with people who work from home. This isn’t about willpower; it’s about how the ADHD brain processes internal signals, like hunger.”
So, just like Bex needed reminders for work and daily tasks and appointments, she would need some sort of reminder system for eating well. Bex felt like she had a whole new framework to work from.
Why the ADHD Brain Can Have a Complicated Relationship with Food
Food and eating require a surprising amount of executive function. Probably more than most people realize. There’s the initial hunger signal that must be noticed to be acted upon. There’s the decision to eat, and the decision of what to eat. The preparation of this food, the pacing of eating, the noticing of the signal of fullness… these all require executive function. And these are all points at which the ADHD brain might find itself paralyzed.
The ADHD brain that misses the signal to start a task can also miss the quiet signal to eat. The same brain that is able to hyperfocus on a high-reward activity it finds interesting can also miss the quiet cues to stop eating. These are different problems, but are both related to executive function.
Common Eating Patterns in Adults with ADHD
Forgetting to Eat
Perhaps the most common eating issue reported among adults with ADHD is forgetting to eat. This means going for long stretches of time without eating (without meaning to), often during periods of hyperfocus. Unfortunately, going for long periods of time without food can lead to drops in blood sugar, which can make ADHD symptoms worse. This can create a self-reinforcing cycle in which the ADHD that caused the missed meal is made worse by it.
Impulsive (or Reactive) Eating
The flip side of forgetting to eat is the impulsive or reactive eating that often follows a missed meal. The desperate hunger that comes from hour upon hour of ignoring quiet hunger signals can suddenly become such that it feels almost inevitable to reach for the nearest, easiest food to hand. This isn’t usually a perfectly balanced meal, but rather one of those dopamine-releasing foods that are high in fat or sugar or salt. Again, this has a self-reinforcing quality to it, in that the aforementioned processed food isn’t going to be satisfying for very long and might well result in a blood sugar drop that reawakens the hunger and then the process starts again.
Grazing or Overeating
Some adults with ADHD describe simply snacking throughout the day as the mood strikes them, referring to this as “grazing.” This type of eating can reflect the ADHD brain’s difficulty initiating tasks— an entire meal might feel overwhelming, whereas reaching for snacks whenever something looks tasty is both manageable and often rewarded by the dopamine system. The flip side of this is the problem of overeating; feeling unable to stop eating once it has begun. This lines up with the hyperfocus side of ADHD.
Sensitivity to Texture and Taste
Sensory sensitivity— including an increase in sensitivity to food temperature, taste, and texture— appears to be more common in people with ADHD than in the general population. The research in this area is still developing, but it appears that a genuine sensory sensitivity can be to blame for some of the limited food choices that certain people with ADHD experience.
H3: The Medication Factor
The stimulant medications often used for treating ADHD can decrease appetite. This can actually directly compound the forgetting-to-eat problem by adding an appetite suppressant, thus making those quiet hunger signals even quieter. Because of this, many providers suggest eating breakfast before taking their mediation in the morning.
ADHD and Emotional Eating
I will mention here, tentatively, that there is emerging research that is linking binge eating disorder with ADHD. The research is complex and not fully understood, but the basic premise is that the impulsivity characteristic of ADHD might contribute to a vulnerability to binge eating episodes. This in no way means that people with ADHD have an eating disorder, regardless of any chaotic eating habits they may have.
Food, whether you have ADHD or not, is generally a reliable and immediately available source of dopamine. Our brains reward us for finding food and want us to find more of it. This is even more pronounced in the ADHD brain, which generally finds dopamine access less reliable than the neurotypical brain. This is an oversimplification of the neurobiology, of course, but understanding this might help assuage the guilt feelings some people with ADHD have about their eating habits.
ADHD Eating Strategies That May Help
Externalizing the Timing of Meals
Like with other areas of life with ADHD, using external reminders instead of relying on internal awareness can be a help. In the same way that Bex sets reminders to get up, to get online, to begin each daily project… this is what she has decided to do with mealtimes as well.
Since she is taking stimulant medication, she will set an extra alarm for 15 minutes before her “Take your pill!” alarm and call it “Eat your breakfast!” She will then, depending on the day’s work, set one or two more alarms for proper meals. What happens when those alarms go off will require some thought…
Minimizing Barriers to the Initiation of Meals
…Because in order for Bex to actually get to the point of putting healthy food in her mouth, she’s going to have to get through several layers of executive function barriers. There’s the choosing of what to eat, how to prepare it, even where to eat it. Reducing the mental cost of all this is vital if Bex’s plan to eat regular, healthy meals is going to become a reality.
She has chosen to do a couple of different things: She has decided that on Sundays, she will make a big batch of healthy soup and save it in 12-ounce jars in the fridge and freezer for the rest of the week. That’s lunch. Dinners will consist of a protein (she has a list on the fridge of stuff she always has in stock, like yogurt and cheeses and chickpeas and nut mixes), a piece of fruit, and a small peanut butter and jelly sandwich, her all-time favorite that she could eat every day of the week.
Having a Meal Before Taking Your Medication
Most providers will suggest having breakfast before taking your morning medication. This will minimize the effects of how stimulant medication decreases your appetite.
Signs That Your Eating Patterns Might Be ADHD-Related
- Reaching a point of hunger that makes impulsive food choices a regular event
- Regularly forgetting to eat
- Grazing continuously throughout the day instead of taking regular meals
- Difficulty stopping eating once you’ve started
- Using food for stimulation or comfort
- Sensitivity to food temperature, textures, or tastes
Making Eating with ADHD More Manageable
You can be diagnosed with ADHD and seek treatment for it at any point; it’s never too late. If ADHD is holding you back, now is the time to find a healthcare provider with experience treating adults with ADHD. If this article resonates with you, consider talking to your doctor about potential treatments. Find a provider who helps you figure out how to move forward into your best life!
Frequently Asked Questions (FAQs):
Is impulsive eating a symptom of ADHD?
Whether or not impulsive eating is a “symptom” of ADHD in the proper sense, it is commonly reported among adults with ADHD. There are several possible reasons for this. The ADHD brain tends toward impulsivity in general, due to neurobiological reasons written about in other articles that have to do with the brain’s reward system, which differs from the neurotypical brain’s reward system. This involves dopamine, which tends to be harder for the ADHD brain to access. Food, in general, is considered by the brain to be a reward and therefore causes dopamine to be released. This is especially true for foods high in sugar, fat, and salt. Reaching for this type of food can lead to further eating impulsivity, as it can cause spikes and drops in blood sugar that continue the comfort-eating loop.
Can ADHD medication affect my appetite?
Yes, it is well known that stimulant medication (which is often used to treat ADHD) can decrease appetite. Generally—and you can discuss this with your provider—many providers recommend having breakfast before taking your morning medication.
What are some practical ways to improve eating habits when it comes to ADHD?
The most consistently used strategies to help with eating habits are the same as with other aspects of ADHD: externalize the reminder! Put reminders in your phone, sticky notes on your laptop, messages on a whiteboard, notes on your fridge. It also helps to have healthy, easy-to-reach snacks for those times when you’ve hyperfocused yourself into a serious hunger and need something quick that won’t come back to haunt your blood sugar later. Having a manageable rotating meal plan might help, as it has helped Bex. Keep it simple, try different things, and see what works for you!
H2: Author Bio
I’m Leigh Anne Hulva, BSN, RN- a registered nurse, women’s health educator, mother of teenaged daughters, and passionate advocate for women navigating perimenopause and menopause. I recently completed the Harvard Medical School course on Women’s Health and in these pages I relish sharing what I learned there alongside what I know from lived experience. I bring to this work not only my training, but also the personal experience of navigating the very transition I write about. It is my privilege to share both, because this work is personal to me. I hope it feels that way to you, too.
I have been on the other side of this conversation, and I understand how much it matters to feel truly heard. At Nashville Concierge Medicines, my work is supervised by Dr. William Conway, MD, and I work directly under his licensure as a nurse educator.
About Leigh Anne Hulva by William Conway, M.D
Leigh Ann is an exceptionally gifted writer in the tradition of American Humanism. To fully learn from Leigh Ann, it is best to read all of her blogs. In her extensive portfolio, Leigh Ann moves past the rather dry medical literature to capture the lived experience of living with both ADHD and perimenopause. Leigh Ann captures the complicated, subtle ways that ADHD can dominate life and make life much more difficult
All of Leigh Ann case studies capture the lived reality of life with ADHD. None of the case studies are drawn from an actual patient.
