Today we’re discussing Binge eating.
Binge Eating Disorder (BED) and Attention-Deficit/Hyperactivity Disorder (ADHD) are two conditions that, unfortunately, often go hand in hand and studies have suggested that individuals with ADHD may be at an increased risk for developing BED.
Binge Eating Disorder (BED) is characterized by recurrent episodes of consuming large amounts of food in a short period of time, often accompanied by feelings of shame, guilt, and lack of control.
BED is different from overeating or eating too much food during a special occasion. It is a persistent pattern of disordered eating behavior that can have significant negative effects on a person’s physical and mental health, relationships, and daily functioning.
To hear our personal reflections on binge eating listen below:
DSM-5 Criteria – Binge Eating Disorder
Let’s get the boring bit out the way. What does our old friend the DSM have to say about Binge Eating?
Well actually, Binge Eating Disorder is only recognised in the most recent edition. Previously it was lumped under “EDNOS” (Eating Disorder Not Otherwise Specified). In the current DSM-5 the criteria it is as follows:
- Recurrent and persistent episodes of binge eating (on average once a week for longer than 3 months)
- Binge eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of being embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed, or very guilty after overeating
- Marked distress regarding binge eating
- Absence of regular compensatory behaviors (such as purging).
Weight is not included in criteria. That’s really important to highlight, you don’t have to be overweight to be struggling with binge eating.
How Is Binge Eating Related To ADHD?
So, why is this relevant to ADHD? Well, as always the exact relationship between ADHD and BED is not fully understood, but theories suggest that those all important neurotransmitters noradrenaline and dopamine may play a role.
In individuals with ADHD, there may be lower levels of dopamine and noradrenaline in certain areas of the brain, leading to symptoms of impulsivity and executive dysfunction.
Research has shown that dopamine is linked to the reward centers in the brain, which can play a role in the development of addictive behaviors such as binge eating. This means that individuals with ADHD may be more susceptible to the rewarding effects of food (an increase in dopamine), which can lead to binge eating episodes.
Impulsivity may lead you to make poor food choices and engage in binge eating, for example choosing to eat immediately available snacks over cooking a healthy meal when hungry. Similarly, difficulty regulating emotions may lead to emotional eating, which is a trigger for both of us to binge eat.
Noradreanline affects executive function and can cause issues such as inability to follow a meal plan, issues judging portion size and poor awareness of internal hunger cues or satiety (fullness).
How Is Binge Eating Treated In Adults With ADHD?
So, how do we go about treating BED in adults with ADHD? The good news is that treatment for both conditions typically involves a combination of therapy, medication, and lifestyle changes.
First, it’s worth mentioning therapy. For example, cognitive-behavioral therapy (CBT) can help individuals with ADHD identify and change negative thought patterns that contribute to binge eating. Additionally, dialectical behavior therapy (DBT) can be used to teach individuals with ADHD skills to regulate their emotions and decrease impulsive behavior.
Medication can also be helpful. Stimulant medications, such as amphetamines, can be used to treat ADHD and BED symptoms simultaneously.
Finally, lifestyle changes can also help. All the usual stuff I’m sure you know such as healthy diet, regular exercise, enough sleep etc can help improve your mood, decrease impulsivity and regulate your blood sugar levels (which reduces cravings for junk food). All easy to type and look good on paper – but do we follow them? Erm….no.
So what do we actually do? These are the practical tips that work to keep our binging to a more manageable level:
- Not having tempting binge food easily accessible. Increase the friction as much as possible. Think of this as the opposite of getting a habit to stick. If you’re feeling tempted to binge and there’s a cupboard full of snacks in your house how many times is willpower going to stop you? On the flip side, if you’ve got healthy snackables like carrots or snap peas in the fridge waiting for you, and the nearest junk food involves leaving home and going to a shop to purchase it you’ve increased the level of friction and therefore made it slightly less likely you’ll eat high calorie snacks
- Identify your triggers. This is really important for catching the binge before it even occurs. There’s not much you can do to stop the occasional bad day, but if you can identify for example everytime X happens I feel really low afterwards and want to binge eat, and you can eliminate X then that’s immediately less binging.
- Try the “Next Best Step” approach. This is about slightly improving your choices rather than relying on willpower to stop you altogether. For example, instead of eating a whole tub of Ben and Jerry’s, eat a tub of frozen yoghurt instead. Little changes can really add up and gradually over time by always doing the next best step you’ll move your markers further than cycling through perfect and failure.
- Don’t buy multipacks (Junk Food Bargains!) They may give you the illusion of saving money, but in reality all that happens is you now have tempting food in the house meaning you are more likely to overeat.
- Practice mindfulness. Try not to distract yourself while eating. Stay away from screens and really enjoy each mouthful. This means you are more likely to stay in touch with your body and listen to those internal cues signaling you to stop eating.
Take Home
Binge eating is not something to be ashamed of. BED is a common co-morbidity of ADHD and not a “weakness” or character flaw you should be beating yourself up over. There are practical steps you can take to manage BED, and if you are struggling then don’t be afraid to reach out for professional help.