The relationship between binge eating and attention deficit hyperactivity disorder

Abstract

The purpose of this chapter is to review the literature on the relationship between attention-deficit-hyperactivity-disorder (ADHD) and binge eating as seen in bulimia nervosa (BN) and binge eating disorder (BED), including the shared phenomenology, genetics and treatment. The authors reviewed all the published peer reviewed literature in the past decade available through PubMed on the epidemiology, phenomenology, genetics and management of binge eating behavior, especially as it manifests in eating disorders (BN, BED), as well as in obesity and within the context of ADHD throughout the lifespan. It was found that there is a significant association between ADHD and binge eating in clinical populations. Inattentiveness and impulsivity noted in ADHD are thought to play a role in the preoccupations, urges and impulsive behaviors of those who experience binge-eating episodes. Molecular genetic studies have also identified common genes involved in dopamine transport, suggesting a shared genetic predisposition to binge eating, obesity and ADHD. Case reports on individuals with BN and ADHD suggest benefit from psychostimulant medication. In addition, other anti-ADHD medications such as atomoxetine have been used independently in trials to treat obesity and BED. Individuals with current symptoms or a past history of ADHD are at risk of having coexisting binge eating and obesity. Screening for ADHD in patients with binge-eating behaviors may identify individuals who could benefit from anti-ADHD medications. Further research may help to identify shared neurobiological mechanisms and particular risk factors, as well as to determine the efficacy and tolerability of certain medications in this population.