Risk for developing eating disorders in adults diagnosed with attention deficit hyperactivity disorder: An integrative literature review
DOI:
https://doi.org/10.33448/rsd-v14i7.49295Keywords:
Attention-deficit/hyperactivity disorder, Binge-Eating, Risk, Adults.Abstract
Objective: to investigate whether adults with ADHD are at risk of developing eating disorders or worsening their clinical condition. Methodology: a six-step methodology was used, including searches in PubMed and LILACS databases and selection of articles in English or Portuguese published between 2015 and 2025. After defining the inclusion and exclusion criteria, the final sample included eight studies, assessed using a structured instrument that included methodological data, outcomes, and level of evidence. Results: the findings showed a significant association between ADHD and eating disorders: adults with ADHD have up to a fourfold increased risk of developing binge eating and bulimia nervosa. In a twin study, 91% of the covariance between ADHD and binge eating was attributed to shared genetic factors. Impulsivity, dysfunction in emotional regulation, and altered reward circuitry emerge as central mechanisms of this relationship. Even after adjusting for psychiatric comorbidities, the association between ADHD and bulimia remained significant, especially in obese women. Conclusion: adults with ADHD have a higher prevalence of eating disorders, with impulsivity and emotional dysregulation as key factors. Further longitudinal studies and specific clinical care are recommended, promoting comprehensive management involving mental health and nutrition.
References
Austerman, J. (2015). ADHD and behavioral disorders: Assessment, management, and an update from DSM-5. Cleve Clin J Med. 2015 Nov;82(11 Suppl 1):S2-7. doi: 10.3949/ccjm.82.s1.01. PMID: 26555810.
Biederman, J, Ball, S, Monuteaux, M, Surman, C, Johnson, J & Zeitlin, S (2007). Are girls with ADHD at risk for eating disorders? Results from a controlled, five-year prospective study. Journal of Developmental and Behavioral Pediatrics 28, 302–307.
Brewerton, T. D, & Duncan, A. E. (2016). Associations between Attention Deficit Hyperactivity Disorder and Eating Disorders by Gender: Results from the National Comorbidity Survey Replication. Eur Eat Disord Rev. 2016 Nov;24(6):536-540. doi: 10.1002/erv.2468. Epub 2016 Aug 2. PMID: 27480884.
Brunault, P, Frammery, J, Montaudon, P, De Luca, A, Hankard, R, Ducluzeau, P. H, Cortese, S, & Ballon, N. (2019). Adulthood and childhood ADHD in patients consulting for obesity is associated with food addiction and binge eating, but not sleep apnea syndrome. Appetite. 2019 May 1;136:25-32. doi: 10.1016/j.appet.2019.01.013. Epub 2019 Jan 11. PMID: 30641157.
Capusan, A. J, Yao, S, Kuja-Halkola, R, Bulik, C. M, Thornton, L. M, Bendtsen, P, Marteinsdottir, I, Thorsell, A, & Larsson, H. (2017). Genetic and environmental aspects in the association between attention-deficit hyperactivity disorder symptoms and binge-eating behavior in adults: a twin study. Psychol Med. 2017 Dec;47(16):2866-2878. doi: 10.1017/S0033291717001416. Epub 2017 Jun 5. PMID: 28578734.
Casey, B. J., Epstein, J. N., Buhle, J., Liston, C., Davidson, M. C., Tonev, S. T., . . . & Glover, G. (2007). Frontostriatal connectivity and its role in cognitive control in parent-child dyads with ADHD. American Journal of Psychiatry, 164, 1729-1736.
Cortese, S, Angriman, M, Maffeis, C, Isnard, P, Konofal, E, Lecendreux, M, Purper-Ouakil, D, Vincenzi, B, Bernardina, B. D, & Mouren, M-C (2008). Attention-deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature. Critical Reviews in Food Science and Nutrition 48, 524–537
Engel, S. G, Corneliussen, S. J, Wonderlich, S. A, Crosby, R. D, Le Grange, D, Crow, S, Klein, M, Bardone-Cone, A, Peterson, C, Joiner, T, Mitchell, J. E, & Steiger H (2005). Impulsivity and compulsivity in bulimia nervosa. International Journal of Eating Disorders 38, 244–251.
Gil, A. C. (2017). Como elaborar um projeto de pesquisas. Editora Atlas.
Ganong, L. H. (1987). Integrative reviews of nursing research. Res Nurs Health. 1987 Feb;10(1):1-11. doi: 10.1002/nur.4770100103. PMID: 3644366.
Gibbs, E. L, Kass, A. E, Eichen, D. M, Fitzsimmons-Craft, E. E, Trockel, M, & Wilfley, D. E. (2016). Attention-deficit/hyperactivity disorder-specific stimulant misuse, mood, anxiety, and stress in college-age women at high risk for or with eating disorders. J Am Coll Health. 2016 May-Jun;64(4):300-8. doi: 10.1080/07448481.2016.1138477. Epub 2016 Jan 29. PMID: 26822019; PMCID: PMC4904716.
Howick, J.; Chalmers, I.; Glasziou, P.; et al. (2009). “The 2009 Oxford CEBM Levels of Evidence (Introductory Document)”. Oxford Centre for Evidence-Based Medicine. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009
Khalife, N, Kantomaa, M, Glover, V, Tammelin, T, Laitinen, J, Ebeling, H, Hurtig, T, Jarvelin, M, & Rodriguez, A (2014). Childhood attention-deficit/hyperactivity disorder symptoms are risk factors for obesity and physical inactivity in adolescence. Journal of the American Academy of Child and Adolescent Psychiatry 53, 425–436.
Leventakou, V, Micali, N, Georgiou, V, Sarri, K, Koutra, K, Koinaki, S, Vassilaki, M, Kogevinas, M, & Chatzi, L. (2016). Is there an association between eating behaviour and attention-deficit/hyperactivity disorder symptoms in preschool children? J Child Psychol Psychiatry. 2016 Jun;57(6):676-84. doi: 10.1111/jcpp.12504. Epub 2015 Dec 26. PMID: 26706046.
Mendes, K. D. S., Silveira, R. C. de C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto Enfermagem, 17(4), 758–764. https://doi.org/10.1590/S0104-07072008000400018
Mikami ,A, Hinshaw, S, Patterson, K, & Lee, J (2008). Eating pathology among adolescent girls with attention-deficit/ hyperactivity disorder. Journal of Abnormal Psychology 117, 225–235.
Moffitt, T. E, Houts, R, Asherson, P, Belsky, D. W, Corcoran, D. L, Hammerle, M, Harrington, H, Hogan, S, Meier, M. H, Polanczyk, G. V, Poulton, R, Ramrakha, S, Sugden, K, Williams, B, Rohde, L. A, & Caspi, A (2015). Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. American Journal of Psychiatry 172, 967–977.
Nazar, B. P, Bernardes, C, Peachey, G, Sergeant, J, Mattos, P, & Treasure, J. (2016). The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Int J Eat Disord. 2016 Dec;49(12):1045-1057. doi: 10.1002/eat.22643. Epub 2016 Nov 15. PMID: 27859581.
Nazar, B. P, de Sousa, Pinna, C. M, Suwwan, R, Duchesne, M, Freitas, S. R, Sergeant, J, & Mattos, P. (2016). ADHD Rate in Obese Women With Binge Eating and Bulimic Behaviors From a Weight-Loss Clinic. J Atten Disord. 2016 Jul;20(7):610-6. doi: 10.1177/1087054712455503. Epub 2012 Aug 28. PMID: 22930790.
Neumark-Sztainer, D, Story, M, Resnick, M, Garwick, A, & Blum, R (1995). Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study. Archives of Pediatrics and Adolescent Medicine 149, 1330–1335.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.
Pag,e M. J, McKenzie, J. E, Bossuyt, P. M, Boutron, I, Hoffmann, T. C, & Mulrow, C. D, et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71. For more information, visit: https://www.prisma-statement.org/
Pompeo, D. A., Rossi, L. A., & Galvão, C. M. (2009). Revisão integrativa: etapa inicial do processo de validação de diagnóstico de enfermagem. Acta Paulista de Enfermagem, 22(4), 434–438. https://doi.org/10.1590/S0103-21002009000400014
Rocco, I., Corso, B., Bonati, M., & Minicuci, N. (2021, 16 de novembro). Time of onset and/or diagnosis of ADHD in European children: A systematic review. BMC Psychiatry, 21(1), 575. https://doi.org/10.1186/s12888-021-03547-x
Rodrigues, R. T. F., Lacerda, R. A. O., Leite, R. C. B., Graziano, K. U., & Padilha, K. G. (2012). Enfermagem transoperatória nas cirurgias de redução de peso: revisão integrativa da literatura. Revista da Escola de Enfermagem da USP, 46(special), 138–147. https://doi.org/10.1590/S0080-62342012000700020
Rosval, L, Steiger, H, Bruce, K, Israel, M, Richardson, J, & Aubut, M (2006). Impulsivity in women with eating disorders: problem of response inhibition, planning, or attention?. International Journal of Eating Disorders 39, 590–593.
Salari, N., Ghasemi, H., Abdoli, N., Rahmani, A., Shiri, M. H., Hashemian, A. H., Akbari, H., & Mohammadi, M. (2023, 20 de abril). The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis. Italian Journal of Pediatrics, 49(1), 48. https://doi.org/10.1186/s13052-023-01456-1
Santos, C. M. da C., Pimenta, C. A. de M., & Nobre, M. R. C. (2007). The PICO strategy for the research question construction and evidence search. Revista Latino Americana de Enfermagem, 15(3), 508–511. https://doi.org/10.1590/S0104-11692007000300023
Sonneville, K. R, Calzo, J; P, Horton, N. J, Field, A. E, Crosby, R. D, Solmi, F, & Micali, N (2015). Childhood hyperactivity/ inattention and eating disturbances predict binge
Sousa, L., Marques-Vieira, C., Severino, S. & Antunes, V. (2017). Metodologia de Revisão Integrativa da Literatura em Enfermagem. Revista Investigação Enfermagem. 2. 17-26.
Steadman, K. M, & Knouse, L. E. (2016). Is the Relationship Between ADHD Symptoms and Binge Eating Mediated by Impulsivity? J Atten Disord. 2016 Nov;20(11):907-912. doi: 10.1177/1087054714530779. Epub 2014 May 7. PMID: 24804686.
Stetler, C. B, Brunell, M, Giuliano, K. K, Morsi, D, Prince, L, & Newell-Stokes, V. (1998). Evidence-based practice and the role of nursing leadership. J Nurs Adm. 1998 Jul-Aug;28(7-8):45-53. doi: 10.1097/00005110-199807000-00011. PMID: 9709696.
Yan, W, Lin, S, Wu, D, Shi, Y, Dou, L, & Li, X. (2023). Processed Food-Sweets Patterns and Related Behaviors with Attention Deficit Hyperactivity Disorder among Children: A Case-Control Study. Nutrients. 2023 Mar 2;15(5):1254. doi: 10.3390/nu15051254. PMID: 36904252; PMCID: PMC10005288.
Ziobrowski, H, Brewerton ,T. D, & Duncan, A. E. (2017). Associations between ADHD and eating disorders in relation to comorbid psychiatric disorders in a nationally representative sample. Psychiatry Res. 2018 Feb;260:53-59. doi: 10.1016/j.psychres.2017.11.026. Epub 2017 Nov 16. PMID: 29172099.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Vitório Cavalheiro Antunes, Clara e Silva Modesto, Gabriel Santiago de Faria, Luiza Magalhães Cipriani, Gabriel Teixeira Cardoso
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
