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ADHD Contributes to Symptom Severity in Bulimia

 

Bulimia nervosa (BN) is a psychological issue that is associated with disordered eating behaviors. People with BN often binge to the point of excess and then purge their food by vomiting or using diuretics. BN is associated with higher body mass index (BMI) and obesity in many people and treatment for BN includes addressing emotional and psychological processes that underlie the condition.

Some of the issues addressed include inattention and impulsivity, factors that are also common in people with attention-deficit hyperactivity (ADHD). Because these two behaviors have symptoms that overlap, Jochen Seitz of the Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics at the University Hospital in Aachen, Germany decided to see how prevalent ADHD was in people with BN and how the presence of ADHD affected BN symptom severity. Seitz recruited 57 women receiving treatment for BN and 40 participants with no history of psychological illness, and assessed them for history of ADHD, eating issues, psychological problems, and impulsivity.

The study revealed that 21% of the BN participants had a history of ADHD. This was significantly higher than the 2.5% of the control participants who had a prior or current history of ADHD. Further, the BN/ADHD participants had higher levels of inattentiveness and impulsivity than the participants who only had BN. These elevated symptoms were directly related to more severe eating problems and overall negative psychological adjustment. Even though most of the BN/ADHD participants had symptoms of hyperactivity and impulsivity, the strongest predictor of BN severity was inattentiveness.

In sum, this study demonstrates that there is a high rate of comorbidity of ADHD and BN and that specific symptoms of ADHD serve to exacerbate BN problems. Seitz added, “Thus, clinicians should identify comorbid patients who might profit from additional ADHD-specific treatments.” Hopefully, taking this approach will result in better outcomes for people with BN and ADHD.

Reference:
Seitz, J., Kahraman-Lanzerath, B., Legenbauer, T., Sarrar, L., Herpertz, S., et al. (2013). The role of impulsivity, inattention and comorbid ADHD in patients with bulimia nervosa. PLoS ONE 8(5): e63891. doi:10.1371/journal.pone.0063891

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Comments
  • Kendall June 12th, 2013 at 2:23 PM #1

    Really?
    I have never heard this before and I wouldn’t have thought that the two really shared any of the same traits or characteristics.
    ADHD seems a little like being out of control while BN seems more about that need to be in control.

  • Peridot December 10th, 2013 at 8:34 PM #2

    I can verify these statements as a former bulimic and also diagnosed with ADHD(primarily inattentive type). ADHD does makes me feel like everything is chaotic and out of control and the binges where what I turned to, to zone out completely. All the chaos and stress would disappear in those moments. It was my only way of controlling everything that felt overwhelming.

  • Leah February 13th, 2014 at 9:36 PM #3

    In response to Kendall: As a bulimic, I can tell you the binge is when you are out of control: the purge is the attempt at control, but it is very much out of control, as well.

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