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Published on: May 10, 2022
The intersection of ADHD and anorexia: a qualitative exploration of how ADHD shapes eating disorder experiences
Romi Goldschlager1,2, Kurea Adrian3, Eva Gregertsen3,4
1Li-Transformative Hub for Research into Eating Disorders (Li-HTRED), HER Centre Australia, School of Translational Medicine, Monash University, Melbourne, Australia. r.goldschlager@alfred.org.au.
Introduction:
Anorexia nervosa (AN) is an eating disorder (ED) characterised by restrictions in energy intake, intense fear of weight gain and distorted body image. AN may coexist with attention-deficit/hyperactivity disorder (ADHD), a neurotype characterised by differences in attention and/or impulsivity and hyperactivity. Despite increasing recognition of neurodivergence in EDs, the co-occurrence of ADHD and AN remains markedly under-researched. Clarifying their interaction will improve diagnostic accuracy, tailor treatments, and ultimately enhance outcomes for individuals living with both neurobiological profiles. The objective of this study is to investigate how features of ADHD and AN influence the lived experience of adults with both profiles.
Methods:
Fifteen adults with co-occurring ADHD and AN participated in semi-structured interviews exploring how features of each profile shaped their experience. Qualitative data was analysed using Braun and Clarke's reflexive thematic analysis.
Results:
Four themes were developed. The interaction and overlap of features of ADHD and AN as well as challenges teasing the two apart was central for participants. ADHD and AN features were intentionally and unintentionally instrumentalised, perpetuating the co-occurring profile and making participants' experiences of co-occurring ADHD-AN challenging to navigate. Participants experienced profound shame resulting from ADHD-related systemic factors which in some cases appeared to predispose them to the development of AN. Overall, participants emphasised the importance of making ADHD-AN visible, highlighting the need for both this research and clinical attunement and dexterity to support individual patient experiences.
Conclusions:
To our knowledge, this is the first qualitative study providing evidence of how the features of ADHD and AN interact. The findings emphasise shared challenges in living with the co-occurring profiles, highlighting the need for increased understanding and greater recognition of ADHD-AN.
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