Q&A: How Often Is ADHD Seen with Eating Disorders?

Q: I’ve heard that many patients with eating disorders also have attention deficit hyperactivity disorder (ADHD). Can you provide any figures? (T.A., Chicago, IL).

A: To put these issues into perspective, results of community studies have suggested that the rate of ADHD in the population at large is about 5%, and that in females it’s about 3.4% (Brit J Psychiatry 2007; 190:402). That said, although one pilot study of patients with eating disorders estimated the rates of ADHD as high as 17%, a larger, more carefully conducted study of 2000 inpatients found ADHD in 3% of patients with AN and in 9% of patients with BN (Psychosom Med 2006; 68:454). How can we reconcile these figures? In a recent review and study of 189 inpatient women with eating disorders, 21% were found to endorse at least six current ADHD symptoms. However, the rate of actual ADHD in this population was estimated to be only 5.8%. The fact is that many of these patients developed attention problems after childhood, suggesting late-onset, non-ADHD origins of the attention problems. Since under-nutrition, mood and anxiety disorders, and substance abuse can all impact attention systems, several alternative mechanisms have to be considered in assessing whether true ADHD exists in your patients.

– J.Y.