Why Was I Diagnosed With an Eating Disorder but No One Asked About ADHD?

Research increasingly points to an important connection between ADHD and eating disorders, but that overlap can be easy to miss.

Especially when treatment focuses on food and eating behaviors without also looking at executive functioning, emotional regulation, impulsivity, sensory experiences, and how someone's brain works.

So, I keep coming back to this question.

How many people have spent years being treated for an eating disorder without anyone asking how their brain works?

We ask about food.

We ask about restriction, bingeing, purging, exercise, body image, fear foods, weight, and eating disorder thoughts.

And we should.

But what if those aren't the only questions we need to be asking?

What if someone isn't just "inconsistent" with eating but genuinely struggles with planning, starting, remembering, transitioning, and following through?

What if they aren't ignoring their hunger cues but have difficulty noticing them until they're intense?

What if food isn't just about hunger but stimulation, comfort, sensory experience, regulation, or dopamine?

What if rigid rules around food aren't only about weight or appearance but also create predictability in a brain that often feels chaotic?

What if the person sitting in eating disorder treatment has ADHD and nobody has ever thought to ask?

I wish we talked about this more.

This intersection matters to me both clinically and personally.

I've seen what happens when someone spends years believing they are lazy, inconsistent, unmotivated, too emotional, undisciplined, or just somehow bad at doing life.

And I've seen what can happen when we finally stop asking:

"Why aren't you doing what you're supposed to do?"

and start asking:

"What is making this so hard?"

Those are very different questions.

And they lead us to very different places.

ADHD is about more than paying attention.

This is one of the biggest misunderstandings I see around ADHD.

ADHD can affect executive functioning—the processes that help us start something, organize it, remember it, track time, switch tasks, regulate emotions, and follow through.

Now think about how much executive functioning goes into simply feeding yourself.

You have to notice you're hungry.

Stop what you're doing.

Figure out what sounds good.

Decide what to make.

Make sure you have the ingredients.

Prepare it.

Sit down long enough to eat it.

Clean up.

Remember to do it again a few hours later.

And then repeat the entire process tomorrow.

For some brains, that's fairly automatic.

For an ADHD brain, there can be a lot happening between:

"I know I need to eat."

and

"I actually ate."

That distinction matters.

Because knowing what to do and being able to consistently do it are not the same thing.

ADHD and eating disorders can get tangled together.

There isn't one "ADHD eating pattern."

That's part of why I think this gets missed.

One person's experience might look like:

Distracted → forget to eat → suddenly starving → eat quickly or impulsively → feel out of control → shame → decide to restrict tomorrow → repeat.

Someone else's might be:

Overwhelmed → can't decide what to eat → put it off → energy drops → executive functioning gets worse → making food feels even more impossible.

Someone might seek stimulation through food.

Someone else might forget food exists when they're hyperfocused.

One person may struggle with impulsive eating.

Another may become incredibly rigid.

Someone may rely on the same foods because choosing something different takes too much energy.

Someone else may have sensory experiences with food that were dismissed for years as being "picky."

And then there is the emotional piece.

The rejection.

The comparison.

The perfectionism.

The feeling that everyone else seems capable of doing things that somehow feel impossibly hard for you.

Over time, food and body can become another place where you try to finally get it right.

And this is where shame enters the picture.

Imagine spending years knowing what you're "supposed" to do and repeatedly struggling to do it.

Plan ahead.

Eat consistently.

Keep a routine.

Listen to your body.

Don't act impulsively.

Be flexible.

Use your coping skills.

Just do the thing.

Eventually, you stop thinking:

"Something about this is hard for me."

And start thinking:

"Something is wrong with me."

That's the part I care deeply about.

Because once shame becomes part of the cycle, we're no longer just talking about food.

We're talking about someone's relationship with themselves.

Sometimes the symptom makes more sense when we understand what it's doing.

This is where my thinking about eating disorders has changed over the years.

Of course we need to address harmful eating disorder behaviors.

But I don't want to stop at:

How do we make this behavior go away?

I want to know:

What is this behavior doing for you?

What does it give you?

What does it quiet?

What does it help you avoid?

What does it organize?

What does it regulate?

What need might be underneath it?

Because sometimes the behavior we're desperately trying to eliminate was a person's attempt to solve something.

Maybe restriction created predictability.

Maybe bingeing offered stimulation, relief, or escape.

Maybe obsessing over food gave an overwhelmed brain one thing to focus on.

Maybe exercise regulated a restless nervous system.

Maybe controlling the body created a sense of competence for someone who constantly felt like they were failing everywhere else.

Understanding the function of a behavior doesn't mean we pretend it isn't harmful.

It means we understand what we're asking someone to give up.

And if we're going to take away something that has been helping a person survive, we better get curious about what they might need in its place.

This can become especially obvious when treatment ends.

I've seen people do incredibly well with the structure of eating disorder treatment and then wonder why everything suddenly feels so much harder when they leave.

Inside treatment, there may be:

Meal times.

Schedules.

Accountability.

Food provided or planned.

People reminding you what comes next.

Predictable routines.

External structure.

Then you're expected to go home and somehow recreate all of it yourself.

Plan.

Shop.

Prepare.

Remember.

Eat consistently.

Manage work or school.

Navigate relationships.

Regulate emotions.

Make decisions about food all day long.

And if you also have ADHD?

We need to at least consider whether some of what looks like "struggling with recovery" is actually a person struggling to create internally what treatment was providing externally.

That doesn't mean the eating disorder isn't involved.

It means there may be more than one thing happening at the same time.

So why wasn't ADHD noticed?

Sometimes it doesn't look the way people expect it to.

Especially in girls and women.

You might have done well in school.

You might have been responsible.

Perfectionistic.

A people-pleaser.

An overachiever.

The person everyone thought had it together.

Maybe you weren't bouncing off the walls.

Maybe you were sitting quietly while your brain was running a hundred miles an hour.

Maybe anxiety kept you organized.

Maybe perfectionism kept you from missing deadlines.

Maybe fear of disappointing people made sure you followed through.

Maybe you became incredibly good at compensating.

From the outside, it looked like functioning.

Inside, it may have felt exhausting.

That's one reason an ADHD diagnosis later in life can bring both relief and grief.

Because suddenly you start looking backward.

And things begin to make sense differently.

ADHD doesn't explain everything.

I want to be really clear about this.

Not every person with ADHD develops an eating disorder.

Not every person with an eating disorder has ADHD.

And ADHD is not some hidden explanation for every eating disorder behavior.

That's not the point.

The point is that when they coexist, we can't just treat them like two completely separate things.

We have to understand the intersection.

How does this person's attention work?

How do they experience hunger and fullness?

What happens when they're overwhelmed?

How do they seek stimulation?

How do they regulate emotions?

How much structure do they need?

What sensory experiences are involved?

What happens with planning and transitions?

How has years of feeling "different" shaped the way they see themselves?

And what role has food or the body played in all of it?

That's a much bigger conversation than simply adding ADHD to someone's diagnosis list.

Maybe we've been asking the wrong question.

For years, many people have asked themselves:

Why can't I just do this?

Why can't I eat normally?

Why can't I be consistent?

Why can't I trust myself around food?

Why can't I follow through?

Why do I know exactly what I'm supposed to do and still not do it?

Why am I like this?

Maybe we need a different question.

What have we not understood yet?

Because sometimes the missing piece isn't another rule.

Another coping skill.

Another meal plan.

Another attempt to try harder.

Sometimes the missing piece is finally understanding how all of the pieces interact.

The eating disorder.

The ADHD.

The anxiety.

The perfectionism.

The nervous system.

The shame.

The coping.

The person underneath all of it.

Maybe recovery isn't just about getting better at controlling the symptoms.

Maybe it's about finally understanding the person who developed them.

And I think we need to start asking about that sooner.