ADHD and the Binge/Restrict Cycle, Part 1: Why Intuitive Eating May Be Hard

Often, clients come to me expressing that they feel like they are broken, struggling more than their peers, and feel like life is so hard for them to manage. They may be first focused on food and feeling out of control with their binging, but it’s common that we discover ADHD (or other neurodivergence) as we dig deeper into their experiences. 

Folks with ADHD often report issues with the binge/restrict eating cycle, and there are many reasons for this. Some research is even showing neural pathway connections between binge behaviors and ADHD.

I want to help you find more peace with eating, help you feel less trapped in all or nothing behavior patterns, and in general have more understanding and acceptance of ADHD. In part two, I include some helpful tips and resources as well.

But first, let’s explore the binge/restrict cycle. 

Essentially, the cycle looks at the relationship between restriction of food and subsequent binges, which then lead to further restriction, and so on. This diagram from Isabel Vasquez, RD< LDN is a great summary of it. 

I want you to think about restriction in general as a shame-based strategy to change your behavior. This can be about food, but also about money, emotional expression, exercise, and so on. I have written about this in depth here. Binging, then, can also be food related or not at all food related, and I want to emphasize the restriction and binge do not have to be about the same topic; meaning, you can restrict yourself about what emotions you’re allowed to express, holding in all your anger and frustration, and then experience a food binge. The important thing to understand here is that binges are almost always in response to a form of restriction. Binging is a very normal behavior, and a very understandable response to restriction. 

Intuitive Eating (IE) is the goal, in theory. IE is all about relying on your body’s cues for hunger and fullness, and relying on your body to lead you in what you want to eat. In practice, IE can be difficult for folks with neurodivergence like ADHD. IE requires an individual to be able to sense what they feel inside their body, or interoception. This is often difficult for brains with neurodivergence because there may be too many or too few internal signals. This blog explains more about interoception and neurodivergence.  

It’s important to hold the goal of IE lightly. And, to find ways to eat that nourish your body throughout the day. And, to not be afraid of binging. (And not be so afraid of fatness, which I’ll have to save for another blog, for another day). This may sound radical to you: binging is not bad. It’s not something to be ashamed of. It’s not a moral failing. It’s not going to make you unlovable. It’s not something you need to hide from others.

Now, let’s explore more about ADHD in particular. 

Attention deficit and hyperactivity disorder (ADHD) is being diagnosed more in adults than ever before. It’s being recognized more in women, folks of color, and basically people that are not white cisgender straight men. ADHD can sometimes look like the hyperactive kid in class who can’t sit still, but it can also be much less visible. Women, folks of color, and queer folks are more likely to have the inattentive type of ADHD in part because they’ve been taught to “mask” throughout their life. Because of societal expectations and oppressions, these groups are more likely to have internal symptoms of ADHD that they are more skilled at hiding from others. They are more likely to suffer in silence. I love the work of Dr. Devon Price for more information on neurodivergence and how it shows up across genders in particular. 

I could spend multiple blogs reviewing symptoms of ADHD, but for our purposes here I want to focus on an important few: 

• Hyperfocus- this is often excluded from diagnostic criteria for ADHD but is a very common symptom. Hyperfocus is when you get so absorbed with what you’re doing that you tune out all external stimuli. You are so engrossed in your task, often a special interest or hobby, that you don’t hear someone calling your name or don’t register that your bladder is super full. 

• Time blindness- this is one most people are familiar with. Folks with ADHD typically have a weaker sense of time, possibly due to temporal processing abilities and executive functioning challenges. This makes it hard to accurately assess how much time has gone by or the amount of time a certain task will take. 

• Execute dysfunction- this is super important to understand. Executive functioning includes behavior and emotion management skills, planning and reasoning skills, working memory, and cognitive flexibility. A perfect example would be making a meal from scratch; you have to buy the right ingredients, initiate following the recipe and gather supplies like measuring cups, complete the recipe which requires focus and keeping track of time, and then followup with cleaning. Executive dysfunction is a key attribute of ADHD and this is a good summary with examples.

• Need for dopamine- Dopamine is a critical neurotransmitter for ADHD. Dopamine is all about pleasure and attention management. Brains with ADHD are often lacking in dopamine, resulting in behaviors that seek out increased pleasure. So if a task is very boring, like meal planning, it can be extremely hard to feel motivated for it. Also, food is a legit source of pleasure and dopamine! More about this neurotransmitter can be found in this article. 

With this understanding, we can anticipate common forms of restriction may be:

• Skipping meals unintentionally through things like time blindness or hyperfocus.

• Hunger suppression due to ADHD medication.

• Difficulty making meals due to executive functioning challenges.

These are just a few examples. All of these scenarios are setting you up for a binge. The most important thing you can do around binging is to not demonize it and not shame yourself for it. This is another way you set yourself for more binging behavior, more restriction, and more self-loathing. Again, the binge is not where you need to intervene- the places of restrictions are where you pay attention. Binging often serves a purpose, and often serves an important function for us. Get curious about what binging may be in response to, what you get out of it or like about it, and how it is trying to care for you.

The main point I want to make with this is go easy on yourself.

Watch what morality you place on your food choices, and watch harsh judgements you make on yourself. IE is a great goal, and having more peace with food is fabulous. And, there are going to be legitimate things that complicate that. Approach yourself with compassion!

In part two of my blog series on ADHD and the Binge/Restrict Cycle, I’ll offer practical tips to break out of the cycle. Stay tuned! And in the meantime, you can contact me for support and additional resources.