A Familiar Story
It is 11:37pm. Anna is in her favorite spot on the couch and isn’t loving this TV show. She wanders to the fridge, then the pantry. A bite of this, a bite of that, until she settles on making nachos…the sad, microwaved kind.
On the counter are the bags that contained the burgers and fries her husband brought home for them all, the only meal she had today. A leftover grilled cheese crust, lots of coffee, half a warm protein shake, and some soggy cheerios from the sticky, insistent hands of her toddler were all that made it into her stomach today otherwise.
She eats the nachos in front of the TV and stops when there are none left, leaving her mind quiet and her stomach uncomfortable.
How did she get here?
Understanding Anna’s Day
After waking up late (someone stayed up doomscrolling and watching too many Tiktoks!), chugging coffee, and rushing the crew out of the house this morning, Anna had missed her dose of her ADHD meds.
At 3:00pm, when her older kids wanted their afterschool snack, she realized she hadn’t eaten. She had been in “the zone” on a home renovation project (definitely not her project for work that is due in two days. She’ll do that tomorrow!) and the time had flown by. Anna shrugged it off because she rarely eats a real lunch anyway, her meds make it so she isn’t hungry.
As they settle in to do homework, she loses track of time. When the kids complain that they are hungry (again??), she realizes she has no idea what to make for dinner, the produce she bought last week has gone bad, and the idea of figuring this all out overwhelms her.
She asks her husband to pick up food on his way home from work and to get “something bad” since she hasn’t eaten all day and “can get away with it”. He arrives, her favorite Whataburger order in hand, because he knows how she gets when she is hungry. After the bedtime routine, her husband goes to bed, and she stayed up to have some “quality time” for herself.
The Connection Between ADHD and Eating Behaviors
Anna’s day is not an unusual one for people with Attention-Deficit Hyperactivity Disorder (ADHD). In ADHD (and other mental health conditions as well as various cognitive conditions) executive functioning is impaired, which can make it difficult to engage in healthy eating behaviors for a variety of reasons.
What is Executive Functioning?
Executive functions are top-down mental processes required when operating on automatic, instinctual, or intuitive processes is impossible or unlikely to be successful. They include the following:
Working Memory
Taking in new information, integrating it with existing knowledge and utilizing that information; planning, self-monitoring, problem-solving.
Inhibitory Control
Focus, verbal and motor behaviors, prioritizing, emotional intensity/expression, task initiation, attention, concentration, screening out irrelevant stimuli.
Cognitive Flexibility
Problem-solving, shifting between tasks, empathy, creativity.
These skills are very important in engaging in healthy eating behaviors, particularly in an environment where we have so many things competing for our attention.
The Impact on Food Choices
Those with ADHD and other conditions that impair executive functioning are more likely to consume ultra-processed foods (UPF) and less likely to consume produce and other nutrient-dense foods.
Western diets (defined generally as including ultra-processed animal products and overall containing high amounts of carbohydrates and fat) are associated with impairment in and faster declines of executive functioning, independent of weight gain and adiposity.
Therefore, those who are most vulnerable to eating large amounts of processed foods are at risk of then further increasing their intake due to the impact of the foods themselves. This makes it increasingly difficult for people to reduce their intake once they have established a pattern of frequent UPF consumption.
Eating Behaviors That Require Good Executive Functioning
Managing healthy eating habits requires significant executive function skills. Here are behaviors that can be challenging for those with ADHD:
- Budgeting for meals/groceries
- Meal planning
- Reading nutrition labels and applying the information
- Cooking multi-dish meals
- Remembering to bring the lunch you packed to work
- Eating a wide variety of foods
- Eating slowly
- Remembering what you ate earlier
- Completing food journals
- Calculating carbs for diabetes management
- Portion control
- Eating when hungry, due to poor ability to detect subtle levels of hunger
- Stopping when full when larger portion sizes available
- Resisting available food when not hungry
- Resisting sales on food
- Saying no to “food pushers” who encourage them to eat
- Resisting cravings
Eating Behaviors That Increase with Poor Executive Functioning
When executive function is impaired, certain eating patterns become more common:
- Eating for stimulation/dopamine
- Externally-prompted eating
- Consuming narrow variety of foods
- Fast food consumption
- Grazing/snacking
- Skipping meals
- Overeating
- Binge eating
- Purging
- Eating only when very hungry
- Eating until very full
- Buying fresh food that then goes bad due to forgetting to use it
- Emotional eating
- Binge drinking
- Fad diets
- All-or-nothing and black-and-white thinking about dieting (ex: “good” vs. “bad” foods)
- Frequency and intensity of cravings and difficulty resisting them
What Healthcare Providers Should Know
There are several factors to consider in the primary care setting where providers are often treating mental health concerns, including ADHD, and making recommendations for diet and nutrition.
Rising ADHD Diagnoses
ADHD in adults has increased since the pandemic. Between 2019 and 2023, prescriptions for ADHD meds rose by 23.8%, primarily in young adults and women. Many practitioners are likely seeing and treating more people with ADHD than ever before as a result.
Importance of Accurate Diagnosis
Because many mental health issues can present with executive functioning deficits, it is important to make an accurate diagnosis. Screening for depression, anxiety, and ADHD using the PHQ-9, GAD-7, and Adult ADHD Self-Report Scale, respectively, can be done quickly with these easily administered tools.
If treating with medication, prioritizing treating ADHD first can address co-morbid depression and anxiety. When the patient can function better in their daily life, their overall mental health is likely to improve as their outlook about future functioning brightens and they have fewer daily negative consequences.
Medication Considerations
However, ADHD medications have their own risks regarding eating behaviors. These medications often suppress appetite, which can contribute to undereating, grazing, and compensatory overeating at meals. These medications can also negatively impact sleep which may increase appetite and weight. Adults with ADHD are disproportionately likely to become impulsive overeaters — not because they lack discipline, but because the neurological wiring that governs impulse control is working differently.
Despite appetite suppression, these medications can improve executive functioning in a way that may reduce risk of aforementioned behaviors and increase ease of engaging in healthy behaviors.
How Health Providers Can Make Practical Recommendations for Better Eating Habits
Assessment Strategies
To determine impact of any executive functioning impairments on eating habits, it can be helpful to ask patients to complete a 24-hour food recall or longer food journal and note any deficits in:
- Variety of foods consumed
- Cooking abilities
- Consistency of food intake
- Intake of fresh foods
Effective Interventions
Rather than directing patients to simply “diet and exercise,” encourage them to:
- Increase variety of foods consumed
- Eat meals regularly throughout the day
- Consume more fresh foods (if available to them)
- Work to improve cooking abilities with fresh ingredients (Help available through Chef SA and SA Food Bank)
If deciding whether to remove a patient from an ADHD medication to start a weight loss medication, consider that removing their ADHD medication may make it more difficult for the patient to engage in necessary behaviors to support the results of a weight loss medication and may make a negative outcome (malnutrition, etc.) more likely.
The Role of Dietitians
Patients with ADHD and obesity are also likely to benefit from referrals to dietitians who can help them to improve their nutrition and health even if the client’s weight does not change. Dietitians can help those who tend to think in very strict diet terms engage in more sustainable behaviors to reduce risk of weight regain after fad dieting. Dietitians can also counsel patients on sustainable movement habits.
A Word About Motivation
A reminder to providers not to emphasize willpower or motivation, as these are not the issues contributing to any eating struggle. Those with ADHD are already likely to blame themselves and this message would further reinforce narratives that discourage effective action rather than enhance it.
Encouragement of sustainable habits and specific recommendations will go a long way in helping clients with ADHD to make progress in engaging in healthier eating habits.
Getting Support at Bariatric Counseling Center
If you’re struggling with ADHD-related eating challenges, our program offers comprehensive support through licensed therapists, registered dietitians, and behavioral strategies designed to address the underlying factors affecting your relationship with food.
Contact us today to learn how we can help you develop sustainable eating habits that work with your ADHD, not against it.
References
- Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168. https://doi.org/10.1146/annurev-psych-113011-143750
- Favieri, F., Tambelli, R., Chen, E., & Casagrande, M. (2024). Self-Regulation in Eating Behaviors: The Role of Executive Function in Response to Food Stimuli. Nutrients, 16(14), 2318. https://doi.org/10.3390/nu16142318
- Wyckoff, E. P., Evans, B. C., Manasse, S. M., Butryn, M. L., & Forman, E. M. (2017). Executive functioning and dietary intake: Neurocognitive correlates of fruit, vegetable, and saturated fat intake in adults with obesity. Appetite, 111, 79–85. https://doi.org/10.1016/j.appet.2016.12.039
- Attuquayefio, T., Stevenson, R. J., Oaten, M. J., & Francis, H. M. (2017). A four-day Western-style dietary intervention causes reductions in hippocampal-dependent learning and memory and interoceptive sensitivity. PloS one, 12(2), e0172645. https://doi.org/10.1371/journal.pone.0172645
- Gomes Gonçalves N, Vidal Ferreira N, Khandpur N, et al. (2023). Association Between Consumption of Ultraprocessed Foods and Cognitive Decline. JAMA Neurol. 80(2):142–150. doi:10.1001/jamaneurol.2022.4397
- Huskamp, H. A., Busch, A. B., & Frank, R. G. (2025). Recent Trends in Medication Treatment for Attention-Deficit Hyperactivity Disorder. Psychiatric services (Washington, D.C.), appips20240574. Advance online publication. https://doi.org/10.1176/appi.ps.20240574
Related Articles
Continue Learning About Eating Behaviors and Mental Health:
- What Is Emotional Eating?
- How to Stop Stress Eating: Simple Strategies to Take Control of Your Habits
- How Do I Manage Cravings and Impulse Eating?
- Binge Eating Disorder: The Symptoms, Causes, and Effective Treatment Options
- Understanding Types of Motivation
- Sustainable Eating Habits: Tips for Long-Term Wellness
How does ADHD affect eating habits?
ADHD can affect appetite regulation, impulse control, and routine, which may lead to skipped meals, impulsive or distracted eating, and using food for stimulation. Some ADHD medications also influence appetite.
Is there a link between ADHD and emotional eating?
Yes. Difficulty with emotional regulation and impulsivity, which are common with ADHD, can increase emotional and binge eating. Structured behavioral support can help.
Can therapy help with ADHD-related eating patterns?
Yes. Behavioral strategies that build routine, awareness, and coping skills can make eating more consistent. BCC’s San Antonio team tailors support to how ADHD affects your relationship with food.
