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ADHD and Intuitive Eating
By: Donae Cannon, OTR/L
I'm a fan of intuitive eating. Like many of us, I found myself with some broken trust when it came to my body, not just my brain. It's not easy to learn to honor our body's signals and ditch food rules when we live in a culture as enamored with dieting as ours. Personally, I found IE an important part of my eating disorder recovery. But...(you knew there was a but coming, right?).
IE has some snags when it comes to ADHD brains. I don't say this to discourage others from IE- just the opposite. I say this to mitigate any shame that crops up if you have ADHD and find that this complicates the process of learning how to eat intuitively (like it did for me). Like me, you may find that you need to tweak IE for your unique brain. Below are some of the challenges that can complicate the practice of IE for those of us with ADHD and what we can do about it.
1. Medication
For those who use medication to manage ADHD, medications frequently interrupt hunger and satiety cues. A lack of physical hunger doesn't mean that our bodies don't need calories. If we rely only on hunger signals to prompt us to eat, we might find ourselves feeling horrible before we even consider eating.
Suggestion- Sometimes, we need more planning in our diets to adjust for the impact of medication on our appetite. That doesn't necessarily mean pushing through a 5 course meal while dealing with appetite suppression, but it may mean eating before medication or eating before we feel actual hunger. This doesn't mean you're not "doing intuitive eating right". True intuition leaves us room to interpret not only our body's signals, but our unique circumstances and context.
2. Executive Function (EF) Challenges
A key tenet in IE is being able to eat the foods that our bodies are calling for-without guilt, shame, or moralizing our choices. Having a variety of foods as options requires a certain amount of planning and preparation, though, and that can present a challenge for those of us with ADHD.
Maybe I want Oreos or maybe I want stir fry, but the Oreos require no extra steps beyond opening their package, whereas the stir fry takes a load of planning and preparation. I need to plan the ingredients I want in the stir fry, shop for ingredients, cut and wash vegetables, wait for the stir fry to cook, etc.). All of this planning taps into a set of skills that are often challenging for those of us with ADHD- executive functioning skills.
Let me be clear- there's nothing wrong with eating Oreos instead of stir fry if that's what you want, but it takes a good deal of intentionality and planning to provide yourself with TRUE options when it comes to food. On a whole, shelf stable and processed foods are easy to have on hand while other foods take much more planning if we want to have them as options.
Suggestion- Simplify, shortcuts, AND habit formation. If you find food prep and cooking overwhelming (and many of us do, due to the executive functioning demands), hunt for ways to simplify and add short cuts. If your budget allows, pay for convenience. This can mean picking up grocery orders, pre-cut and washed produce, prepared or partially prepared meals, etc.
Another suggestion is looking at creating habit formation around food preparation. Some of us live with brains that recoil from habits and routines (me!), but the irony is, we need them more than most. When trying to build new habits, it helps to "anchor" a new task to one that already exists. Example- I charge my phone before I go to bed. If I want to add the habit of planning dinner for the next day, I can choose to do that after I plug in my phone each night so it's easier to get that habit to stick.
3. Hyperfocus
Attention regulation is a challenge for those of us with ADHD. This can show up as inattention to less preferred tasks, but it can also show up as hyperattention/hyperfocus on interesting or preferred activities. This hyperfocus can cause us to become so absorbed in a task that we're oblivious to our external environment and even our internal sensations (like hunger). We can miss our body's signals completely and neglect basic needs such as using the bathroom, sleeping, or eating. When in a hyperfocus time warp, intuitive eating may get derailed.
Suggestion- It may be helpful to be in the habit of having some quick/ready nutrition prepared for fueling your body when you suspect you may "lose time" with hyperfocus. This may also be a time when we approach food more systematically rather than intuitively. Although I often rely on my body's signals to determine what, when, and how much I eat, there are other times I choose to eat with the intention of fueling my body apart from these signals. This is referred to as "practical hunger" within the IE framework. If I suspect I'm likely to hyperfocus for a time (for me these are usually artistic/creative endeavors) I either try to eat something before I start or have food ready to go and set a timer to eat for later in the day.
4. Dopamine system in ADHD brains
ADHD brains have a less efficient dopamine system. Many people with ADHD describe seeking out dopamine "fixes" in daily life and find themselves drawn to pleasure seeking behaviors more than their neurotypical peers. This pleasure seeking pattern can show up in food choices, and can drive those with ADHD to use food as a regulation tool. This makes becoming attuned to our hunger more complicated.
Suggestion- Try to find ways to boost dopamine levels throughout your day. Experiment with things like exercise, meditation, rest, and creative/fun activities and make these "feel good" activities a priority. Notice if any of these things impact cravings, energy level, or mood. This is not about "good" or "bad" eating, it is about knowing your brain and trying to be proactive in giving it what it needs.
5. Emotional regulation and Impulsivity My sister used to tell me that I "burned bright" which was her kind way of saying that I had intense emotions and a difficulty staying in that "middle" zone. Difficulty regulating emotions often comes with the territory in ADHD. Eating can be a tool used for emotional regulation, and is often one that is used without awareness.
Impulsivity is also common in ADHD. A neurotypical brain may respond with more of a pause before eating than a brain with ADHD. This pause gives space to listen to one's body and evaluate needs and preferences. Many with ADHD tend to be quick responders, so pausing between impulse and action may not always happen.
Suggestion- Explore mindfulness meditation. Mindfulness allows us to be in the moment and helps us pause without trying to jump off of difficult emotions or sensations. It builds our tolerance for a range of experiences and allows us to approach ourselves with curiosity instead of judgment. Like any practice, it takes time to learn this skill and it can be practiced in many different ways. Many people with ADHD shy away from mindfulness assuming they'll need hours of stillness to practice it, but this isn't true. Mindfulness can be practiced less formally during the tasks you are already doing in your day.
6. Sleep- Many people with ADHD have difficulty with sleep. Falling asleep, restless sleep, and staying asleep can all be problematic. A lack of sleep can affect our ability to control impulses and regulate emotionally, but it can also have hormonal consequences that impact our feelings of hunger and satiety.
ADHD Suggestion- Make sleep routines and schedules a priority. Regular sleep routines and practices can be helpful. Avoiding using electronic devices close to bedtime and using practices that help us gear down and disconnect before sleep can help facilitate better rest.
Supplementation can also be useful when addressing sleep difficulties. Magnesium deficiency is correlated with ADHD and some find that increasing magnesium intake has a positive impact on sleep. Melatonin is a hormone that plays a role in sleep cycles and can be supplemented to improve sleep (It's important to consult with your doctor when adding any supplements since these can interact with other prescription medications).
If you're an individual with ADHD who would like to practice IE, be encouraged. Arming yourself with knowledge about your unique brain can allow you to adopt the IE eating practices that serve you and adjust for your needs. Pursuing IE is a journey, but it's one that can be valuable in rebuilding trust in your brain and your body.
If you are interested in learning more about how to work with your unique brain to create the changes that matter to you, please contact me for a free discovery call below.
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