Bulimia Nervosa and ADHD: More Proof of a Connection

Recent studies have shown greater-than-expected comorbidity of attention deficit hyperactivity disorder (ADHD) in persons with bulimia nervosa (BN). Altered dopaminergic activity has also been reported in these individuals. Researchers from the Eating Disorder program at Toronto General Hospital recently described the results of their study of 120 normal-weight subjects with current or past BN, purging subtype.

The mean age of the subjects was 25 years and the mean body mass index (BMI) was 23 mg/kg2. Among the patients with BN, the mean frequency of binge eating/purging was 23 episodes over the past 28 days. They had a lifetime substance abuse rate of 43%; 3% were currently abusing substances. The group had a mean lifetime anxiety disorders rate of 58%; 36% had current anxiety disorders. Thirty-two percent had a history of anorexia nervosa. The mean score on the WURS questionnaire was in the same range found in individuals with clinically significant ADHD symptoms.

The authors’ study provides early evidence of psychometric and genetic associations between BN and ADHD.

Eating pathology and ADHD

Dr. A. Y. Mikami and colleagues at the University of Virginia recently reassessed eating pathology, or body image dissatisfaction and symptoms of BN in a 5-year study of an ethnically and socioeconomically diverse sample of 93 teenage girls with ADHD and a comparison group of 88 teen girls (Abnorm Psychol 2008; 117:225). Baseline impulsivity symptoms, as opposed to hyperactivity and inattention, were the best predictors of eating pathology among the teens.