Hannah’s struggle with low energy availability & ADHD

As a dietitian, it’s expected that you’ve got food sorted out. You see so many posts from other dietitians sharing their fancy recipes and perfect plans… and I just want to throw something.

Since moving out of home I’ve found food hard. All through uni I think I lived on oatmeal and pasta in various forms.

Food is hard sometimes

For me it’s the steps involved in planning, buying groceries, cooking and eating. For someone with ADHD food can be really overwhelming. It’s like every step is isolated and brings friction. For example, where someone may consider making a sandwich to be just a couple of steps, i.e get the ingredients from the fridge, cut them and then put it all together, I see many many steps, i.e. get up and transition from whatever activity I was doing, get the bread from the fridge, get the tomato, get the cheese, get to ham, get the chopping board out, slice the tomato, wash the knife, slice the cheese, etc. It get’s overwhelming!

The hardest step for me is the transitioning. If I’m deep in a task there isn’t enough drive to switch to doing something new – like there is just a mental wall that prevents me from moving.

I used to think that I was lazy and I felt embarrassed and ashamed because I felt that as a dietitian, I should have this worked out. Why could my clients seem to take on strategies while I struggled to eat anything.

ADHD Diagnosis

For so many years I was low key worried I had some form of memory and cognitive issues but never suspected ADHD until my husband asked me to help him with his own ADHD assessment / screen. As we read through the questions for him, we both couldn’t help thinking how highly I ranked on almost every single question.

I thought I was being dramatic and didn’t like the idea of self diagnosing but I brought this up with my psychologist at our next session and she said that she actually had flagged ADHD and did another screen with me. From there I was [eventually] formally diagnosed by a psychiatrist.

This diagnosis was so important for me to make sense of the things I struggled with, but had previously attributed to a character floor. It helped me develop actual strategies that would help my unique brain rather than continue telling myself to ‘just try harder’ or ‘just be better’.

Low Energy Availability

As I hope you’ve gathered, although I’m a dietitian, I find food hard and eating enough to fuel my body hasn’t always happened. When I increase training, I find it very hard to eat enough to meet my energy needs. There was a point in 2021 when I was training 7-8 times per week for 1-2 hours and forgetting to eat a lunch. I felt very low in energy and I had times where I felt like my body just wanted to shut down or sleep while I was at work and my menstrual cycle was irregular. My weight roughly maintained but I became leaner.

I felt like I was trying my best with food but it just wasn’t enough. I felt quite anxious about being in a state of low energy availability (LEA) but I felt that other’s didn’t really see it. People would comment that I was looking strong and lean and my GP didn’t believe my health issues were caused by LEA as my weight had maintained. At this stage, my husband and I, hadn’t yet fully understood how much ADHD impacted my ability to feed myself and so I felt a lot of shame that I was struggling with this.

Learning to fuel

With time, as I learnt more about how my brain worked and began to accept that, I was able to develop strategies that do work for me. The diagnosis also helped my husband understand and support me. Shame began to change to compassion. I stopped focussing on what I felt I ‘should’ be able to do and focussed on where I’m actually at. We often think we ‘should’ be capable of something but where do this arbitrary standards come from?

The point of this story

The strategies that work for me, make not work for others, so the purpose of this story is to share that if you struggle with food, you’re not alone. I, as a Sports Dietitian who has worked with countless athletes to fuel their high training loads, struggled to feed myself to the point it was having a very real impact on my health. However, things didn’t begin to get better until I gave myself some compassion.

If you’re struggling with food, you’re not alone and it’s okay. What is working for your friend, team mate, spouse etc may not work for you and that doesn’t make you a failure. There will be path forward for you and it’s going to be a lot easier to find when we take off pressure from arbitrary standards and focus on where you are currently at.