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Should you take ADHD medications if you have an eating disorder?

First things first, we are not your psychiatrist.
Our eating disorder recovery coaching is built upon 3 core values, self-compassion, curiosity and autonomy. We believe that you need to be informed to have full autonomy to make decisions throughout your recovery. As dietitians we are absolutely interested in how your medications impact your food choices and we wont you to be empowered with that understanding. However, we don’t have the training or depth of understanding that your psychiatrist will have. Please note that this is not advice on what you should, rather, information about medications to help you make an informed decision with your psychiatrist.

What are stimulant medications?

Stimulant medications are a type of drugs that increase activity in the brain. They are commonly used to help improve focus, attention, energy and emotional regulation in ADHD. Some common examples of stimulant medications include amphetamines, like Adderall, and methylphenidates, like Ritalin and Concerta.

How do they impact eating?

Appetite:

Stimulant medications can often suppress appetite, leading to decreased food intake. This is because they affect the part of the brain that controls appetite and satiety. This can often make eating regularly and adequately in recovery even harder.

If you are taking stimulant medication, you may notice your appetite changes across the day. Some medications are slow release and peak around lunchtime. You may notice appetite is greater at breakfast or at dinner but really low at lunch.

During recovery, appetite can give us helpful insights into what is happening in the body and medications can mask this.

Food Preferences:

Stimulant medications can also impact food preferences. Some people on these medications can notice changes in food preferences, often leaning towards more bland or simple foods. This might be due to the fact that these medications can sometimes make certain tastes or textures seem more intense, leading to aversion to complex or strongly-flavoured foods.

On the other hand, some people feel a grounding with medication and a greater capacity to tolerate different textures, smells and flavours. In these cases, some people find they may consume a wider variety of foods when medicated.

Dry Mouth:

It’s also worth noting that some people may experience a dry mouth as a side effect, which can impact taste and food preferences as well.

Impact on executive functioning

ADHDers often find stimulant medications help improve executive functioning, a set of cognitive skills that manage other abilities and behaviours. These include skills like working memory, flexible thinking, and self-control, which are essential for planning, organising, and managing time effectively. By improving these skills, the medications can help us better plan meals, make grocery shopping and cooking easier and help us remember to eat. More specifically, when we are feeling less overwhelmed, it’s easier to think more flexibly and be open to other challenges. For some people, this can be an easier headspace to challenge eating disorder thoughts & behaviours.

Emotional regulation

Not only does malnutrition / the eating disorder itself make regulating our mood tough, many ADHDers struggle with emotional regulation even with a nourished mind. It can feel like mood is here, there and everywhere and that can be super exhausting. You may noticed that the way we feel can impact our body image and how we feel about food. Often, if we aren’t feeling too crash hot, our body image feels worse.

For some people stimulant medications can have a significant impact on their ability to regulate their emotions.

To medicate or not to medicate?

Ultimately, this is a question to discuss with your psychiatrist. This is a complex question and a lot needs to be considered and your prescription may not be the same across your entire recovery journey.

To help you prepare for your next psychiatry appointment, you can consider:

note: if you are in the early stages of recovery, reflection can be tough and the eating disorder voice can be really strong, you may find it helpful to discuss these with a trusted loved one who knew you well prior to the eating disorder:

  • Did you notice changes in your intake when you started taking medication?
  • What are the biggest barriers to eating at the moment? Do they feel easier, harder or no different when you take medication?

Coping without medication

Here we come to an important conversation you can have across your care team. If you and your psychiatrist have or may decide to not medicate with stimulates at this point in time, do you have the tools to cope with the challenges that may present?

Sometimes in early recovery, developing psychological coping tools isn’t the focus as our malnourished brains struggle to engage with those types of activities. However, it’s still important to note where the challenges may present and harness the support of those around you. Here, the eating disorder will likely tell you that ‘no one understands’ or we feel extreme guilt for putting them in this situation and it can feel really isolating. Our encouragement to you is to push as hard as you can against that eating disorder voice and let your loved ones support you. This may be calling on support for someone to:

  • Plan meals with your or for you
  • Do the grocery shopping with you or for you
  • Pack lunch for you
  • Gently remind you to bring lunch with you
  • Help you regulate your emotions. Sometimes it’s helpful to agree on what this might look like ahead of time e.g. “when you notice I’m getting agitated, please gently prompt me to do something different / give me a hug / go have a shower etc”

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