Insatiable

how untreated ADHD may have been the root cause of my binge eating disorder

Photo by Siegfried Poepperl on Unsplash

CW: I will be discussing disordered eating and body dysmorphia, and if you’re in a place where that might be upsetting/triggering, please feel free to skip this one.

I spent most of my life being hungry. All the time. No matter how much food I ate, I always wanted more. I thought I was just a glutton. Insatiable. Greedy. I have spent incalculable hours thinking about food, how I eat, what I eat, and the size of my body.

My binge eating behaviors started somewhere around middle school. By 8th grade, I had filled out substantially. Puberty hit fast and furious, and suddenly I found myself with big boobs, wide hips and sturdy thighs. I had stretch marks and cellulite. My hair went from slightly wavy to a mess of curls I had no idea what to do with. I couldn’t fit into any of the offerings at 5-7-9 (millennials know what this is). I got my period when I was 14, which was a little later than some of my friends, but more or less on schedule. The week before my period was the time I was the most hungry (this is still true today). My appetite was ravenous, and I remember the feeling of never being satisfied, using all of my spare change to hit the vending machine every time I got a chance. I also suffered from fatigue and extreme mood swings, and food became emotional comfort. Up to 46% of girls and women with ADHD have Premenstrual Dysphoric Disorder (PMDD), but this was not a part of the conversation in the early 90s.

As my life became busier in high school, and my home life was descending into chaos, my binging behaviors got more frequent. Sometimes I would eat massive bowls of ice cream with hot fudge or peanut butter sauce (I worked at Baskin Robbins briefly, and I remember binging while closing up the store). Sometimes it would be a pile of Oreos with glasses of milk. Sometimes I’d eat half or more of a large pizza. Sometimes it was an entire bag of Cool Ranch Doritos and a 2L bottle of Pepsi. This was on top of normal meals, where I usually ate too much to begin with. My diet in general was atrocious, as I was too busy to eat properly. I always felt horrible afterwards, but once I started, it felt impossible to stop. I would eat too much, too fast. It felt completely out of my control, as if I were being governed by a powerful, unconscious force.

I did not develop bulimia or anorexia. I have always had emetophobia, something I still struggle with today. I hate throwing up more than just about anything, and if I feel nauseated it can trigger an anxiety attack. When I binged, I would inevitably feel sick, guilty, and anxious about gaining weight. I forced myself to throw up a couple of times, and found the entire experience so traumatic that I abandoned the idea of it entirely. I tried to just stop eating, but I could never make it more than a day. Instead, I’d go through periods of binge eating followed by crash dieting. I remember replacing meals with Slim Fast as young as 13. At one point, I was Sweatin’ to the Oldies with Richard Simmons, and using his Deal a Meal plan. I used Weight Watchers on and off for most of my adult life. I tried just about every diet plan out there.

You know you’re an 80s baby if you wondered if this guy would one day pop out and randomly surprise you while you were eating french fries in your car.

Eating quieted my brain down. As a teenager/young adult, I was dealing with a lot, and eating would muffle what felt like constant noise in my brain. It soothed my anxiety, especially if I was bored or sad. I went through the same cycle over and over again - binge, diet, binge, diet. As a result, my weight fluctuated. I covered up my body with oversized band T-shirts, flannels, and wide leg jeans. My burgeoning womanhood drew unwanted attention from the time I was in middle school, and I never felt comfortable under the male gaze. On top of that, I hated my body. I hated the rolls, the cellulite, and I especially hated my thighs. I stopped wearing shorts and skirts above the knee, and after some cruel comments at a pool party, I stopped wearing two piece bathing suits.

When I moved to New York for college, I felt the pressure to be thin in a way I never had, but the binge eating continued. One night, after a particularly terrible day, I ate an entire Entenmann’s chocolate cake and washed it down with a quart of milk (skim, duh!). That DID make me throw up. I had an aversion to frosting for a year after that. I always binged in secret. Then I would eat nothing but salad and water for days. I fainted once because I was taking caffeine supplements and attempting that lemonade cayenne cleanse that was all the rage. I was also an actor at the time, and it was made abundantly clear to every woman who was pursuing a career in the performing arts that you had to make yourself impossibly thin if you wanted any chance of having a career. It wound up being one of the reasons I decided to not pursue a career in acting.

Over time, my binges became less frequent. When I started therapy, and was able to talk openly about my disordered eating and body dysmorphia, it gave me a better understanding of my triggers. The hyperfixation on food, however, was still a challenge. The same thing would happen over and over again. I’d lose weight, keep it off for a few years, then gain it back plus some. My last big weight loss was before the pandemic. On the outside, I looked great, and was in the best physical shape of my life. I was also overscheduled, stressed out, obsessing over calories, and on my way to a mental health crisis. I still hated my body, no matter how much smaller I made myself. And I was still hungry all the time.

The pandemic sent me straight back into binge eating. I was bored, scared, stressed out, and had lost my ability to cope and mask. On top of that, my mother in law was dying from cancer in Fall of 2020, and food was a big source of comfort during that terrible time. Food helped keep the noise in my brain quieter, as did alcohol. Sometimes, in fact, I would have another drink because I didn’t want to eat anymore (drunkorexia is a useful term here), and I thought if I gave my stupid brain something else to do, I would put the potato chips down. Problem being that once you are drunk, the chips find their way back into the equation. It’s like playing Whack a Mole, but instead of winning a stuffed animal, you get weight gain and hangovers instead. I was in a terrible cycle and felt hopeless. I was also on antidepressants, which didn’t help. I gained over 40 pounds in a little over a year. I was still exercising regularly, but the weight kept piling on. My health began to suffer. Frankly, I felt like shit most of the time. Worst of all, I felt like all the work I’d done on myself in therapy had been undone. How did I get back here?

Unsurprisingly, people with ADHD (especially women) are prone to eating disorders, including Binge Eating Disorder (“BED”). People with ADHD don’t have good control over their attention spans, and that can create fixations on food, and we also tend to struggle with impulsivity. Once I started thinking about food, it was all I could think about, and my brain would not stop thinking about it. I’d have very specific cravings, and a disappointing meal could ruin my whole day. Once again, it’s all about the dopamine. Binge eating can increase the dopamine levels in the brain, and since ADHD brains don’t make enough dopamine for executive function and mood regulation, food becomes yet another way we self-medicate.

Boredom - and I was SO bored - has always been a bad thing for my brain. Eating gives you something to do. My busy life had come to a screeching halt, and my brain needed to get dopamine from somewhere. Narratives have always helped me cope, so I imagine that a busy little Dopamine Rat has always lived in my head, like Templeton from Charlotte’s Web.

Since being diagnosed and going on medication, I stopped binging.

I didn’t even have to think about it. It just stopped. I also have not had an episode of binge drinking (I’ll talk about booze in a later post). I’m not naïve enough to think I’m cured, or that I will never struggle again, but it has been an illuminating reprieve.

Stimulants are well known to suppress the appetite, and for the first few months on meds, I was not hungry. At all. In fact, I had to remind myself to eat. That has worn off quite a bit, but the noise in my head around food has grown quiet. I am not obsessing about food, and to my surprise, my body dysmorphia is a lot better. I don’t experience the self loathing I used to when I look in the mirror. I am working on healthier habits, but I’m also not depriving myself. When I am full, I simply stop eating. And, for the first time since I was a kid, I am not actively trying to lose weight. I lost a little of what I gained over the pandemic, and my joints are grateful, but it’s not as important to me as it used to be. I don’t weigh myself every day anymore. I feel more confident in my own skin, and I’m learning to appreciate my body in a way I did not think I was capable of. I feel healthy and strong.

Vyvanse, which is another stimulant medication prescribed for ADHD, was just approved by the FDA to treat BED, even in people without ADHD. Semaglutide medications such as Ozempic - which are prescribed for diabetes and weight loss - are now being studied to treat eating disorders as well as addiction. While these medications are controversial, I’m glad that science is finally catching up to the idea that eating disorders and issues around weight are not simply a matter of choice or willpower. I am hoping that the advances in medicine and the increased awareness of these issues will bring about positive changes for people who are suffering.

I still love to eat. I love food. I love cooking. I love trying new restaurants. I love sharing food with friends. Eating - like sex - is something we can do solely for pleasure. Women are punished harshly for their appetites and desires, and I have always seen the unfairness in that. We all deserve pleasure. It’s a wonderful and rich part of the human experience.

I can’t say I don’t have some big feelings about not understanding this sooner, but I keep coming back to gratitude. My relationship with food and my body is an ongoing process, and I am slowly deprogramming myself. It’s going to take a long time to undo decades of terrible messaging, but for the first time, I feel like I have a fighting chance to truly love my body. It is my home for life, after all, and I am grateful for it in a way I never thought I could be.