Cognitive and neural mechanisms underlying the relationship between Attention Deficit Hyperactivity Disorder and disordered eating behaviour

Lead Research Organisation: University of Birmingham
Department Name: School of Psychology


Disordered eating behaviour is a common comorbidity of attention deficit hyperactivity disorder (ADHD). Previous research has linked specific symptoms of ADHD (e.g. inattention, impulsivity) to specific types of disordered eating behaviour, and these relationships seem to be mediated through both negative mood and through attention to and reliance on internal cues of hunger and satiety. This PhD project will further investigate the mechanisms through which specific symptoms of ADHD lead to specific types of disordered eating. The project will first assess how inattention towards interoceptive cues of satiety/hunger may lead to disordered eating behaviour, through the completion of a systematic literature review and laboratory-based eating behaviour studies. The nature of the relationship between ADHD symptoms and disordered eating behaviour will then be assessed through the use of Lisdexamfetamine, a drug used in the treatment of both ADHD and binge eating disorder. This will allow the observation of the specific ADHD symptoms which are influenced by LDX, and how this effect may mediate the action of LDX on binge eating. The project will also assess the relationship between ADHD symptomatology and disordered eating behaviour in adolescents, which is of particular interest as ADHD symptomatology changes at this age and disordered eating patterns may emerge. This will be achieved through longitudinal collection of survey data, allowing the predictive modelling of which ADHD symptoms are most predictive of the development of disordered eating behaviour, which will be potentially useful in guiding development of preventative measures. A further laboratory-based eating behaviour study will assess the relationship between ADHD symptoms and disordered eating behaviour in adolescence, to observe how the longitudinal survey results are consistent with effects on ad libitum food intake.

Studentship Projects

Project Reference Relationship Related To Start End Student Name
BB/M01116X/1 30/09/2015 29/09/2023
1915105 Studentship BB/M01116X/1 01/10/2017 24/03/2022 Elizabeth Martin
Description Work conducted as part of this award has provided new insights into the neurocognitive processes that underlie disordered eating by 1) studying self-reported eating behaviours of young people with attentional deficit hyperactivity disorder (ADHD) and 2) examining the effects of the drug Lisdexamfetamine Dimesylate (LDX) (which is used to treat both ADHD and binge eating disorder) on food intake and cognition in the laboratory. An analysis of online data from a representative cohort of young people highlighted associations between of attentional symptoms of ADHD and the development of disordered eating over time. These data suggest that becoming distracted easily and having trouble focusing on the task at hand somehow increases the risk of disordered eating. How inattention links to disordered eating is not known but may relate to the ability to perceive or utilise signals from the body about nutrient status (feelings of hunger/fullness). In support of this idea, a systematic review of the literature completed through this award revealed that deficits in the process of interoception (e.g. sensing and interpreting internal signals such as hunger, heart rate and temperature) are linked to a range of disordered eating behaviours and eating disorders. This review also found for the first time that deficits in interoception across a range of modalities (e.g. cardiac, respiratory, pain, gastric) are associated with disordered eating. Analysis of data from a further online community dataset confirmed that the relationship between inattention is associated with disordered eating through problems using hunger and fullness to guide eating. Additionally, the data revealed that the perceived accuracy of internal signals (e.g. hunger) specifically explained the relationship between inattentive symptoms and binge eating, rather than the tendency to notice these signals. Finally, the results of a mechanistic study of the effects of LDX on food intake and cognition in young women with binge eating symptoms found that the drug reduces appetite and food intake and improves performance on a measure of sustained attention. These results suggest the observed effects of LDX on food intake (and by implication the efficacy of LDX in treating binge eating disorder) could be related in part to the actions of the drug to increase attentional control. Additionally, LDX reduced activity in the thalamus during viewing pictures of food, suggesting that a reduction in activation in this brain region may partially underlie the efficacy of LDX in treating binge eating disorder. Overall, the results from this award indicate that further investigation of the role of attentional processes in the development of disordered eating is warranted and that future research should also assess whether treatments and behavioural therapies that directly target attentional symptoms may prove effective in the management of both ADHD and eating disorders.
Exploitation Route The outcomes of this project highlight the potential role of attentional processes in the development of disordered eating and suggest that future research should consider focusing on attentional processes as a target for treatments of both ADHD and eating disorders.
Sectors Other

Description BBSRC MIBTP CASE studentship 
Organisation P1vital Consortium
Country United Kingdom 
Sector Private 
PI Contribution The research groups contributes student data and research findings to P1vital, as part of the supervisory role provided by the collaboration. In addition, during an industrial placement which is compulsory during the MIBTP studentship, the PhD student will contribute with analysing data and preparing presentations of this data for a project which is underway at P1vital.
Collaborator Contribution Colin Dourish (CEO of P1vital) provides a supervisory role throughout the PhD, particularly on studies involving his area of expertise (psychopharmacology). The MIBTP CASE involves an industrial placement for the PhD student, allowing the PhD student to learn research skills in non-academic organisations. After completion of the placement, a report is submitted to BBSRC by the PhD student to summarise the training experience, the novel expertise that has been learned, and new perspectives on the benefit of research collaborations.
Impact No outputs yet
Start Year 2017
Description Animated video titled 'What is interoception and what does it have to do with eating?' 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The activity was a short (3 minute) animated video of an introduction to one focus area of this award, the relationship between interoception and disordered eating. The role of interoception in the control of eating has been well documented and the aim of the video was to explain this relationship in an accessible way to the general public (approx 10+ years old). A questionnaire was made to accompany the video, to obtain quantitative and qualitative feedback from those who watched it. The majority of viewers rated the video 5/5 for how informative they found it and written responses indicated an increase in knowledge in the topic and requested more videos of a similar nature.
Year(s) Of Engagement Activity 2020
Description Online podcast covering PhD research topic 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Lab members were interviewed about their research area (including this award), and this interview was posted on youtube as a podcast. The inbuilt view counter on youtube shows that over 30 people have watched the video.
Year(s) Of Engagement Activity 2019