Stressed! Grab a bite? Stress eating in adults with Attention-Deficit/Hyperactivity Disorder: An Ecological Momentary Assessment study

Abstract

Meta-analytical evidence suggests that adults with Attention-Deficit/Hyperactivity Disorder (ADHD) face a 70% higher risk for obesity. Elevated levels of stress, the lack of adequate stress coping strategies, and the tendency to overeat might make individuals with ADHD vulnerable to stress-induced eating, i.e., engaging in (over)eating when feeling stressed – a behavioural pathway through which ADHD symptomatology may contribute to obesity. Research indicates that particularly impulsivity symptoms of ADHD are associated with overeating. This study is the first to use Ecological Momentary Assessment (EMA) to assess (1) whether stress is generally associated with (over)eating in adults with ADHD and (2) whether trait and state impulsivity moderate the stress and eating relationship. Thirty-six adults with ADHD completed a 3-day EMA period. Participants reported perceived stress and state impulsivity eight times a day (signal-contingent) and recorded food intake (event-contingent). Multilevel two-part models were used to study the relationship between stress and the occurrence as well as the amount of food intake. Stress was not related to the occurrence and the amount of food intake. Trait and state impulsivity did not moderate the stress and eating relationship. This study provides preliminary evidence that adults with ADHD might not be at particular risk for stress eating. Future studies are needed to replicate these findings. Advancing our understanding of eating – a central, indispensable human behaviour – in this under-researched at-risk population is crucial given its significant public health impact due to the high disease burden and personal suffering associated with obesity and ADHD.