Illustration by Cathryn Virginia
How to wrap your head around the finer points of prescription drugs.
When Spencer Jardine was 15, she was diagnosed with attention-deficit/hyperactivity disorder (ADHD) and prescribed treatment in the form of Adderall. Within days, Jardine began experiencing the drugs effects: greater focus and less impulsivity, as promisedbut also a dry mouth and a drastically lower appetite. Jardine lost 20 lbs. off her 53 frame, growing so thin that she covered herself in bulky sweatshirts to disguise her body and drank the kids nutritional supplement PediaSure to try to gain weight.
Jardine, who is now 28 and a stay-at-home parent in Truckee, California, recalled that, at one point, her high school guidance counselor asked her if she had an eating disorder. I was like, I take meds that make it very hard for me to eat, but she didnt believe it, Jardine said.
While not every person on ADHD medications experience decreased appetite, many do; according to recent research, at least half of children and possibly an even greater number of adults experience some [...] appetite reduction from being on the medication, said Russell A. Barkley, a clinical professor of psychiatry at Virginia Commonwealth University School of Medicine.
When stimulants such as Adderall and Vyvanse (the most commonly prescribed ADHD medication for adults), along with others like Focalin and Concerta, raise the brains levels of the chemical dopamine to heighten concentration and combat restlessness and hyperactivity, they can also decrease appetite. While a lack of hunger is typically most extreme immediately after starting treatment, it can last as long as the drugs are usedwhich means that, for many people with ADHD, keeping a close eye on their daily food intake each day can be as essential as remembering to take the medication itself.
For those with a history of eating disorders and/or negative feelings about their bodies, monitoring food and weight is a double-edged sword. And even for people who dont have that history, our cultures obsession with thinness is so prevalent that it can be easy to fall into destructive thinking and unhealthy eating habits. Experts often say that being closely in touch with hunger is key for maintaining a healthy food intake, but if thinking more frequently than usual about your consumption is causing you to focus obsessively on it or view taking in fewer calories as a goal, it can do more harm than good. It also can make dealing with your ADHD more difficult, as it requires focusing intently on two complicated parts of your mental stateyour attention, and your relationship with food.
I have certainly seen [ADHD medication] being a contributing factor to the development of an eating disorder, said Anna M. Lutz, a nutritionist and dietician specializing in eating disorders. Part of it, she noted, has to do with diet culture; when decreased eating leads to weight loss, and weight loss leads to compliments from others, All of that can be... a trigger for body-related disorders, said Lutz. Treating ADHD through medication without allowing the side effects to negatively affect their eating habits can be a challengebut there are ways to cope. Below, experts provide advice on managing both the disorder and its side effect.
Write down your biggest concerns.
Whether you have a history of disordered eating or are just starting to deal with that issue, consider writing down your biggest fears and worries about how your ADHD medication could affect your eating habits. Seeing your concerns on paperWhat if I lose too much weight? What if I like weight loss, even though I dont need it?can make them seem less overwhelming, and easier to deal with. You can bring that list to your doctor or therapist and get their advice on how to approach each questionand think through any others that might come up along the way.
Talk to your doctor about your body- and food-related concerns.
If you have or had an eating disorder, or are worried that taking ADHD medication is leading you into worrying thoughts about your body, its crucial to be open about your concerns with your doctors at the beginning of your treatment plan. Lutz said that when she meets with patients who have both eating issues and ADHD, they work together on a nutrition plan that allows for both conditions to be addressed. Oftentimes, Id be talking to my patient about, What is recovery going to look like for you? What is nourishing your body going to look like for you, given that youre taking this medication? And can you recover from your eating disorder if youre taking this medication, if its kind of triggering those feelings? said Lutz. Depending on their answers, a nutritionist might suggest their patient talk to their doctor about switching to a non-appetite suppressing ADHD medication, or encourage the intake of foods that are both nutritional and easy to consume.
Discussing your relationship with your body and food with medical professionals can be uncomfortable. But it can also be necessary, especially if youre already eating less and losing weight due to your medication. If theres an eating disorder coexisting with ADHD, you have to treat bothno different than if you have ADHD and co-existing depression, for example, or ADHD and coexisting anxiety, said Peter Jaksa, a clinical psychologist at ADHD Center Chicago.
Set reminders for mealtimesand stick to them.
Before taking your medication each morning, have breakfast. Make sure you eat first, said Jaksa. That way, even if you eat lightly for the rest of the day, youve ensured youve gotten some nutrition.
Encourage yourself to eat later in the day by setting reminders. ADHD medication is typically at peak therapeutic levels around midday, or 23 hours after its ingested, Barkley noted, meaning people taking the drugs often experience the most appetite loss right when others would be having lunch. As a result, you might forget about mealtime completelyso making reminders for when its time to eat can be useful in order to avoid skipping out.
Lutz said eating by the clockwhether thats a few times a day at regular mealtimes, or at shorter intervals if you prefer snackingwill help keep things on track and should occur each day, regardless of how hungry you are.
Dont criticize yourself for not consuming the right foods.
Because forgetting or not feeling its urgent to eat is normal for those on ADHD medication, some people gravitate towards foods that are simple to make and to eatthink sandwiches over salads; soups over big spreads. Although these arent always the most nutritious options, they do the job, and according to Lutz, giving up some health value in order to ensure you eat enough can be perfectly fine. Try to remember that you still are getting some nutrition and, just as important, are feeding yourself on a regular basis.
Keep your loved ones in the loop.
Managing the effects of ADHD can be challenging enough, but when you add in having to constantly monitor your food intake and relationship with eating, it can become an exhausting mental burden. You dont have to carry it alonereach out to family and friends to let them know if youre struggling and tell them how they can support you best. Maybe your partner could check in on you during the day to remind you to eat, or perhaps your people have tips about pre-made foods that require little effort to eat. Even if you dont need help in those capacities, it can be a relief just to talk to someone about what youre going through.
Pay attention to your bodys warning signs.
Just because your stomach isnt rumbling doesnt mean youre not hungry. If your focus is waning and your mood is worsening despite the ADHD medication, that might be signs your blood sugar is too low, said Jaksa, and you need to eat. By skipping out on meals, Jaksa said, youre actually contradicting the effect of the medication, so its even more important to get some food ASAP.
Additionally, keep an eye on your eating habits when the drugs arent in your system. Catalano said that her lowered food intake during the day led to overeating once the medication wore off. When I crashed at night or took the weekend off from meds, I found myself craving really high-calorie foods to make up for the deficit I was in all week, she said.
Remember that readjusting your relationship to eating and your body can take time.
I would consider my relationship with my body and food to be a forever work in progress, said Erica Zenn, a Los Angelesbased 28-year-old in Diversity and Inclusion whos taken ADHD medication for 13 years. Slipping back into old patterns of thinking and behaving is so easy, especially when my relationship with my body and food is so intertwined with my self-worth.
Sravya Attaluri, a 26-year-old creative director in London, said she struggles with body dysmorphia, and while shes worked hard to not let her ADHD diagnosis worsen her dysmorphia, she also knows itll be a lifelong project. I've accepted that I may need ADHD medication for a long time, and, if that's the case, I need to put extra effort into taking care of myself and developing my willpower and self control so that I do not become a prisoner of my disordered eating, she said.
Consider trying a non-stimulant medication.
Although stimulants like Adderall and Vyvanse are considered the most effective ADHD treatments currently available, theyre not the only choices. Medications in the methylphenidate family, such as Ritalin and Focalin, are less potent stimulants, and non-stimulants such as Strattera, Clonidine, and Guanfacine also treat ADHD while targeting the condition in a way that doesnt typically lead to extreme appetite loss. That said, each of these alternative medications do come with their own side effects, said Barkley, such as nausea or insomnia, and anyone considering taking a non-stimulant or methylphenidate should weigh the cost-benefit analysis first.
If your ADHD symptoms are severe and you feel you can safely handle the appetite loss, a stimulant might be the best bet, but if your condition is more manageable, and youre concerned about eating less, talk to your doctor about other possibilities. When it comes down to it, said Barkley, Its just a matter of the tradeoff.
If you or someone you know is dealing with an eating disorder, you can contact the helpline of the National Eating Disorders Association (NEDA) at 1-800-931-2237, or visit their site. You can also live chat with a volunteer via Facebook Messenger, and text 'NED!' to 741741 for crisis support 24/7.
Follow Rachel Simon on Twitter.
View post:
What to Do if Your ADHD Medication Messes With Your Appetite and Body Image - VICE
