Weight Management and ADHD - Some Guidelines

By John Fleming, Ph.D., C.Psych.

1. Emphasize positive action over restraint. People with attention deficit disorder are typically better when they can throw themselves into doing something. Having ADD is like having a good engine and lousy brakes. By placing your emphasis on doing things such as cooking, shopping, ensuring that you eat enough vegetables, or initiating a program of exercise, you are emphasizing positive action. Engage that high revving engine and push yourself to get up and do something.  Consider alternatives (try to avoid the “ready, fire, aim” problem) and force yourself to choose a course of action.

2. Use environmental constraints. Don't expect to always resist temptations, try to avoid them instead. Keep the foods you typically overeat out of the house. Plan to eat difficult foods with a friend or in a public setting. For example, choose to go to McDonald's with someone who eats in moderation. Schedule outings to such places infrequently, such as once a week.

3. Don't try to keep your mind off of thinking about food. The positive side of distractibility is using it to focus your mind on something else. Redirect your thinking by engaging in an alternate activity. Do something you really enjoy or are excited about.  People seldom report difficulty with overeating when they are actively engaged in something challenging and rewarding.

4. Respond positively to changes in mood and fatigue. When you feel a slump in your energy or mood, do what comes un-naturally. Force yourself (without asking whether you feel like it) into a short burst of activity, such as a 10 minute brisk walk. This will leave you with greater energy, decreased tension, and less subjective hunger.

5. Use delay tactics to help avoid a binge. If you have a powerful urge to binge eat, tell yourself that you must first go for a walk or do some other activity which requires either physical output or mental engagement.

6. Make sure that you get your minimum daily requirement of stimulation. Bored and restless will frequently translate into hungry. By ensuring that you provide excitement through active engagement in challenging and interesting tasks you will decrease your reliance on food for amusement. Try to avoid watching TV since it provides so little satisfying stimulation, and is a terribly common occasion for overeating. If you must watch TV, find something else to do while you watch (reading magazines, needlepoint, check your email….). If evenings are difficult for you, find a night course to take, volunteer for something you believe in, embark on a program of self directed study.

7.Freedom through commitment. One of the major stumbling blocks for individuals with ADD is their resistance to committing themselves to a schedule that clearly defines what they are going to do throughout their day (not just at work). They typically associate schedules with their past struggles to fulfill the expectations of others. Without commitment to a plan, people with ADD tend to spend much of their personal time floating around and accomplishing little. Without commitment, people live in a chronic state of low satisfaction because their behavior is driven by external pressure rather than by personal choice. While there will always be external pressure, it is much easier to resist these forces when one has a clear personal agenda. Discover and define what you love the most, what gives you the greatest fulfillment, what you want to be remembered for, and try to ensure that you spend as much time as possible committed to these things.

8. Hunger and fullness awareness. People with ADD are notorious for their poor awareness of feeling states. With so much going on in their heads and the tendency to always be thinking three steps ahead, they are often disconnected from what they are feeling. While it may sound ridiculous, many people with ADD need to be reminded to eat in order to avoid getting overly hungry and thereby greatly increasing the chances they will overeat. Set reminders for yourself, however many are necessary, to ensure that you eat every four hours. Similarly, don’t fool yourself into thinking that you will know when to stop eating. When left on autopilot, people generally eat enough to maintain their current weight. Use preset serving sizes, measure, or count. Alternatively, try to stay focused on the changing feeling states during a meal, and practice stopping at the different feeling states that proceed “stuffed”. Try eating with a friend who may be able to talk you through it. Learning to know when to stop eating takes a substantial amount of effort and time, don’t think it is easy or obvious.

9. Eating well takes a fair amount of time and planning, two things that are typically not in abundance in the lives of individuals with ADD.  Don’t try to be the Martha Stewart of good eating. Every meal is not going to be “special” or completely balanced. Just make sure it is satisfying, adequate, and within striking distance of “balanced”. Simplify, make it do-able, get help with meal planning, shopping (try internet sites for meal planning since they generate shopping list and then place an order with Grocerygateway for example). Do a group cook. Get creative. Understand that “good” food is not nearly as easy to find as “bad” foods.  High fat foods are available in abundance, from the ubiquitous fast food restaurant to your local gas station. Squirrel away good food (dried fruit, yogurt, nut mix, meal replacement bars) that can be eaten in a pinch if time pressure and other demands keep you from having a proper meal.

10. Don’t give up when you blow it.  Eating well is not an all or nothing business. Don’t berate yourself when you make a mistake. Mistakes can be overcome, don’t label them as a failure, which is so much more ominous. Don’t be hard on yourself. If yelling at yourself was effective, wouldn’t you be perfect by now? Try to understand what went wrong, and create an action plan for a different approach. Recognize and celebrate success.