Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with disordered eating, especially addictive-like eating behavior (i.e., binge eating, food addiction, loss of control overeating). The exact mechanisms underlying this association are unclear. ADHD and addictive-like eating behavior are both associated with negative affectivity and emotion dysregulation, which we hypothesized are mediators of this relationship. The purpose of this systematic review was to review the evidence related to this hypothesis from studies assessing the relationship between childhood or adulthood ADHD symptomatology, negative affectivity, emotion dysregulation and addictive-like eating behavior. The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. The literature search was conducted in PubMed and PsycINFO (publication date: January 2015 to August 2020; date of search: 2 September 2020). Out of 403 potentially relevant articles, 41 were retained; 38 publications reported that ADHD and disordered eating or addictive-like eating behavior were significantly associated, including 8 articles that suggested a mediator role of negative affectivity or emotion dysregulation. Sixteen publications reported that the association between ADHD symptomatology and disordered eating or addictive-like eating behavior differed according to gender, eating behavior and ADHD symptoms (hyperactivity, impulsivity and inattention). We discuss the practical implications of these findings and directions future research.

Objective: This study aimed to investigate ADHD in adult outpatients seeking treatment for a behavioral addiction and to identify the specificity of psychopathological features if the behavioral addiction cooccurs with adult ADHD. Method: Sixty-five outpatients consulting for a behavioral addiction were assessed for ADHD (DIVA-5), addictive disorder (alcohol, tobacco, cannabis, gambling, gaming, food, and sex), impulsivity (UPPS-P), and emotion dysregulation (DERS-36). Results: In our sample of outpatients seeking treatment for a behavioral addiction, adult ADHD was independently associated with higher compulsive sexual behavior disorder severity, “sensation seeking,” “positive urgency,” difficulties in “goal-directed behavior,” “impulse control,” and use of “emotion regulation strategies” in the context of intense emotions. A 29% of the sample was diagnosed for adult ADHD. Conclusion: The association of adult ADHD with specific dimensions of impulsivity and emotion dysregulation, pave the way for future clinical and research perspectives.

Background: Addictive-like eating and attention-deficit/hyperactivity disorder (ADHD) are both common among persons seeking treatment for severe obesity. Given that ADHD and addictive-like eating, especially binge eating (BE) and food addiction (FA), are both strongly associated with personality dimensions and emotion dysregulation, it is possible emotional and personality characteristics contribute to the link between addictive-like eating behaviors and ADHD in people with severe obesity. This study aimed to investigate the psychological factors associated with BE and FA in bariatric surgery candidates, and to explore the mediational role of emotional factors (emotion dysregulation and alexithymia) and personality dimensions in the association between ADHD and BE.Method: Two hundred and eighty-two (n = 282) bariatric surgery candidates were recruited during the systematic preoperative psychiatric assessment (University Hospital of Tours, France). We assessed significant BE (Binge Eating Scale), probable adult ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (Yale Food Addiction Scale 2.0, YFAS 2.0), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), alexithymia (Toronto Alexithymia Scale-20) and personality dimensions (Big Five Inventory). Mediation analyses were performed using the PROCESS macro for IBM SPSS Statistics 22.Results: Prevalence of probable adult ADHD, significant BE and FA were 8.2, 19.1, and 26.6%, respectively. Participants who screened positive for addictive-like eating showed higher prevalence of probable adult ADHD, as well as higher scores on adult and childhood ADHD symptoms. They also reported lower conscientiousness, but higher emotion dysregulation, higher alexithymia, and higher neuroticism. Only BE (as opposed to FA) was also associated with lower scores on agreeableness and openness. Analysis of the association between adult ADHD and BE suggests that emotion dysregulation, conscientiousness, agreeableness, and neuroticism are total mediators and alexithymia a partial mediator.Conclusion: Our findings suggest a significant association between ADHD and addictive-like eating among bariatric surgery candidates, and also suggest a significant role of emotion dysregulation and personality dimensions in this association. For individuals with ADHD and obesity, eating may be a way to cope with negative emotions, potentially increasing the risk for addictive-like eating behavior.

"Background: Several psychological features are implicated in the dieting success. Better understanding of these features may allow reducing dieting failure of both surgical and non-surgical weight loss interventions, especially for individuals with food addiction (FA). In non-clinical population, low perceived self-regulatory success (PSRS) in dieting is associated with higher BMI (body mass index), FA, food craving and impulsivity. PSRS could partially explain weight gain in FA, but no study investigated this association in the specific FA population. Method: To diagnose FA, 288 women recruited online completed The Yale Food Addiction Scale 2.0. They also completed the following self-administrated questionnaires: the French adaptation of the PSRS in dieting scale, the Food Craving Questionnaire Trait-Reduced, and the Barratt Impulsivity Scale-11. They specified their height, current and lifetime maximal weight, and if they were in a current diet. Mean age was 26.1±10.3 years. Mean current BMI was 23.4±5.5 kg/m². Results: 79 women met criteria for FA (27.4%), indicating significant less PSRS in dieting and higher probability to be in a current diet to lose weight. In the whole population (n=288), PSRS in dieting was negatively correlated with current and lifetime maximal BMI, food craving, FA, attentional and non-planning impulsivity. In a multiple linear regression conducted in the subgroup of women with FA, PSRS score was predicted by age, current BMI, food addiction and food craving. More, results suggested food craving enable the association between food addiction and PSRS. Conclusion: These results showed the high preoccupation about food intake and weight gain in the FA population. Psychological features associated with FA such as food craving and impulsivity, seem to impact the PSRS in dieting, increasing psychological vulnerability."