ADHD, Eating Behavior, & Weight: What You Need to Know with Dr. Karen Stewart, PhD

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Episode 31. This week I sat down with Dr. Karen Stewart, PhD. This was a very important conversation where we talked about her own experiences with dieting and struggles with food, her ADHD diagnosis, and how her personal journey led her to eventually become a health psychologist. Here are some of the highlights of this interview so you know what to expect:

Her process of repeated dieting and eventually having gastric bypass surgery a few years ago
How she decides whether to share her story with her personal network and with patients
Her personal and professional goal of hers to increase awareness of the relationship between ADHD and eating behavior
An overview of ADHD symptoms
Changes in how it’s diagnosed
The importance of understanding yourself and advocating for yourself with whatever psychological strengths and difficulties you might have

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Meet Dr. Karen Stewart

Dr. Karen Stewart is a licensed clinical psychologist specializing in behavioral medicine with expertise in weight management, bariatric surgery, and the impact of mental health symptoms on efforts at lifestyle change. In particular, she is interested in the largely underrecognized impact of ADHD symptoms in adults who are struggling with healthy habits.

Dr. Stewart has published a number of peer-reviewed articles and book chapters on assessment and treatment of a range of eating and weight related issues. She has also published in the area of integrated care and associated cost savings. Her career is focused on helping individuals realize their personal goals and the larger community by advocating for health care system change.

You can connect with Dr. Stewart on Twitter, Facebook, or Instagram.

Are You New Here?

Welcome! I’m so glad to have you. You might be wondering what this blog and podcast are all about.

We relate everything in this podcast back to motivation, but not the hustle and grind kind. Truly sustainable motivation that keeps you feeling energetic and engaged in your life for the long haul. We talk about why “I’m just not motivated” is a myth, and why the TYPE of motivation you have is so important to fully understand. If you are ready to learn about motivation and respecting your body in an effective way so that you can live a life you truly love, you are in the right place.

Check out the Foundational Episodes of the Motivation Made Easy Podcast here!

Introduction: What is this podcast all about?
Episode 1: Want to Get & Stay Motivated? A Crash Course on Motivation, Weight Loss, and Health
Episode 2: How Dieting Steals Our Motivation
Episode 3: How To Get Motivated To Improve Your Health (Motivation 101)
Episode 4: How to Transform Health Fears Into Forward Progress

“I’m terrified I’m wasting my life.”

I wrote this in a journal in the middle of the diet-binge cycle. And frankly, I kind of was.

I’m here to tell you it’s never too late to gain control of your eating, respect your body, and live a life that’s TRULY consistent with your values. But you need to take the first step.

One of the very first steps in developing truly autonomous and body respecting motivation is to clarify what actually matters to you. Not your mom, not your sister, not your best friend, YOU.

The more you reflect on this, the more you can connect your values to your behaviors in a sustainable and empowering way.

Grab the free guide at DrHondorp.com/goals and get started today. I promise you, it’s never too late to stop dieting and start truly living. You will not regret it.

Karen’s Personal Journey with Eating & Weight Struggles

Karen briefly explains her own personal journey with weight struggles and repeated dieting. She talks about how she was caught in a dieting cycle for years before ultimately deciding to have gastric bypass surgery around 3 years ago.

ADHD and the Impact of Not Being Diagnosed Until Adulthood

Karen shares that she and her brother both have ADHD, but hers wasn’t picked up on until adulthood. She goes on to talk about how the way ADHD presents in women and men and girls and boys can be very different, and many, many women are not diagnosed until adulthood or more specifically, until they become parents themselves and see it manifest in their own children.

ADHD is not a priority in the healthcare field and it goes undiagnosed more times than not, especially in women. It is possible to mask ADHD symptoms and learn how to cope with the disorder in some cases, so it’s sometimes left unrecognized or even misdiagnosed.

People who are undiagnosed may struggle with activities of daily life more than the average person and work harder to get things done, but they may have no idea they’re working harder because it’s all they’ve ever known.

What is ADHD and How Do You Know if You Have It?

The symptoms fall into three main categories, and these categories present in very different ways. See table for overview of symptoms in DSM-5 here.

Inattentive: This area is characterized by poor listening skills, misplacing items, becoming sidetracked, and forgetting daily activities. Dr. Stewart mentions that this is the type of ADHD she has, and it is usually more difficult to diagnose because the symptoms are quieter and less obvious to other people.
Hyperactive: Some telltale symptoms of hyperactive ADHD include fidgeting, restlessness, and always being on the go. This form of ADHD is easier to diagnose, as the symptoms are more at the forefront, and can significantly impact relationships.
Impulsivity: People with ADHD in this area tend to interrupt people, intrude in conversations, and blurt out answers. Like hyperactivity, impulsivity is easier to recognize than inattentiveness.

Children who are 17 and under require 6 symptoms to receive a diagnosis, and adults 18 and over require just 5 symptoms.

ADHD is not truly a deficit of attention, it’s actually a neurological difficulty in directing attention.
– Dr. Karen Stewart, PhD

“The experience can be highly reinforcing, and deeply painful.”

Dr. Stewart talks about how ADHD is extremely difficult to navigate, but it can also be a superpower in some respects. She shares that her ADHD causes her to hyper focus, and she doesn’t think she would have gotten through her dissertation without it.

Hyperfocus caused her to hone in on very small details and truly immerse herself in the work for an extended period of time. She says that she probably spent a lot longer on the dissertation than she should have, but it allowed for a quality result in the end.

Assessment of ADHD

She talks about the fact that now, there is less focus on neuropsychological testing to diagnose ADHD, and more on the clinical history and functional effects of symptoms.

She also states that adult diagnosis of ADHD can be tricky. It can often be impeded by a lack of evidence of symptoms as a child, as ADHD is a developmental disorder and much of the diagnosis is based on childhood symptoms.

For many with the disorder, however, symptoms can be less prevalent in childhood due to several factors, including high levels of intelligence, clear expectations, and structure in school and home environments.

Because of these factors, some children don’t really need to use many self-regulating skills at all.

ADHD, Eating, & Weight

There is an increased risk of obesity and a higher prevalence of emotional eating and eating struggles in some adults with ADHD.

But where does the correlation lie?

Where Might the Connection Be Between Weight & ADHD?

Association does not mean cause, but there is some longitudinal data suggesting that ADHD may cause weight gain. Mechanisms may include:

Increased binge eating and emotional eating: People with ADHD sometimes use food as a tool for emotional regulation.
Impulsivity: Those with impulsive symptoms have trouble saying no. For example, if there is a chocolate cake on the table that looks delicious but you have trouble digesting it because you are lactose intolerant, you’d have to work twice as hard to turn it away because impulsivity causes you to only focus on the satisfaction you’ll receive in the moment.
Infrequent meals: Dr. Stewart uses the example of people who only eat one large meal per day to expand on this. Those who have trouble with organization caused by their ADHD tend to focus on one task for long periods of time rather than multiple tasks throughout the day. They also have trouble maintaining structure and sticking to plans, which can sometimes put meals on the back burner until later on, leading them to eventually eat just one large meal per day.
Increased boredom and boredom eating: Boredom can be a common result of hyperactivity, and this can lead those who experience it to eat even when they aren’t hungry.

The Importance of Understanding Yourself

It is so important to understand your symptoms and how they manifest in your everyday life. Actively working to remove blame from yourself and learning to recognize and work with the tendencies caused by your ADHD can be freeing.

Finding positive, internally motivated outlets to regulate boredom and negative emotions can also make a huge difference in struggles with emotional eating and binge eating, and can make life more enjoyable in general. Be kind to yourself. You’ve got this!

Main Takeaways

ADHD is often missed, particularly in women. Dr. Stewart shares that her brother was diagnosed as a child, but given that her symptoms were primarily inattentive, her ADHD went missed until she was 40.
ADHD is underemphasized in the field. Dr. Stewart explains that ADHD is an area that is rarely considered in mental health in general, and rarely considered in terms of the impact it can have on weight and eating behaviors. We both received very little to no training in this area in our clinical psychology programs.
There are many ways that ADHD symptoms can impact eating behavior and/or weight. Understanding yourself and learning to work with your tendencies with self-compassion can be powerful. This will make the process much more successful and self-affirming.

Support Independent Bookstores Near You!

Did you know that that if nothing slows their momentum, Amazon will have almost 80% of the book market by the end of 2025?

Look, I love the convenience of Amazon, but I’ve got a super cool way that you can support local bookstores and my blog and podcast simply by buying books like you already do! You can choose any bookstore on the list in the US and Canada (they plan to expand to other counties in the future) OR you can just let the donation get split between all stores. As of this recording, they have raised 15 million dollars for local bookstores. On my bookshop, you will see my absolute favorite books related to health and wellness, courage and vulnerability, and even my favorite fiction and kids books!

My recent favorite related to improving the quality of our lives was Digital Minimalism. Our family actually has decided to do an optional screen free August to re-evaluate the role of screen time in our lives.

So if you believe in supporting local businesses, please consider buying your books through Bookshop from now on!

The Psychology of Wellness Bookshop Link.

Disclaimer: This blog and podcast is for informational and educational purposes only. It is not a substitute for individual professional advice or treatment, including medical or mental health advice. It does not constitute a provider patient relationship.

Disclosure: Using the Bookshop.org links in this post means that I would get an affiliate fee if you purchase from the online bookshop (this supports my business, and local bookstores too!).

Credit: This blog post was co-written and edited by Sarah Grace Rapoport, podcast and blog manager and Psychology of Wellness Intern, and Dr. Shawn Hondorp.