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Is there a connection between RSD and eating disorders in ADHD? 

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Updated
ByMy Patient Advice
Author: Dr. Rebecca Fernandez, MBBS

Emotional regulation challenges are a hallmark of ADHD. Rejection Sensitivity Dysphoria (RSD), the intense emotional pain triggered by perceived rejection or criticism, can make this even harder. For some people, food becomes a way to cope with these emotions. According to NICE guidance (NG87) and the Royal College of Psychiatrists, impulsivity and emotional dysregulation in ADHD can increase vulnerability to disordered eating behaviours, especially when linked to rejection, shame, or low self-esteem. 

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How emotional sensitivity affects eating behaviour 

Research in Frontiers in Psychiatry and PLOS ONE suggests that RSD and binge-eating share overlapping brain circuits involving dopamine (reward processing) and amygdala hyperreactivity (emotional arousal). When someone feels rejected or criticised, these systems can drive impulsive eating or restrictive control as a way to manage distress. NHS clinicians note that individuals with ADHD may eat to soothe rejection-related anxiety or to regain a sense of control when emotions feel overwhelming. 

The link between rejection and disordered eating 

Emotional pain from RSD can trigger patterns that resemble binge-eating, restriction, or emotional eating. In adolescents, repeated social rejection can lower self-esteem and reinforce perfectionism around body image. Adults may describe using food to numb feelings or to cope with emotional emptiness. Studies in ScienceDirect (2022) and Frontiers in Psychology (2025) show that emotional dysregulation predicts disordered eating severity in people with ADHD, particularly when combined with depressive symptoms or trauma history. This suggests that rejection sensitivity is not the cause of eating disorders, but a powerful emotional amplifier. 

Managing both conditions together 

Effective care involves treating ADHD, emotional regulation, and eating patterns as interconnected. 

  • Cognitive Behavioural Therapy (CBT) can help individuals identify emotional triggers that lead to eating episodes. 
  • Dialectical Behaviour Therapy (DBT) and mindfulness support distress tolerance and body awareness. 
  • Nutritional and psychological support should be trauma-informed and sensitive to rejection patterns. 
  • Medication reviews can ensure ADHD treatment is not contributing to appetite changes or mood swings. 

Private services such as ADHD Certify provide structured ADHD assessments and medication reviews that can complement psychological care and support emotional stability. 

The takeaway 

There is growing evidence that RSD and eating disorders in ADHD share a common emotional root: difficulty managing rejection, shame, and impulsivity. Recognising this link helps clinicians and individuals focus on integrated treatment, addressing both emotional pain and eating behaviours in a compassionate, evidence-based way. 

Discover if you have ADHD
Dr. Rebecca Fernandez, MBBS
Author

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

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