Eating Disorders, ADHD & RSD…Oh My!
Rebecca spent 37 years trying to be perfect. And exactly zero minutes succeeding.
Not that anyone else could tell.
From the outside, she had her life together as a high-powered attorney with a sharp wardrobe and her hair rarely out of place. She could argue a case in her sleep — but couldn’t, for the life of her, figure out how to feel good enough.
Because underneath the pricey skincare and practiced confidence, she was a walking stress case. Thanks to the holy trifecta of ADHD, rejection-sensitive dysphoria (RSD), and an eating disorder that just wouldn’t quit.
ADHD: Her Unexpected Party Guest
Growing up in her culturally Jewish family, Rebecca was expected to be driven, brilliant, and effortlessly put together. She didn’t know she was an ADHDer until she was 32—which, honestly, was impressive considering she had spent her entire life losing things, zoning out during conversations, and forgetting to eat until she was feral with hunger.
ADHD was the quirky roommate in her brain. People saw her as smart as hell and vibrant. She had worked at least twice as hard as anyone she knew. And she played the role of a “successful person” outwardly so well that she became one.
What she actually felt was that something was wrong with her. She never felt quite like she fit in. And, she often felt like someone or the other was disappointed in her. It’s because her ADHD came with a nasty little thing called rejection-sensitive dysphoria (RSD). Which meant that every mildly critical email, unanswered text, or weird look from a stranger on the subway felt very personal.
🧠 The Science: RSD is an intense emotional reaction to perceived or actual rejection, criticism, or failure, often causing deep shame, anxiety, or avoidance. It is commonly associated with ADHD and can lead to overcompensating for approval, self-sabotage, or extreme emotional distress in personal and professional relationships.
Which brings us to the food thing…
The ADHD-Eating Disorder Connection
From an early age, Rebecca understood one fundamental truth: if you can’t control your brain, control your body.
ADHD made life unpredictable, but food? Food could be tracked. Restricted. Managed. And in her family, looking good wasn’t just encouraged—it was expected. Thinness was proof that you were disciplined. Beautiful. Successful.
So she became very, very good at control.
She skipped meals in high school because it made her feel powerful. She learned to ignore hunger pangs like they were a suggestion, not a necessity. And when that backfired (because, spoiler: it always does), she binged in secret and punished herself after.
🧠 This was a documented, science-backed connection:
People with ADHD are three times more likely to develop an eating disorder (Brewerton, 2021).
30%–42% of people with eating disorders also have ADHD (Bleck et al., 2015).
ADHD impulsivity leads to binge eating, while RSD and perfectionism push people toward restrictive eating patterns (Davis et al., 2021).
For Rebecca, it was all connected—ADHD made her impulsive, and RSD made her terrified of failure.
Both made her desperate to control something, anything.
ADHD Coaching Changed Her Mind
At 35, after yet another friendship imploded over something she later realized was probably not that deep, Rebecca decided she needed help. She had tried therapy — helpful but slow. She had tried journaling — which lasted three days because she was copy edting everything. And then she read about ADHD coaching.
🛠 We came up with a few coaching exercises that were based on her learning style and goals.
My Dopamine Menu – Instead of using food to self-soothe, she made a list of dopamine-boosting self-care activities that didn’t involve sabotaging herself. Strongly scented candles and listening to feminist podcasts while getting dressed? Very effective.
Body Doubling Meal Prep – Since ADHD and her new medication made her forget to eat, she started FaceTiming a friend to food prep for her week. It felt a little childish at first, but she realized it was supporting her friend too.
What My Heart & Gut Say… – RSD made her say yes to things she didn’t want to do just to avoid disappointing people. We worked on understanding the signs her body was giving her about the situation.
A Work in Progress is Fine
Now, at 37, Rebecca wasn’t “fixed”—because that’s not how brains work. But she was better.
She still had bad days. There were still mornings when she picked herself apart in the mirror. Nights when she had to talk herself down from overanalyzing a text. But she had tools now. She had language for what was happening. And she had proof that she was never actually broken, to begin with.
And maybe, just maybe, she was finally okay with being a little bit of a disaster—because the truth is, she always had been wonderful anyway.
ADHDers don’t need more willpower—we need more supportive resources in our lives.