Attention deficit hyperactivity disorder affects many young school-age children with approximately 5 percent of children affected by the condition. Because three times as many boys are affected as girls, the effects on girls have not been fully explored. A study from 2008 found that girls who had ADHD were at a significantly higher risk for developing an eating disorder during adolescence than girls without ADHD. Led by University of Virginia psychologist Amori Yee Mikami, the study showed that girls with ADHD often developed a problem with body-image dissatisfaction that led to patterns of behavior characteristic of bulimia nervosa. Symptoms that often lead to testing for ADHD include a short attention span, excessive talking, disruptive behavior and restlessness and irritability. It often manifests itself in lower academic achievement and poor relationships both in the family and among social networks at school, including teachers and friends. The authors of the study note that because ADHD is largely associated with boys, many girls with the disorder are not identified as struggling with the disorder and may be left untreated. Because girls with ADHD struggle with impulsivity, they may be more at risk for developing an eating disorder. As they get older, impulsivity may lead to problems with weight gain and result in binging and purging patterns. The researchers recruited 228 girls in the San Francisco area, of which 140 had been diagnosed with ADHD. They were interviewed first between the ages of 6 and 12 and a follow up session was conducted five years later. The results of the analysis revealed that girls who had a “combined type” of ADHD (both inattention and hyperactivity/impulsivity) were most likely to exhibit symptoms of bulimia nervosa. Girls who had the “inattentive type” of ADHD (inattention only) and girls without ADHD were much less likely to display symptoms characteristic of bulimia. Additionally, girls with both types of ADHD were more likely to be overweight, to have a history of harsh or critical parenting and to have been rejected by other girls who did not suffer with symptoms of ADHD. The authors believe that these experiences may contribute to the presence of symptoms of bulimia. The researchers also indicate that an additional concern is related to the stimulant medications used to treat ADHD. The drugs have a side effect of appetite suppression, which may tempt overweight girls to abuse the medication to aid in weight loss. Though the researchers have not tested the theory, it may be necessary for further understanding of the dynamics of girls with ADHD who struggle with binging and purging cycles. The findings of the study appeared in the Journal of Abnormal Psychology.