How Autism and ADHD shape eating disorder behaviours

We have recently published two studies exploring how Autistic and ADHD adults with binge- or purge-type eating disorders understand the ways their Neurodivergence influences their eating difficulties. You can read these papers here (bulimia-focused) and here (binge-eating focused). We have also written a separate blog post focusing on the support needs of this group.

Together with existing research on the links between Autism and anorexia nervosa (see review here), these studies help us better understand how Autism and ADHD can influence how eating disorders develop and present. 

In our two studies, we interviewed 26 adults with living or lived experience of bulimia nervosa, binge eating disorder, or other similar eating disorders, or they self-reported binge eating. 

Many participants told us that they found it difficult to fully understand how their Neurodivergence might be affecting their eating disorder. Despite this, they shared valuable insights into how aspects of their Autism or ADHD influenced their eating behaviours.

From these lived experiences, we identified several ways that Neurodivergent traits may exacerbate or shape eating disorder behaviours. We hope these findings can help improve understanding among Neurodivergent people with eating disorders, as well as those supporting them. 

Participants described how ADHD traits such as emotional overwhelm, boredom or under-stimulation, sensation-seeking, and impulsivity could contribute to eating disorder behaviours, particularly binge eating. ADHD participants also described avoiding certain food textures or flavours, missing hunger or thirst cues when hyper-focused, and skipping meals as a result. 

Autistic participants, both in our studies and in previous research, described similar experiences. These included avoiding certain textures or flavours, difficulty noticing hunger or fullness, and a tendency to develop strict rules and routines around food. These traits could contribute to restrictive or under-eating. Some Autistic participants also described difficulties identifying or communicating emotions, which could lead to restrictive eating to numb feelings, bingeing for comfort, or both as a form of distraction. 

Both ADHD and Autistic participants highlighted how discrimination, lack of social acceptance, and insufficient accommodations can negatively affect self-esteem and sense of identity, especially when individuals were unaware of their own Neurodivergence or did not yet have a diagnosis. For some, eating disorder behaviours developed as a way of coping, seeking belonging, or creating a sense of identity. 

We hope this overview has been helpful if you are, or care for, a Neurodivergent person with an eating disorder. Our two studies explore these topics in more detail and include quotes from participants, which you can read here (bulimia-focused) and here (binge-eating focused). The papers also discuss the support needs of this group, which are summarised in our other blog post, here. For more information and resources, please visit the PEACE pathway website here.

Written by Lauren Makin