Neurodivergent-friendly support and treatment for eating disorders

We have recently published two studies exploring what Autistic and ADHD adults with binge- or purge- type eating disorders want eating disorder support to look like. You can read these papers here (bulimia-focused) and here (binge-focused). We have also written a separate blog post on how neurodivergence can influence eating disorder behaviours, which you can read here. 

Alongside existing research on Autism and anorexia nervosa (see review here), these studies are helping us better understand how eating disorders should be treated and understood in Autistic and ADHD individuals.  

In our two studies, we interviewed 26 adults. Most had previously received eating disorder treatment and had lived experience of bulimia nervosa, binge eating disorder, or other similar eating disorders, or they self-reported binge eating.  

Participants in our studies, as well as in previous research, emphasised the importance of having their Neurodivergence recognised and acknowledged during eating disorder treatment. This included screening for neurodivergence and clinicians and carers remaining attentive to potential signs of Autism or ADHD in people with eating disorders.  

Participants also wanted clinicians and carers to take a neurodivergent-affirming approach. This meant distinguishing Neurodivergence from the eating disorder and not trying to change or ‘fix’ a person’s Neurodivergence. Where Neurodivergent traits contributed to eating disorder behaviours, participants wanted these addressed using gradual, affirming strategies. 

Many participants also wanted their care adapted to their Neurodivergence, including sensory and communication adaptions. They described how Autistic and ADHD people may experience certain environments or foods as overwhelming or unpleasant, highlighting the need for sensory adaptions. This included adjustments to dietary guidance, meal plans, and therapeutic environments, alongside practical strategies that could be used outside of treatment settings. Participants also wanted communication adaptions, such as offering different communication methods and using clear, concrete language while avoiding unnecessary abstraction.  

Consistency and routine were also important. Participants wanted regular appointments, frequent reminders, and support in developing sustainable, ‘just good enough’ routines around meals. They also wanted help in shifting eating-disorder-related focus towards other meaningful, non-food-related activities.  

Time was another key theme. Participants wanted enough time to build trust clinicians or carers, make slow and sustainable changes and explore how their Neurodivergence might be affecting their eating disorder or recovery. Some also wanted regular breaks, shorter sessions, or extra time to process verbal information. 

Some participants described wanting support to develop adaptive coping strategies for emotional and interpersonal challenges, provided this support did not aim to change or ‘fix’ their Neurodivergence. 

Finally, participants emphasised the need for clinicians and carers to receive adequate training and resources on Neurodivergence to enable all of the above adjustments. 

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 how Neurodivergence may influence eating disorder behaviours, which are summarised in our other blog post, here. For more information and resources, please visit the PEACE pathway website here.