Considering ADHD in the context of eating disorders through a neuro-affirming lens

Abstract

PURPOSE OF REVIEW: Research on neuro-affirming eating disorder (ED) care has expanded rapidly but has focused primarily on Autism. Attention to attention-deficit/hyperactivity disorder (ADHD) in ED populations has increased only recently. This review summarizes emerging research on ADHD in EDs and considers implications for neuro-affirming clinical practice. RELEVANT FINDINGS: ADHD is overrepresented in ED populations and is associated with increased clinical complexity, including higher rates of binge eating, psychological distress, and functional difficulties in work and social domains. Current evidence suggests that links between ADHD and EDs are unlikely to be explained solely by core ADHD features such as inattention, impulsivity, or hyperactivity. Instead, research highlights indirect and interactional pathways involving emotional burden, reward sensitivity, and sensory processing differences. ADHD may also influence treatment experiences, with patients often benefiting from greater external structure and support with building routine. Strengths-based, collaborative, and creative approaches are also beneficial. However, recognition of ADHD within ED services remains inconsistent, and clinicians report uncertainty around screening, diagnosis, and pharmacological management. SUMMARY: Improving recognition of ADHD within ED services and adapting treatment approaches to reflect ADHD-related differences may enhance treatment engagement and outcomes. Further research is needed to clarify mechanisms linking ADHD and EDs and to guide neuro-affirming service development.