# Regulating with food: a qualitative study of Neurodivergent experiences in adults with binge eating disorder

## TL;DR

This study explores how ADHD and Autism influence binge eating disorder in adults and highlights the need for personalized treatment approaches.

## Contribution

The study identifies unique mechanisms linking Neurodivergence to binge eating disorder and emphasizes the need for adaptable, personalized treatment strategies.

## Key findings

- Neurodivergent individuals with BED use bingeing to regulate sensory, emotional, and stimulation needs.
- Participants emphasized the importance of personalized and adaptable treatment approaches that consider cognitive and sensory differences.
- Factors like appetite-suppressing medication and irregular routines contribute to binge eating in Neurodivergent individuals.

## Abstract

ADHD and Autism are overrepresented in adults with binge eating disorder (BED) and are linked to unique mechanisms and poorer treatment outcomes. This qualitative study explored how Neurodivergent individuals with BED understand their Neurodivergence in relation to their BED and treatment needs.

Ten Neurodivergent adults (or those who score above threshold on screeners; AQ-10 > 5, ASRS-Screener > 3) who exhibited binge-type eating pathology were interviewed. The data were analysed with reflexive thematic analysis.

We generated four themes: the need for greater self-understanding of the Neurodivergence–BED link; Neurodivergent-related factors contributing to irregular eating; Bingeing to regulate Neurodivergent-related sensory, stimulation, and emotional needs; and the importance of personalised, adaptable support that accounts for cognitive, sensory, and communication differences.

These findings suggest that ADHD and Autism can influence BED experiences and understanding this can improve treatment engagement and guide the development of more effective personalised treatments for Neurodivergent individuals. Furthermore, these findings allow us to expand existing models of how Neurodivergence interact with eating disorders to include BED.

Neurodivergence, such as Autism and ADHD, is more common in people with binge eating disorder, which involves repeatedly eating large amounts of food while feeling unable to stop, often followed by guilt or distress. Little is known about how Neurodivergence affects this eating disorder or what treatments work best. We spoke to ten adults with binge eating disorder who had diagnoses or traits of Autism or ADHD. They described wanting help understanding how their Neurodivergence influenced their eating disorder. Factors like appetite-suppressing medication, missing hunger cues due to distraction, or irregular routines made bingeing more likely. Participants also used bingeing for comfort, reward, or seeking certain textures or tastes. Participants wanted treatment that was personalised, flexible, and understanding of Neurodivergent needs. Our findings suggest psychoeducation about Neurodivergence and adapting therapies to address sensory, emotional, and routine-related challenges may improve treatment engagement and outcomes.