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

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.