NOTHING ABOUT US WITHOUT US: THE OVERLAP OF ADHD, AUTISM, AND EATING DISORDERS.

“I thought I was just lazy.”“Everyone focused on my weight, but no one asked why I couldn’t eat.”“I’ve masked for so long, I don’t know who I am under it all.”

As a counsellor, I hear these words far too often—especially from clients who’ve been dismissed, misdiagnosed, or misunderstood for years. Many are neurodivergent. Many have disordered eating or a full-blown eating disorder. And many don’t fit the conventional profiles that services are built around.

The overlap between ADHD, autism, and eating disorders isn’t just common—it’s critically under-recognised. In this article, I want to share why that matters, what gets missed, and how we as professionals can respond differently. I write from my perspective as a counsellor with over 20 years of experience supporting neurodivergent individuals and those struggling with disordered eating.

Why this overlap is so common – and so overlooked

Although research is still catching up, what we already know is compelling: people with autism or ADHD are significantly more likely to experience disordered eating. Yet the systems around them often don’t see it.

Why? Because many neurodivergent individuals don’t match the "classic" eating disorder profiles used in diagnosis and treatment. Their behaviours are often misinterpreted as defiance, fussiness, or poor self-control rather than indicators of deeper challenges. Add in masking, especially among women and marginalised genders, and you have a perfect storm of invisibility.

ADHD and disordered eating: it’s not just impulsivity

The common stereotype is that people with ADHD binge eat due to impulsivity. But the reality is much more complex.

Executive dysfunction plays a major role. Difficulty planning meals, remembering to eat, managing time, or coping with routine disruptions can all lead to irregular eating patterns. Some clients may go all day without eating and then binge at night. Others may rely on ultra-processed foods due to low energy, decision fatigue, or sensory preference.

Emotional dysregulation and rejection sensitivity can also fuel binge-restrict cycles, often driven by shame, frustration, or internalised blame.

Autism and eating disorders: beyond stereotypes

Autism is often associated with "picky eating," but that label masks a much deeper experience.

For many autistic individuals, food is a source of overwhelm. Sensory sensitivities to textures, smells, temperatures, or the sound of chewing can make eating an anxiety-laden experience. Rigid thinking and preference for sameness can create narrow food repertoires. Eating in social settings can be distressing.

These are not quirks. They are meaningful adaptations to an intense sensory and social world. And when these needs are ignored or pathologised, eating becomes a battleground.

Some autistic individuals present with anorexia or ARFID, but are overlooked because they don’t appear "underweight enough," or because clinicians misattribute their behaviours to other causes.

When they co-exist: complexity, not chaos

When ADHD and autism co-exist, the picture becomes even more nuanced. One moment, a client might struggle with impulsivity; the next, they’re paralysed by decision-making. They may crave stimulation through food, yet be overwhelmed by its textures.

This isn’t inconsistency. It’s the reality of living with a brain wired for both speed and sensitivity.

Misdiagnosis is common. Clients are often labelled with personality disorders, anxiety, or even "treatment resistance" when standard interventions fail. But the issue isn’t non-compliance—it’s misalignment.

Why it matters – and what we can do

The stakes are high. When we don’t understand neurodivergence, we risk retraumatising our clients, blaming them for behaviours that are actually adaptations, and applying treatment models that simply don’t fit.

What can we do?

• Get curious, not judgmental. Ask about sensory needs, routines, and energy levels.

• Avoid one-size-fits-all strategies. Personalisation is key.

• Advocate for multidisciplinary care that understands both neurodivergence and eating behaviours.

• Include lived experience in shaping services. Nothing about us without us.

We’re not here to fit clients into boxes. We’re here to see them in their full complexity—and support them in reclaiming their identity, safety, and relationship with food on their own terms.

If you’d like to explore this topic further, I’ll be facilitating two upcoming online trainings:

• Understanding ADHD on 6th June 2025

• Understanding the Autism Spectrum on 13th June 2025

  These sessions are designed for anyone who want to better understand and support neurodivergent individuals through a neuroaffirming, compassionate lens.