Autism and ADHD are both reported to be overrepresented in eating-disorder (ED) services. A new quantitative study examined what happened when the two conditions occurred together—often described as AuDHD—in adults entering one specialist service.
The study, by Lauren Makin, Karina Allen and Kate Tchanturia, used three years of routine intake data from the South London and Maudsley specialist adult ED service. The data were collected between December 2022 and August 2025. Because the research captured each patient at a single point when they entered treatment, it can show patterns but cannot establish causes or treatment effects.
What the study found
Among 1,252 patients, 32 people—2.6%—were classified as AuDHD. A further 45 people—3.5%—were classified as autistic-only, while 81—6.5%—were classified as ADHD-only. The remaining 1,094 patients—87.4%—were placed in the Neither group.
Classification was based on information reported on the intake form. Patients were included if they reported a known or suspected diagnosis; for ADHD, reporting ADHD medication also counted. This approach is important when interpreting the results because it did not identify every patient through a full diagnostic assessment.
The AuDHD group had the highest scores for psychological distress, measured with CORE-10, and for work and social impairment, measured with WSAS. Every group was in the severe range for WSAS, indicating substantial disruption in work and social functioning across the sample.
Past suicide attempts were reported by 56% of patients in the AuDHD group, compared with 42% of autistic-only patients, 36% of ADHD-only patients and 25% of those in the Neither group. This difference is an observation from the service data; it does not show that neurodivergence causes suicide risk.
AuDHD patients were also the most likely to report taking time off work because of their ED: 56%, compared with 22% of patients in the Neither group.
Eating-disorder symptoms looked more similar than expected
Differences in EDE-Q scores, a measure of ED psychopathology, were small. Scores were highest in the ADHD-only group, followed by the AuDHD, autistic-only and Neither groups.
The researchers therefore found little difference in overall measured ED psychopathology between the groups. However, that result does not establish that co-occurring autism and ADHD have no additional effect. The EDE-Q may not fully capture restriction linked to sensory differences in autistic patients, potentially making the severity of their ED appear lower than it is.
Bulimia nervosa was more common in the ADHD-only group. The study authors suggested that ADHD might contribute to ED psychopathology through impulsive bingeing and purging cycles. They also suggested that autism’s effects could be more indirect, involving co-occurring anxiety and depression and a closer relationship with restrictive eating. These were proposed explanations, not pathways tested by the study.
Why screening and classification matter
Previous findings cited by the authors provide context. People with EDs have been reported to be around twice as likely to have ADHD as people without EDs. In one study, roughly 29% of people with anorexia nervosa scored above the autism cut-off on gold-standard assessments. That figure refers to assessment scores, not confirmed autism diagnoses.
Autistic patients with anorexia nervosa often need longer and more intensive treatment, while ADHD has been associated with higher treatment dropout and more symptoms remaining after treatment. Around 40% of autistic people also have ADHD, making the overlap relevant when services assess support needs.
Still, suspected ADHD can be difficult to interpret in an ED setting. Bingeing and purging can produce ADHD-like traits that may ease with recovery, according to the fact sheet. Screening results therefore need to be understood alongside the wider clinical picture.
What the authors say should happen next
Makin, Allen and Tchanturia described their work as the first quantitative study of AuDHD in an ED population, to their knowledge. They concluded that autistic and ADHD patients may arrive at ED services with greater support needs and more complex presentations.
The authors called for routine autism and ADHD screening, person-centred adaptations informed by the PEACE pathway, and larger studies through the UK Eating Disorders Clinical Research Network. The current study did not test whether particular adjustments improve treatment outcomes.
Important limits on the findings
The study identified 12.6% of patients as autistic and/or ADHD. That is lower than the 31% who screened positive for ADHD alone in another adult ED service. The authors said many neurodivergent patients may therefore have been included in the Neither group, which could make differences between groups appear smaller.
The AuDHD group contained only 32 people. The analyses were descriptive rather than adjusted for ED diagnosis, and ED diagnosis was missing for about one in five cases. The sample was predominantly female—89%—and white—75%—with an average age of 29, and it came from one specialist adult service. That service does not treat binge-eating disorder or avoidant/restrictive food intake disorder, limiting how widely the findings can be applied.
The cross-sectional design also cannot show whether neurodivergent patients respond differently to treatment or whether service adjustments improve outcomes. The study was exploratory and did not test hypotheses, so its group differences should be treated as signals for further research rather than causal evidence.
AI tools were used to assist with the preparation of this article under our editorial standards.
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