Affirming Eating Disorder Treatment for Neurodivergent Clients
If you’re an adult who discovered you’re neurodivergent later in life, you’re not alone—and the realization can be both clarifying and overwhelming. For many, a late diagnosis (medical or self diagnosis, both count!) helps make sense of lifelong struggles with food, body image, and emotional control that were often misunderstood or mislabeled. At The Current, we often work with adults who’ve masked their neurodivergent traits for years—only to find that their eating disorder was never just about food. It was about safety, structure, and survival in a world that didn’t quite fit. In this blog, we explore how eating disorders and neurodivergence often intersect, and how affirming, specialized therapists and treatments such as Radically Open DBT (RO-DBT) can make all the difference and help support sustainable, compassionate healing.
April is Neurodiversity Awareness month and it’s a time to celebrate the many ways brains can work differently. If you're navigating the overlap between neurodivergence and an eating disorder, you're not alone—and your experience deserves affirming, knowledgeable, and individualized care.
What do we mean by Neurodivergence?
Neurodiversity: A word to describe the endless variation in neurocognitive functions among human beings.
Neurotypical: Individual with typical neurological development and functioning.
Neurodivergent: An “umbrella” term for individuals whose brains develop and function differently than the norm.
The most commonly thought of forms of neurodivergence can include the diagnoses of:
Autism Spectrum Disorder (ASD)
Attention-Deficit/Hyperactivity Disorder (ADHD)
Neurodivergence can also include the diagnoses of Obsessive Compulsive Disorder (OCD), Sensory Processing Disorder (SPD), Learning Disabilities and Tourette’s Syndrome. It is a broad definition, one that can encompass many different experiences and presentations of brains that work differently than what is considered the “norm”.
The Overlap between Neurodivergence and Eating Disorders
The mental health community is becoming increasingly aware of how neurodivergent experiences can intersect with eating disorders. For years, these two areas were treated as separate concerns—but research, lived experience, and clinical insight now show a strong connection between them.
Research indicates a significant co-occurrence between ADHD, Autism and OCD and eating disorders. A meta-analysis found that individuals with ADHD are nearly four times more likely to develop an eating disorder compared to those without ADHD. This association is particularly strong with binge eating disorder, where the risk is over five times higher. It is estimated that up to 40-50% of individuals with Anorexia Nervosa will also meet criteria for Autism. ARFID seems to be the other most common eating disorder for autistic folks, with estimates of co-occurring ARFID and ASD to range from 12.5% all the way up to 33.3%.*
These statistics highlight the importance of integrated screening and treatment approaches that address both ADHD or ASD and eating disorders simultaneously. At The Current, all of our eating disorder specialized therapists have done their due diligence to increase our knowledge about neurodivergence so that we can adapt our treatment approach to meet the needs of our clients.
*Keski-Rahkonen, A. (2023). Avoidant-restrictive food intake disorder and autism: Epidemiology, etiology, complications, treatment, and outcome. Current Opinion in Psychology.
*Nickel, K., Maier, S., Endres, D., Joos, A., Maier, V., Tebartz van Elst, L., & Zeeck, A. (2019). Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Psychiatry, 10.
The Connection: Why Eating Disorders Often Co-Occur with Neurodivergence
Eating disorders such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and ARFID (Avoidant/Restrictive Food Intake Disorder) are complex conditions. But for neurodivergent individuals, several factors can increase risk. Below is a list of some of the common traits or experiences with neurodivergence and how they can overlap with eating or body image issues.
Sensory Sensitivities: You may have always been seen as “picky” about your food, but what you were really experiencing was overwhelming textures, smells, or temperatures, and an urge to avoid what was overwhelming or unpleasant. For some, this leads to chronic under-eating or a diagnosis like ARFID where there can be a strong preference for certain types of food or avoidance of certain types of food or food related experiences. For others, sensory overload leads to binge eating as a form of soothing or numbing.
Interoceptive system: Interoception is defined as the “process of how the nervous system senses, interprets, and integrates signals originating from within the body”. This can present as difficulty noticing your own thirst, hunger, and fullness cues and/or there may be overwhelming interoceptive experiences. This can make consistent food intake and hydration challenging.
Executive functioning: Executive function refers to skills that you use to manage everyday tasks like making plans, solving problems and adapting to new situations. It also manages memory and motivation. It can be overwhelming to perform all the steps necessary for consistent food intake including the processes of buying, preparing, cooking, & cleaning up. Challenges in executive functioning can also make task switching difficult. There is often fear that there will be no motivation or energy to return to the task later, or it might be forgotten, if time and attention is taken away to eat.
Hyperfocus: ADHD is not a deficit in attention, it is actually an abundance of attention and difficulty regulating or managing it. This sometimes results in hyperfocusing on a special interest or a task and when this happens, sometimes forgetting to eat or not wanting to stop the activity to eat.
Impulsivity: Increases binge eating risk with reactivity to food choices or loss of control when eating. Neurodiverse individuals also commonly experience low dopamine levels and may unknowingly seek out dopamine increases through pleasurable or large amounts of food.
Rigidity: Rigidity can show up as having difficulty adapting to a change of plans around food, meal times, or eating environments. Or by having difficulty with coping with an unknown experience with food (some examples could be pressure to try something new or not knowing what is on the menu). It can also show up in the desire to have a very predictable routine with food choices and eating environments.
Rejection Sensitivity: Rejection sensitivity is a trait that can show up with Autism or ADHD that makes a person expect, perceive, and react intensely to rejection, real or perceived. They may have a strong desire to meet societal ideals with food choices and amounts. This may also include trying to conform to society’s “ideal” body type as to not experience rejection.
Pathological Demand Avoidance (PDA): Pathological Demand Avoidance (PDA) refers to a specific profile within the Autism spectrum, where individuals have an increased sensitivity towards demands that challenge their autonomy. Tasks that appear simple such as being told to have breakfast can evoke significant emotional responses in individuals with PDA, this response can send them into “fight or flight”, making complying with tasks incredibly challenging.
Stimulant Medication: Common medications for ADHD can have an affect on appetite, often appetite suppression.
Co-Occurring Physical Issues: Autism and ADHD have higher rates of co-occurrence with physical ailments such as GI issues, Ehlers Danlos syndrome, chronic pain, fibromyalgia, and POTS that can make consistent and comfortable eating difficult.
What Affirming Treatment Looks Like
Healing doesn’t mean “fixing” or “taking away” these traits. It means building a life that works for your brain and body, not against them.
At The Current, we offer affirming, neurodiversity-informed support that can include:
Sensory-aware meal planning
Safe, consensual exposure work that is aware of sensory overwhelm
Support for executive functioning around eating habits
Emotional regulation or emotional expression tools. Understanding of stimming behaviors.
Curious exploration of the intertwining of your neurodivergent experience and eating or body image issues
Therapists who get the nuances of life long masking, encourage unmasking and internalized abelism
Therapists who also identify as neurodivergent
If the treatment doesn’t account for sensory overload, executive functioning challenges, or a neurological need for structure, it’s not resistance—it’s mismatch. If you’ve ever been blamed for not “progressing” fast enough or have heard things like: “You’re just being resistant.”, “Why can’t you follow the meal plan?”, “You need to be more flexible.”, then your treatment has not been affirming.
RO-DBT: A Different Kind of Therapy for a Different Kind of Brain
One of the most powerful and affirming tools we use at The Current is Radically Open Dialectical Behavior Therapy (RO-DBT). It’s especially effective for individuals who experience overcontrol—a trait common in both restrictive eating disorders and many neurodivergent experiences.
Why RO-DBT Works for Neurodivergent Adults:
It respects your bio-temperament and doesn’t try to “fix” it. Rather than trying to “fix” perfectionistic, rigid behavior or unique sensory experiences, RO-DBT helps clients understand their natural temperament and gently increase flexibility—without sacrificing identity or core values.
It provides skills to increase a sense of safety, helping you find your way out of overstimulation or emotional or sensory overwhelm
It helps you build authentic connection—without forcing social norms, giving you agency over social signaling and emotional expression.
It uses a structured, skills-based format that many neurodivergent clients find predictable and comforting.
It encourages radical openness—not as a demand, but as an experiment in self-trust and belonging.
Validation and Empowerment: RO-DBT doesn't label clients as "resistant" or "noncompliant"—instead, it validates their coping strategies as adaptive responses to a world that may feel unsafe or overwhelming.
In short: RO-DBT meets you where you are, and gently invites you into more freedom, flexibility, and connection.
It’s important to know that you are not broken. Whether you're neurodivergent, struggling with disordered eating, or both, affirming support is available.
Therapy can help untangle the complex relationship between brain wiring, emotions, and eating behaviors. It can also help you build a more compassionate relationship with food, your body and your mind.
At The Current, we’re here to meet you where you are—with understanding, curiosity, creativity, and care.
Looking for Support?
We specialize in working with neurodivergent individuals and those recovering from eating disorders. If you or a loved one is looking for therapy that honors your unique experience, we invite you to reach out.
Contact us today to schedule a free consultation or learn more about our services.