Adapting eating disorder treatment for ADHD: clinicians’ perspectives on building structure, harnessing strengths, and negotiating boundaries

AI Summary

ADHD-related disorganisation, reward seeking and emotional volatility underpin eating disorder behaviours and disrupt therapy, requiring focused structure and planning.
Use strength based, collaborative and creative approaches to harness patients' energy, build therapeutic alliance and adapt interventions to attentional and motivational profiles.
Address recognition, diagnosis and medication barriers via closer collaboration between eating disorder and ADHD services and using multidisciplinary dual expertise.

TL;DR (AI Generated)

Although previous studies have explored patients with ADHD's perspectives on their ED and treatment, clinician accounts remain underexplored, despite clinicians shaping recognition, formulation, and treatment adaptation in routine care.

However, challenges around recognising, diagnosing, and medicating ADHD were particularly salient, highlighting the need for greater collaboration and knowledge exchange between ED and ADHD services, alongside better use of existing multidisciplinary and dual expertise within ED teams.

Basic summary

J Eat Disord. 2026 Aug 19;14(1):268. doi: 10.1186/s40337-026-01740-5.

ABSTRACT

BACKGROUND: ADHD is overrepresented in clinical eating disorder (ED) services, and patients with ADHD present to services with increased ED psychopathology, psychological distress, and functional difficulties. They are also more likely to drop out of treatment and have poorer outcomes. Although previous studies have explored patients with ADHD’s perspectives on their ED and treatment, clinician accounts remain underexplored, despite clinicians shaping recognition, formulation, and treatment adaptation in routine care. This study therefore explored ED clinicians’ perspectives on working with patients with ADHD.

METHODS: Semi-structured interviews were conducted with 19 multidisciplinary ED clinicians and analysed using reflexive thematic analysis through a neuro-affirming lens.

RESULTS: Three themes were developed: (1) ADHD as pervasive life chaos; (2) Harnessing energy, alliance, and creativity; and (3) Navigating service boundaries.

CONCLUSIONS: Clinicians described ADHD-related disorganisation, reward-seeking, and emotional volatility as underpinning ED behaviours and disrupting therapeutic processes, highlighting the importance of supporting structure and planning during treatment. Strength-based, collaborative, and creative approaches were also emphasised. However, challenges around recognising, diagnosing, and medicating ADHD were particularly salient, highlighting the need for greater collaboration and knowledge exchange between ED and ADHD services, alongside better use of existing multidisciplinary and dual expertise within ED teams.

PMID:43026602 | DOI:10.1186/s40337-026-01740-5

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