More than half of adults seeking treatment for eating disorders may be living with undiagnosed attention-deficit/hyperactivity disorder, according to a new cross-sectional study conducted at Esquirol Hospital in Limoges, France. The research, published in the Journal of Eating Disorders, found that 61 of 120 participants — roughly 51 percent — met diagnostic criteria for ADHD, yet only two of them had ever been formally diagnosed. The finding points to a striking blind spot in psychiatric care, where the symptoms of one condition may be masked or overshadowed by the more visible behaviors of another.
The study recruited treatment-seeking adults with restrictive or binge-purge subtypes of anorexia nervosa, bulimia nervosa, and binge-eating disorder between June 2020 and September 2023. Participants, whose median age was 26 years and who were 95.8 percent female, were first screened with the ADHD Self-Report Scale, a widely used questionnaire that probes attention difficulties, impulsivity, and restlessness. Those who screened positive were then assessed with the Diagnostic Interview for ADHD in Adults, a structured clinical instrument that traces symptoms back to childhood to establish whether the disorder persisted into adulthood. This two-step approach matters because self-report questionnaires alone can overestimate prevalence, and the confirmation step gives the findings considerably more clinical weight.
The scale of the result is difficult to overstate. In the general adult population, ADHD is estimated to affect a small fraction of people, so a rate above 50 percent in an eating disorder treatment population represents a dramatic enrichment. It also suggests that the two conditions are not merely co-occurring by chance but may share underlying neurobiological and psychological dimensions. Both involve dysregulation — of attention and impulse control in ADHD, and of eating behavior and emotional regulation in eating disorders. Researchers have long noted that impulsivity and difficulties with emotional regulation sit at the intersection of the two conditions, and the new data provide a quantitative portrait of how those shared dimensions manifest in a clinical population.
The diagnostic breakdown was telling. Logistic regression analysis identified bulimia nervosa as the eating disorder most strongly associated with ADHD, and prevalence was higher in binge-eating disorder than in anorexia nervosa. This pattern fits a broader conceptual framework in which the binge-type eating disorders are characterized by loss of control over eating, a behavior that resembles the impulsive, compulsive episodes seen in other ADHD-related dysregulation. Restrictive anorexia, by contrast, is often associated with overcontrol and rigid inhibition — traits that sit closer to the opposite end of the impulsivity spectrum. The association between ADHD and bulimic pathology therefore appears to track the impulsive dimension of the eating disorder itself.
Beyond diagnosis, the study mapped the clinical correlates that distinguished participants with ADHD from those without. Those with ADHD carried more psychiatric comorbidities overall, a finding consistent with the well-documented tendency of ADHD in adulthood to travel with depression, anxiety, and substance-related problems. They also reported higher levels of smoking and alcohol use, measured with validated instruments including the Fagerström test for nicotine dependence and the AUDIT for alcohol consumption. Substance use screening also covered cannabis with the CAST instrument. Taken together, these correlates sketch a picture of patients whose difficulties extend well beyond eating behavior and who may need broader psychiatric evaluation than their referral diagnosis suggests.
Two psychological measures stood out in particular. Participants with ADHD scored significantly higher on the Barratt Impulsiveness Scale, a standard instrument that decomposes impulsivity into attentional, motor, and non-planning components. Elevated impulsivity is a core feature of ADHD and has also been implicated in binge eating and purging, so its elevation in the comorbid group provides a mechanistic link between the two conditions. Equally notable was body dissatisfaction, assessed with the Body Shape Questionnaire. Participants with ADHD reported greater dissatisfaction with their bodies than their non-ADHD peers, an association that had been less firmly established in earlier literature and that raises questions about how attentional and self-regulatory difficulties might shape the way patients perceive and evaluate their own bodies.
Physical activity, measured with the Global Physical Activity Questionnaire, did not differ between the two groups, suggesting that the clinical differences were not driven by gross differences in energy expenditure or lifestyle activity. That null result is useful because it narrows the field of plausible mechanisms. The divergence between groups appears to lie in psychological traits — impulsivity, body image, personality — rather than in behavioral patterns such as exercise that are sometimes proposed as mediators of eating disorder severity.
The personality findings added a further layer of specificity. Using the Temperament and Character Inventory, the researchers found that participants with ADHD showed greater reward dependence and greater self-transcendence, while those without ADHD scored higher in self-directedness. Reward dependence reflects sensitivity to social approval and reinforcement, a trait that resonates with the altered reward processing increasingly documented in ADHD. Self-directedness, by contrast, captures the ability to regulate one’s own behavior in accordance with personal goals, and low self-directedness is a hallmark of poor self-regulation across psychiatric conditions. The higher self-directedness scores in the non-ADHD group thus align with the expectation that intact self-regulatory capacity buffers against both attentional dysregulation and disordered eating driven by loss of control.
The practical implications of the study are straightforward but consequential. Because only two of the 61 participants with ADHD had a prior diagnosis, the condition appears to be systematically underrecognized in adults presenting for eating disorder treatment. The authors argue that their findings support routine ADHD screening in this population, with particular vigilance for patients with bulimia nervosa and binge-eating disorder, where the association is strongest. Screening is only the first step, however. The researchers also call for integrated treatments that target impulsivity and attentional dysregulation alongside the eating disorder itself, on the rationale that treating one condition while ignoring the other may leave the underlying self-regulatory difficulties — and the risk of relapse — intact.
The study has limitations inherent to its design. It was cross-sectional, conducted at a single specialized center, and involved a predominantly female sample, so the findings describe prevalence and associations rather than causal pathways, and their generalizability to men and to other care settings remains to be tested. The sample size of 120, while adequate for the analyses performed, is modest. Even so, the central message is hard to dismiss: in a group of adults seeking help for eating disorders, ADHD was roughly as common as not, almost entirely undiagnosed, and consistently associated with greater impulsivity, greater body dissatisfaction, more comorbidity, and a distinct personality profile. For clinicians, the study suggests that the question is no longer whether some eating disorder patients also have ADHD, but how many are being missed — and what a more integrated approach to assessment and treatment could offer them.
Subject of Research: Prevalence and clinical correlates of ADHD in adults with eating disorders
Article Title: Attention-deficit/hyperactivity disorder in adults with eating disorders: prevalence, clinical correlates, and personality profiles
Article References: Bonilla, A., Torelli, S., Virevialle, A.-L., Laplace, B., Sohier, N., Gauthier, A., Okassa, M., Vinais, T., Foucher, A., Sazerat, P., Nubukpo, P., & Lacroix, A. (2026). Attention-deficit/hyperactivity disorder in adults with eating disorders: prevalence, clinical correlates, and personality profiles. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01793-6
Image Credits: AI Generated
DOI: 10.1186/s40337-026-01793-6
Keywords: ADHD, eating disorders, bulimia nervosa, binge-eating disorder, anorexia nervosa, impulsivity, body dissatisfaction, comorbidity, personality traits, screening, psychiatry, self-regulation
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Ophelia Keating. (September 30, 2026). More Than Half of Adults With Eating Disorders Show Undiagnosed ADHD, Study Finds. Scienmag. https://scienmag.com/more-than-half-of-adults-with-eating-disorders-show-undiagnosed-adhd-study-finds/
Ophelia Keating. “More Than Half of Adults With Eating Disorders Show Undiagnosed ADHD, Study Finds.” Scienmag, 30 September 2026, https://scienmag.com/more-than-half-of-adults-with-eating-disorders-show-undiagnosed-adhd-study-finds/. Accessed 30 September 2026.
Ophelia Keating. “More Than Half of Adults With Eating Disorders Show Undiagnosed ADHD, Study Finds.” Scienmag. September 30, 2026. https://scienmag.com/more-than-half-of-adults-with-eating-disorders-show-undiagnosed-adhd-study-finds/
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Tags: ADHDanorexia nervosabinge eating disorderbody dissatisfactionbulimia nervosacomorbidityeating disordersimpulsivitypersonality traitspsychiatryscreeningself-regulation
