Why is nobody talking about ADHD and Anorexia? (Dopamine Diaries Part 1)

In this first installment of Dopamine Diaries, Livia Sara unravels the overlooked connection between autism, ADHD, and anorexia. You’ll learn how dopamine differences create a neurodivergent vulnerability for engaging in anorexia behaviors, including restriction, compulsive exercise, ADHD hyperfocus, and constantly thinking about food!

Further resources:
📚 Neurodiversity-Affirming Books: https://livlabelfreebooks.com
✨ Existential Autistic Membership: https://www.livlabelfree.com/membership
💗 1-1 Coaching: https://www.livlabelfree.com/coaching
📖 Free Extreme Hunger Guide: https://www.livlabelfree.com/extreme-hunger-guide
🎙️ Free Autism and Eating Disorders Training: https://www.livlabelfree.com/free-audiotraining

Mentioned episodes:
Autism and Binge Eating: https://youtu.be/V1Ut5spEVHs
But Restriction Helps Me Focus! https://youtu.be/_MHB8y9qack
Black & White Thinking in Autism and Anorexia https://youtu.be/TpDAEncit2Y
Autism, Anorexia, and Metabolism https://youtu.be/xsOBtfY9CcA
Is it harder for an autistic person to recover? https://youtu.be/jh7kYLOpUcM

Episode transcript:
Ok my friends, we need to talk about something that I literally have never heard anyone talk about but (at this point) it comes up with almost every one of my clients, because almost every one of my clients isn’t only autistic but is also ADHD. So what we’re gonna be talking about today is the connection between ADHD and anorexia.

And I’m super excited to finally be diving deep into this connection because most of the information on neurodivergence and eating disorders is still quite binary. Supposedly, autism is linked to anorexia and ARFID (Avoidant-Restrictive Food Intake Disorder), while ADHD is linked to binge eating and compulsive overeating. While, of course, these links are valid and true, where’s the nuance? Why is no one talking about how autistic people struggle with binge eating or how ADHDers struggle with restrictive eating disorders?

Well, I’ve already done a whole series on autism and binge eating on this podcast, so now I’m starting a series on how those of us who are autistic and ADHD interact with food and movement. In this first episode specifically, I’m unpacking the overlooked connection between autism, ADHD, and anorexia through both scientific research and lived experience as an AuDHDer with a history of anorexia nervosa. We’ll explore how core anorexia symptoms like restriction, compulsive exercise, and mental hunger can be better understood through the ADHD lens, and what this understanding means for more effective approaches to recovery – or should I say, discovery? Whatever term you prefer to use on your unique journey, let’s get to discovering!

Busting the Dopamine Myth: Wanting vs. Liking

Before we get to any of the specific ADHD and anorexia overlaps, we need to bust a common myth about dopamine. Many people believe that dopamine floods our brain when we engage in rewarding activities. I mean, this is why ADHD people are constantly seeking stimulation, right? Because they constantly want to experience reward? Well, not quite.

In reality, dopamine isn’t primarily responsible for pleasure or satisfaction. Rather, it’s at the foundation of anticipation and motivation. What this means is that a dopamine surge happens not when we experience the reward itself, but during the anticipation phase right before we obtain it. This “wanting” versus “liking” distinction is critical to understanding both ADHD and eating disorders.

In ADHD brains – and autistic brains too – dopamine is lower when compared to neurotypical brains, which obviously creates a specific vulnerability. Us AuDHD folks experience intensified “wanting,” but a diminished “liking” of the actual reward, which creates a perpetual cycle of seeking satisfaction without ever feeling satisfied. This is why so many ADHD people do experience binge eating and compulsive overeating – in these cases you’re constantly wanting the food to stimulate you in a way that your brain and nervous system are never satisfied with.

So that’s the binge eating angle. But again, why is no one talking about the dopamine high – the euphoria – that you get from engaging with anorexia or bulimia? Why is no one talking about how addictive restriction is, how the anorexia is never satisfied, and so you keep setting new “precedents” around food and exercise? Because I don’t know about you, but for me, the eating disorder made me feel superhuman. I was able to numb out everything that didn’t directly support the eating disorder, including the existential questions, my relationships, and, well, everything else that makes life meaningful. So I’m going to elaborate on all of this later in today’s episode, because right now I really want to emphasize this concept of numbing and how it applies to the full spectrum of disordered eating behaviors, which I have termed The Adaptive Eating Spectrum (TAES).

So even though anorexia nervosa and binge eating disorder seem like the epitome of contradiction, the underlying mechanisms – especially in neurodivergent people – aren’t actually different. Whether someone restricts food or eats too much of it, the root of the behavior is to numb and escape. It’s an escape from sitting with the discomfort of being a soul so infinite, so vast, and so boundless that being in a human body feels like being trapped in a cage. The eating disorder – or as I like to call it, eating adaptation – is a way to numb yourself from the existential thoughts, the fear of being wrong in this world, and the perpetual anxiety that arises as a direct result of navigating a world that wasn’t built for your neurodivergent nervous system.

How My Autism Manifested as Anorexia Nervosa

If you’ve been around for a while, you know that I’ve talked plenty about how I believe my autism manifested as an eating disorder, or again, eating adaptation.

My need for predictability turned into strict eating schedules and rigid exercise routines.

My sensory overwhelm turned into fear of weight gain.

My fear of being healthy – and, more specifically, being healthy in a female body (we’re talking boobs, butts, and periods) – manifested as trying to stay as small as possible.

It hasn’t been until more recently – due to, ya know, being a lifelong learner, being relentlessly curious, and constantly asking WHY – that I’ve started reflecting on eating disorder behaviors through an ADHD lens. (And major shoutout to all my clients right now, because none of these insights I’m sharing would have occurred to me without the meaningful conversations I’ve had, and continue to have, with other neurodivergent beings.)

 It’s worth disclaiming here that my personal experience of anorexia in relation to both ADHD and autism will always be skewed because I’m not purely ADHD or purely autistic. I’m AuDHD, which means the autism and ADHD are interlinked, and it’s this interlinking that creates the unique conditions for my unique experience of, well, everything! Including my history of disordered eating. And I am planning on recording a dedicated episode about how my autism and ADHD are constantly battling each other, which obviously creates its own set of difficulties, eating disorders aside. But obviously that’s a story for another day, so back to the main topic of today which is ADHD and anorexia. In fact, now it’s time to get juicy because we’re starting off with the infamous claim “but restriction helps me focus!”?

But Restriction Helps Me Focus!

The reason I’m starting with this restriction and focus aspect of the ADHD-Anorexia connection is because I’ve done an entire episode and blog post with this title on the Liv Label Free Podcast before, so I definitely encourage you to listen to that episode if this is a topic you resonate with. But what exactly do autistic and ADHD people with eating adaptations mean when they say restriction helps them focus? How can this even be true? Doesn’t everyone say that eating more and recovering will improve your focus?

Well to answer all those questions, we need to start by debunking the belief that this statement is used to “lie” or “manipulate.” Because I’m sure we’re all familiar with the idea that weight gain is a top priority when someone is malnourished because a malnourished brain equals a brain that cannot think clearly, right? This understanding lies at the root of why so many people with anorexia who aren’t autistic may display autistic traits. Not because their anorexia has caused autism or they are now becoming autistic, but because the brain simply does not have enough energy to process information that it doesn’t deem necessary for survival. (And I do explain this energy trade-off in my book How to Beat Extreme Hunger and in my episode on Black & White Thinking, so do go check those out if you haven’t already!)

Because the brain does not have adequate energy to consider a vast array of options, it narrows its focus to what can be easily grasped. Enter the ability to hyperfocus on meal plans, calorie counts, exercise routines, and watching What I Eat in a Day videos, but getting a full-blown panic attack when your mom can’t read your mind of how many almonds you always put on your oatmeal when you test her to make sure she still loves you (because hello codependency, which is a whole nother topic, and if you want to read more about my experience with this, go do yourself a favor and grab a copy of my book Rainbow Girl!).

It’s worth clarifying that just because a malnourished brain mimics an autistic brain in many ways, this obviously does not mean that an autistic brain is inherently a malnourished one (and yes, I am well aware that many health “experts” have their own theories about how diet causes autism and ADHD and other bullshit like that, but we’re not even going to get into that here for obvious reasons.). Well, to be fair, nutrition can help improve the more disabling aspects of neurodivergence – such as anxiety and depression, which have everything to do with the gut-brain connection, which is why I created my cookbook Nourishing Neurodiversity!

It’s no rocket science that the autistic brain processes more stimuli more intensely, which also means it uses more energy (so yes, it burns more calories!) compared to neurotypical brains. And there have been scientific studies on this as I shared in my podcast a while back on Autism, Anorexia, and Metabolism, although it’s worth putting a large footnote here that the research is significantly lacking, and is, no surprise, incredibly biased towards males because, again, people across the entire gender spectrum are being left out.

It’s this heightened sensory processing that leads to an overstimulated brain. Merging this with what I said earlier about adequate energy – because all of the brain’s resources are being directed towards dealing with the bombardment of stimulation – there’s simply no energy left for other tasks – including social interactions, executive function, and even digestion. So, no surprise most neurodivergent people experience challenges in these areas. Add the trauma of disordered eating to the mix, and, well, I’m sure you have your own lived experience to calculate the results of this complex equation.

When your body and mind are overwhelmed in every way possible, we seek that escape I mentioned earlier. People who present with restrictive eating disorders such as anorexia or ARFID will avoid food, adhere to rituals and routines, fidget excessively, engage in compulsive movement, and isolate themselves.

Someone who isn’t familiar with neurodivergence may hear these behaviors and think “Clear signs of an eating disorder!” But if you are even the slightest bit familiar with my work and approach, you know that one of the greatest dangers of traditional eating disorder treatment models is that they completely misunderstand the fact that in autistic people, the “ED behaviors” are merely a manifestation of the autistic traits. And if there’s also ADHD in the mix, the “ED behaviors” are a manifestation of that as well, which is of course what we’re talking about today.

Myths About Autism and Eating Disorders

In my recent episode titled “Is it harder for an autistic person to recover?” in which I debunk 3 myths about autism and eating disorders, I talked about how there’s this belief that you can’t diagnose someone with autism (or ADHD) when they have active anorexia because anorexia behaviors allegedly mimic autistic traits. So like I just said, these may include strict adherence to rituals and routines, compulsive pacing or other exercise, excessive fidgeting like leg bouncing, and I’m sure you have other examples coming up right now because there are so many.

And I’m sure I don’t have to repeat that this claim that you can’t diagnose neurodivergence in someone with an active eating disorder is problematic for SO many reasons…because the obvious implication of this belief is that we’re not even going to consider the person as autistic until they’re “recovered” from anorexia, which, as we all know, the medical people equate to being “weight restored.”

They claim that the person will magically start “thinking clearly” once they’re no longer starving, but this logic is so twisted! Why? Because they somehow forget the fact that someone developed the eating adaptation before they were already starving, meaning that the starving brain is not necessarily the driver of anorexia. I mean, someone decided to diet or exercise or what have you because they needed a way to feel safe in the world. See how it’s an adaptation? They adapted their behaviors to reduce overwhelm.

What makes the medical people’s “weight gain needs to come before the mental work can start” logic even MORE twisted is that an individual actually needs to address the underlying fears and root causes in order to start accepting weight gain. I mean, how do we expect someone to even begin doing this when we aren’t acknowledging the possibility of underlying autism and/or ADHD (and other conditions, for that matter)? This awareness could allow us to make accommodations to help them reach a point when their brain does start functioning better, state of nutrition aside! Well, here comes the plot twist, my friend, which circles back to the claim that “anorexia helps me focus.”

Eating Disorders are Protective Mechanisms

The plot twist is that many people with eating disorders secretly don’t want their brain to start functioning better. Why? Because a healthy brain for us autistic and ADHD folks means a brain that’s overwhelming. A brain that’s constantly asking those existential questions. A brain that’s constantly confronted with awareness itself. And if you listened to my spontaneous “go on a walk with me” episode in August 2025, you may remember my sharing of my experience with this confrontation with consciousness as existential nausea.

When your sole focus is food, and in a way, the eating disorder is almost serving as an autistic special interest, you don’t have the mental capacity to think about anything else! You’re numbed from the existential questioning because anorexia creates the ultimate answer to everything. You don’t have to face the responsibilities that come with being healthy, or if we go further, being a meaningful member of society. You don’t have to face your own vastness and creative potential, and what about all those ADHD bouncing balls in your head? Well, because there’s not enough energy in the brain, the bouncing balls can’t bounce as high or as fast. When we view the eating “disorder” from this perspective, wow, how adaptive that someone with ADHD and/or autism would develop anorexia!

Of course, this isn’t to say that starving yourself is a positive adaptation. When an adaptation becomes maladaptive, that is to say, it hinders your ability to lead an authentic life, the behaviors are no longer sustainable. Even more than that, they’re destructive to both the individual and everyone around them. Because I’m obviously not here to promote restriction. There’s a reason I chose to recover! My mission here is to help you understand why you or your loved one may feel so addicted to the eating disorder so that you can create your own “why” for leading a meaningful life. So, in a nutshell, anorexia is addictive because it’s the tried-and-true method of transcendence. It’s a way to distract yourself from physical reality, to quiet the constant autistic and ADHD noise that can be so goddamn overwhelming.

Trust me, I know. Because I experience that noise all day and night long, my friend. I dread going to sleep due to that confrontation with consciousness, and even when I’m sleeping, I have all the thoughts! I don’t know about you my friend, but I have VERY intense dreams and a lot of neurodivergent people I speak to say the same thing. I find this very fascinating because no joke, I literally did not dream when I had an eating disorder.

Now that I think about it, it’s probably because my brain was just too tired to come up with stories. Wait let me rephrase that, because if you’ve read How to Get Out of Quasi Recovery, you know that that entire book is about the whole idea of the eating disorder and the recovery identity being stories in and of themselves, and the power in acknowledging this is that it creates space for writing a new story – the story you actually want to be part of. So if you haven’t yet read How to Get Out of Quasi Recovery (or listened to the audiobook), grab yourself a copy at livlabelfreebooks.com or on Amazon, and grab the Discovery Workbook while you’re at it! Now going back to the dream thing, because my entire body, including my brain, was operating in survival mode during anorexia, when I woke up, I just hadn’t dreamt of anything.

But on the rare occasion that I did dream, it was almost always a nightmare of me eating food that wasn’t allowed or it was me not being able to go on my run because my parents had a court order placed on me to force me into treatment. In fact, I once woke up at 3am sweating and having heart palpitations because I had dreamt about eating an entire kilogram bag of pepernoten, which are Dutch spice cookies, and they are oh so good. And oh my god, me eating that entire bag had felt SO real. Of course, that’s what made the extreme hunger so terrifying because my binge nightmares had literally become a reality; and if you want to read more about my experience with this, grab a copy of my book How to Beat Extreme Hunger! By the way, now that I’ve mentioned all my books anyways, you can actually get a bundle discount when you buy them all directly from my website livlabelfreebooks.com, so go do that if you’re curious.

Anorexia as Autistic Hyperfocus

Anyways, now that we are talking about hunger, I feel it just makes sense to talk about another ADHD & anorexia link which is hyperfocus. Specifically, hyperfocus on food, which is basically mental hunger right? And oh god, the restriction high because hellooo dopamine. Now, if you’re listening to this, chances are you know what mental hunger is…but just in case you’re new here or you’re a caregiver and are like “Wait, what?” let me briefly explain. Mental hunger is exactly what it sounds like: it’s being hungry and having your hunger cues be mental. It’s constantly thinking about food, mentally counting calories, shifting food items around in your mind to create the “perfect” balance. And thinking about exercise all the time can be a form of mental hunger too if you’re wanting to move more so you feel less guilty about eating.

One of the biggest fears of my clients is that mental hunger is just a “bad habit,” like a negative thought loop you’ve conditioned yourself to be stuck in. They fear that giving into their mental hunger will make them an “emotional eater,” and OH NO, we don’t want that! So instead of surrendering to our body’s innate wisdom, we micromanage our food and exercise habits and tell ourselves the story that we can’t be trusted. But again, that’s all it is – a story. And this is why, in my courses and coaching programs, we really dive deep into the stories you’re telling yourself and the limiting beliefs you’re convinced are the absolute truth, because the real truth is that your biggest fears are just lies. Sure, they’re protecting you, but they’re equally shielding you from living the life you know in your heart you are capable of living.

As autistic, ADHD, or AuDHD people, we WANT to have a special interest. We WANT to hyperfocus. It’s how we channel our energy, the way we transcend this shallow world and enter our own creative dimension. As I write in How to Get Out of Quasi Recovery, I believe we are all artists. That’s why we’re on this planet. To create art so we can connect and contribute. But of course, this is also where the possibility of failure comes in. Because how do you know that your unique creations won’t be judged and shamed? How do you know people will even like you? There’s no proof, because, well, welcome to life! So what do you do? You adapt. You pick a hyperfocus that’s predictable, and well, welcome to eating disorder land, and later on, the land of quasi recovery!

So how do we break free? How on Earth can you recover when your hyperfocus is food? Well first, we must acknowledge that restriction is going to make you hyperfocus on food whether you’re neurodivergent or not. This doesn’t make you special, it just makes you a mammal whose only priority is survival. The brain obsesses over what it can’t have, which is why you spend your days dreaming about food while not trusting yourself to actually eat enough of it.

When you prove abundance to your body and brain, you’ll simply have no reason to hyperfocus on food. I know that might sound unimaginable, especially because you’re probably listening to this while simultaneously planning what you’re going to eat next or how to “balance out” what you just ate, but my clients and I are living proof that you can fully recover and fill your life with true meaning and purpose. You can fully recover and discover your gifts, and yes, even use your gifts to help others, even if that feels like a lot of pressure. This is all part of the meaningful suffering, the life worth suffering for.

So if you’re listening to this and are like “No, but I need proof first! I need to know for certain that I won’t swing to the other side if I honor my mental hunger!” please do yourself a favor and grab a copy of my books How to Beat Extreme Hunger and How to Get Out of Quasi Recovery. Literally the first chapter of my quasi recovery book is titled “knowledge” and the accompanying Discovery Workbook helps you create a life where you’re living ON PURPOSE. To be clear here, this isn’t about finding a “replacement” for your eating disorder because the eating disorder is nothing but emptiness itself. Rather, this is about creating a life you don’t need to escape from. Because again, THAT is what the ED is. It’s an escape! It’s nothing but a giant distraction from your true self. And by the way, if you’ve already read my books and have completed the exercises in the workbook and you still feel stuck, well then schedule a discovery call for 1-1 coaching to receive support directly from me! Or if you’d like more affordable options, check out my courses and memberships

The Role of Exercise in Anorexia and ADHD

Now, all that being said, damn we’ve covered a lot so far. And now that we have covered everything we just did, it’s time to move onto another real important connector of ADHD, autism, and anorexia which is exercise. Because oooohhh this was a big part of my eating adaptation and it is for most of my clients. And it’s SO misunderstood in eating disorder treatment. I mean, one of my clients even told me she got reprimanded for bouncing her leg while sitting. Like WTF?!

Anyways, it is SO important to understand how compulsive movement, or, as you may know, I like to call it adaptive movement because it completely changes the game for ED recovery. So I do have multiple chapters on exercise in my quasi recovery book, and I have done two previous podcast episodes on exercise addiction so I’m just gonna jump straight into the connection to ADHD and autism now.

The first thing that’s coming to mind is how exercise is one of the top recommendations for improving ADHD. Why? Because we all know exercise releases dopamine, and my theory is that the exercise addiction in anorexia is just a form of self-medicating. When you compound this with the hypervigilance – so being in constant fight-or-flight mode due to being neurodivergent – exercise is a way to release that energy. It’s a form of stimming, which is short for self-stimulatory behavior, or as I prefer to call self-regulatory behavior, because that’s the entire point of it: to regulate your nervous system. During my eating disorder, the running and the pushups and the HIIT workouts and everything in between, these things weren’t about weight loss or trying to burn calories. The intensity was a biological drive to release stress, and the strict adherence to distances and times and sets and reps was to maintain predictability and routine. When I was forced into eating disorder treatment, I did secret exercises in the bathroom, and even these were not truly “ED behaviors.” The secret exercises were literally just my PDA because I wasn’t gonna let anyone tell me what I could or couldn’t do.

Oh my god, so this is probably one of the longest solo episodes I’ve ever done, and you bet I’m gonna be using some of this in the book I’m currently writing about anorexia and autism, because my time is valuable and honestly, what a waste if I don’t repurpose this! But that’s just me, always optimizing, just like I know you are my friend. Anyways, I do hope you loved this episode, I hope you got a lot out of it, and if you did, please leave a positive rating and review for the podcast! Or if you’re listening on YouTube, subscribe and like and do all the things. It’s a completely free way to support my work and helps other people find the show. And of course, if you want more help, head over to my website livlabelfree.com where you can buy my books, join my courses and membership, and of course, work with me privately. I hope to talk to you soon and otherwise, I’ll be back in your ears for the next episode. Bye bye for now!