JMIR Publications

ABSTRACT

Background:

Eating disorders (EDs) and attention-deficit/hyperactivity disorder (ADHD) co-occur at rates substantially exceeding chance, potentially due to shared neurodevelopmental, genetic, and reward-processing mechanisms. Despite growing clinical recognition of this overlap, no comprehensive synthesis of the effects of ADHD pharmacotherapy on ED outcomes in individuals with co-occurring ADHD and EDs currently exists. Clinicians prescribing ADHD medications to this population must balance potential risks, including appetite suppression, weight loss, and misuse, against possible benefits, including improved impulse control, improved engagement in ED treatment, and reduced binge-eating frequency, all in the absence of astructured evidence base to draw upon.

Objective:

This scoping review aims to: (1) map existing evidence on the effects of ADHD pharmacotherapy on ED symptom outcomes in individuals with co-occurring ADHD and EDs; (2) characterise the safety and tolerability profile of ADHD medications in this population; (3) describe the range of study designs, populations, medication types, and outcome measures re- ported in the literature; and (4) identify key methodological gaps to inform future research priorities.

Methods:

The review will follow the PRISMA Extension for Scoping Reviews methodology. Eligible studies will include individuals with a formal diagnosis of ADHD or clinically significant ADHD symptoms, alongside a diagnosed ED or clinically significant ED pathology, across all ED diagnoses and age groups. Any pharmacological agent approved or used off-label for ADHD, including stimulants and non-stimulants, will be eligible as the primary intervention. All study designs will be included, from randomised controlled trials to case reports, consistent with the anticipated sparsity of controlled trial data in this population. Seven electronic databases will be searched (MEDLINE, Embase, PsycINFO, PubMed, CENTRAL, Web of Science, SCOPUS), alongside trial registries and manual searches. Title/abstract and full-text screening will be conducted independently by two reviewers, with discrepancies resolved by a senior reviewer. Findings will be synthesised narratively, structured by population group, medication class, and outcome domain.

Results:

Ethics & Dissemination Ethical approval is not required as this review involves secondary analysis of publicly available data. Findings will be disseminated via peer-reviewed publication and are intended to inform prescribing practice, highlight evidence gaps, and provide a foundation for future controlled research at the intersection of ADHD and EDs.

Conclusions:

Ethics & Dissemination: Ethical approval is not required as this review involves secondary analysis of publicly available data. Findings will be disseminated via peer-reviewed publication and are intended to inform prescribing practice, highlight evidence gaps, and provide a foundation for future controlled research at the intersection of ADHD and EDs.