Hunger is a biological drive which can promote unhealthy dietary decisions. Yet, the cognitive mechanisms underlying this effect, and in particular the interactive role of attention and choice processes, remain elusive. To address this gap, we conducted an eye-tracking experiment, in which 70 participants completed a multi-attribute food choice task in hungry and sated states. Confirming our preregistered hypotheses, participants’ preference for tasty over healthy food items was amplified by hunger. Attention mediated this influence of hunger, as hungry participants focused more on tasty options, leading them to make less healthy decisions. Rigorous model comparisons revealed that an extension of the recently proposed multi-attribute attentional drift diffusion model best explained choice and response times. According to this model, hunger did not only increase the relative taste compared to health weight, but it also increased the fixation-related discounting of health but not taste information. Our results suggest that the cognitive mechanisms underlying unhealthy dietary decisions under hunger are characterized by a nuanced interplay between attention and the significance assigned to the options’ underlying attributes.