Eating Disorders

Disordered or restrictive eating is often the first sign of autism in a person who does not have their neurodivergence recognised.

It is VITAL to seek medical attention/supervision if a person is restricting their food or fluid intake to a dangerous extent.

However, many Eating Disorder Services in the UK dismiss eating difficulties that do not put a person in a ‘dangerous’ threshold for weight loss/intake, or only offer standard therapies related to Anorexia Nervosa treatments that can be inaccessible to neurodivergent people. This is despite it being a myth that ‘You can’t have an eating disorder if you’re not underweight.’

It’s a fact that eating disorders can affect people of any body weight, size or shape. In fact, most people who have an eating disorder are not underweight. How someone looks does not determine the severity of their eating disorder.

We hope that the information contained in this article will help explore some of the issues surrounding food and eating, and help you support yourself or the person you are caring for.

Disordered Eating / Eating Disorders can become especially prevalent when there is extra stress: Sometimes the circumstances can be changed which can result in improvements in intake, if the person is able to identify the issue.

ARFID – Avoidant Restrictive Food Intake Disorder

Only eating certain things – Feeling safest with foods that are familiar, foods that are branded, and eating / drinking a small range of meals is very common among neurodivergent people, including adults.

Having a range of foods that are predictable, where you know exactly how it will taste, that doesn’t expend too much energy to prepare and will ‘do the job’ of providing nutrition might seem different to a broad and varied neurotypical diet. These are commonly understood as Safe Foods.

Many autistic folk thrive with a diet that might seem ‘restricted.’ This might include having exactly the same food for each meal every day.

These strong food preferences might have been apparent from early childhood, including weaning.

If the chosen diet is impacted by other factors it might become too restricted to be healthy – if someone is experiencing extremely high levels of anxiety, the food that was previously safe can be dropped. Sometimes all food is dropped, leaving that person with a dangerous eating disorder which is known as ARFID.

This can occur at any point in life, and many autistic people will expand and contract their ‘safe foods’ list without danger.

However, in childhood, and especially around the time of puberty, ARFID can present very rapidly and dangerously. In young folk who were assigned female at birth, it can often appear to be Rapid Onset Anorexia.

If someone you care for is restricting their eating to a point that is concerning you

Please seek medical attention

  • Try to remain calm and not force your worries on to that person – the additional pressure can be very counterproductive.
  • Ensure that the medical professional is aware of any safe food eating patterns in the past
  • Ensure that any remaining safe foods are easily available in the home, and that the person can grab them whenever they feel like it
  • Create meal spaces where there are few sensory triggers, and allow the person to eat alone if they prefer

If the medical team wish to pursue treatment for anorexia nervosa, please ask for a rapid autism assessment for the person and immediate consideration of neurodivergent need.

Some Anorexia pathways are very difficult for autistic folk to follow as there is no sensory food control, and inpatient units can be highly detrimental.

There are research findings emerging which explore autism and anorexia A Guide to Mental Health Issues in Girls and Young Women on the Autism Spectrum

Conversation on Autistic Young People and Eating Disorders with Elizabeth Shea

Autistic Girls Network YouTube channel

A video discussing eating issues and Autistic Individuals. It lasts for 2 hours 10 minutes and is hugely informative : the sections are broken down so that you can dip in and out.

Additional Support

BEAT Eating Disorders is a UK based charity specialising in eating difficulties.
They have a support group offering weekly sessions for those caring for a young person with ARFID Endeavour – ARFID carer support group

ARFID support for parents & carers in the UK/Ireland is a very kind and supportive Facebook Group for parents and carers in the UK