Navigating life with stigma and barriers can be especially challenging for autistic people but how does it affect eating disorders and how does it present differently? Autism is apart of natural biodiversity of humans and human cognition. It is apart of neurodiversity and how autistic people think and communicate can be different in comparison to people perceived as neurotypical. In the past, there used to be many barriers that prevented Autistic people for achieving success societally through stigma. While there has been considerable progress, a lot more still needs to change in terms of understanding and how disorders such as eating disorders affected autistic people differently.
Atypical or disordered eating is common among autistic people, with 70% experiencing food or mealtime issues. This can manifest in sensitivity of texture/senses surrounding food as well as social aspects as well. Furthermore, with the sensitivity issues surrounding food and its environment, meal times can be distressing for an autistic person. As well as this, autistic people can often struggle with hunger signals and as a result will experience atypical eating patterns as they might wait until physical signs of hunger show. As a result, autism and eating disorders can be related and due to the under-diagnosis for autism for assigned-female-at-birth, being diagnosed with an eating disorder can be a first step for an autism diagnosis.
As a result, the most common eating disorders for autistic people is anorexia nervosa (AN) or AFRID (Avoidant/Restrictive food intake disorder)
Anorexia nervosa often presents in different ways for autistic people than people who are neurotypical. Firstly, body image that can be a significant component for some people who are neurotypical is viewed as less significant in some autistic people. This is mostly because of greater inflexibility and greater likelihood to systemise routines creating repetitive routines of disordered eating/behaviours that can have a negative focus (e.g. calories or exercise). This relationship of autism and AN is most predominant with assigned-female-at-birth with 20-35% of AN meet the criteria for autism as well as more experiencing signs of autism.
As a result of these eating disorders, a major risk is malnutrition. This is especially important for autistic people as it can exacerbate symptoms.
As the link between autism and eating disorders becomes more known, there has been an increased understanding that disordered eating in childhood prevention can minimise risk of an eating disorder in the future. Treatment for autistic people can also differ to people who are neurotypical, this can include;
- Sensory, based environment (dimmed lights, no loud music)
- Not weight, body image reliant
- Individual-based therapy over group-based therapy
- A minimally disruptive routine
- A more gradual process to reduce disruptive and integrate into routine
- Precise food choices if required
- Clairvoyance on rules and expectations with treatment
Picture Source: canva
Butterfly Foundation. (2022). Autism, Eating Disorder & Me. Butterfly Foundation. https://butterfly.org.au/autism-eating-disorders-and-me/
Eating Disorders Victoria. (2022). Eating Disorders & Autism. Eating Disorders Victoria. https://www.eatingdisorders.org.au/eating-disorders-a-z/eating-disorders-and-autism/
Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The lancet, 392(10146), 508-520.