Understanding Autism & Eating Disorders

An eating disorder is a mental health condition where an individual may use food and eating as coping mechanisms for emotional or situational challenges. The NHS defines it as having an unhealthy attitude toward food that can significantly impact life and health.

While non-autistic children and young people often develop eating disorders due to issues related to weight or body image, the underlying factors which contribute to an autistic child or young person developing an eating disorder may be less obvious.

video from First Episode Rapid Early Intervention for Eating Disorders | FREED (freedfromed.co.uk)

Factors which can contribute to eating disorders for autistic people

Contributing factors to eating disorders for autistic people include:

• Sensory differences regarding food
• Challenges in recognising hunger or fullness (known as interoception)
• Intense interests or rules related to food, counting calories, or exercise as a means to manage general anxiety levels or to manage difficult emotions (which may be related to alexithymia or difficulty recognising and understanding emotions).   

PEACE Pathway Animation explaining eating disorders and autism

Types of Eating Disorders

Common types of eating disorders include:

• Anorexia nervosa
  • involving insufficient food intake or excessive exercise.
  • Anorexia is thought to be the most common eating disorder experienced by autistic people. https://www.spectrumnews.org/news/anorexias-link-to-autism-explained/
• Binge eating disorder
  • regularly consuming excessive amounts until uncomfortably full
• Bulimia
  • binge eating followed by methods to prevent weight gain
• Other Specified Feeding or Eating Disorders (OSFED)
  • similar symptoms but not an exact match for specific eating disorder
  • May have a fear of food or weight gain
• Avoidant and restrictive food intake disorder (ARFID)
  • describes when someone has a limited diet in terms of range and quantity. AFRID is often driven more by sensory differences.
  • Possible reasons for ARFID include negative feelings over the smell, taste or texture of certain foods; or a response to a past experience with food that was upsetting, for example, choking or being sick after eating something
• Pica
  • describes the consumption of non-nutritive, non-food items.
  • Pica is not considered an eating disorder but is a difficult eating behaviour experienced by many families of autistic children and young people. Pica carries health risks including the potential for ingestion of harmful substances, choking, or gastrointestinal issues.
  • Understanding and managing Pica

Interview with Dr Liz Shea explaining Autism and eating disorders produced by the National Autistic Society.

More information on eating disorders can be accessed on the PEACE Pathway website