Understanding Eating & Autism
Eating = Survival
Eating is a basic survival drive. When this drive gets disrupted by undernourishment, restrictive diets, stress, trauma or anxiety, persistent problematic patterns around food can emerge. As these patterns take hold and repeat, people can begin to feel stuck and unable to make changes even when the pattern feels bad or wrong.
Disruption leads to Vulnerability
Neurodivergent people are vulnerable to disruptions of their eating drive and to getting caught in persistent problematic patterns with food. These vulnerabilities come from 2 sources:
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Being Neurodiverse. This includes differences and sensitivities in the brain, body and nervous system.
Read more.
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The impact of being a neurodivergent person living in a neurotypical-normative world.
Read more.
Neurodivergent Strengths
On the flip side, neurodivergent people have distinct strengths and capacities that, with affirming treatment, can powerfully translate into new and nourishing patterns with food that align with their needs, desires and life goals.
Our Approach
Our treatment focus is:
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Understand and minimize vulnerabilities.
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Build on your strengths.
Vulnerabilities of
Being Neurodiverse
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Vulnerability to inadvertent energy deficit/undernourishment.
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Unmet sensory needs leading to undereating.
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Medical issues like GI problems that make it difficult to eat enough.
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Reduced interoceptive awareness leading to missed hunger cues.
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Food insecurity.
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Challenges with practical aspects of eating because of differences in executive functioning like time management and planning, differences in focus (like getting stuck in project mode and forgetting to eat), differences in motivation and reward pathways and differences in sleep/wake cycles.
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Challenges with practical aspects of eating due to overall burn out or limitations of energy (low on spoons).
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Reduced appetite due to mood issues resulting from trauma, challenges with emotional processing, alexithymia, medical issues, loneliness, alienation, or burn out.
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Vulnerability to disrupted eating.
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Trauma around eating due to violations of sensory needs, bullying or shaming of how or what the person is eating,
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Overstimulating or under-stimulating eating environments.
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Food insecurity.
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Public humiliation from vomiting or getting sick after eating.
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Challenges with practical aspects of eating.
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Disorganized or erratic eating due to mood issues.
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Vulnerability to starting a diet that has been encouraged by social media, a family member, a friend or friend group, a coach or a medical professional, leading to energy deficit or disrupted eating.
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Pressure to ‘perform normalcy’ or mask in a neurotypical-normative world.
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Need to find a way to be accepted, desired, and protected against bullying or abuse.
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Need to ‘solve for’ feelings of inadequacy resulting from being different or from struggling with things that ‘should be easy’.
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Need to manage gender non-conformity or fluidity within gender normative systems.
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Need to find relief from GI problems or other medical issues.
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High drive to follow rules and be good
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High drive to excel at athletics or sports.
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High drive to optimize health.
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Vulnerability to getting caught in a reinforcing cycle of persistent problematic patterns with eating. These patterns can feel safe and familiar amidst the general overwhelm and anxiety of life as a neurodivergent person in a neurotypical world.
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Undernourishment and repetitive food behaviors can buffer or mute loneliness, existential angst, relationship pain, emotional overload, emotional pain, sensory overload or deprivation, rejection sensitivity, physical distress, social anxiety, gender distress, sexuality distress, burn out, mistreatment from others, marginalization, frustration with injustice and feelings of failure or inadequacy.
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Rigid rules or routines with food that aren’t congruent to true needs can take hold because the diet or routine has become a special interest or object of hyperfocus.
Vulnerabilities of
Mainstream Treatment
Vulnerability to being failed or harmed by mainstream treatment, leading to worsening issues with food and increased shame and hopelessness. These approaches can:
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Make incorrect assumptions about neurodivergent people based on their eating behaviors.
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Violate autonomy with authoritarian and arbitrary rules.
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Ignore or pathologize specific sensory needs around food and eating environments.
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Pathologize self-soothing behaviors around food like fidgeting or stimming.
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Require normative social engagement as part of group therapies.
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Lack recognition and support for the ways that issues of gender and sexuality affect eating.
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Push people into normative patterns of eating that might not fit for the person.
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Assume certain capacities like interoceptive awareness, normative emotional awareness or executive functioning which sets neurodivergent people up to fail.
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Force therapies that are harmful or ineffective for neurodivergent people such as exposure therapy for sensory desensitization or CBT (when not tailored to ND people) that invalidates real sensory and somatic experiences.
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Push ND people into normative ways of being in their body, or existing as a body, that don’t fit for them.
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Focus only on behaviors while failing to support the person with underlying issues.
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Focus only on underlying issues and failing to provide practical strategies to allow for sustainable nourishment.
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Lead ND people to acquiesce to eating behaviors that don’t fit for them which can be harmful, set them up to fail and increase self-alienation.
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Lead ND people to be labeled as resistant or problematic when they don’t follow eating rules or meet expectations that don’t fit for them.
Strengths of
Neurodivergence
Each client brings their own strengths to the process. Some examples:
High drive for understanding
Exploring the science of eating and how eating patterns emerge can offset shame and counter the sense that problems with eating are a personal failing. This understanding also allows for clarity in where and how to make sustainable changes.
High drive for agency and autonomy
Separating one’s own preferences, values and needs from negative external pressures and fighting for those values and needs can provide a way to move toward positive nourishment patterns.
High drive for change once motivated
Identifying individual motivation for change based in values such as justice and fairness, body or gender diversity, achievement in athletics/academics/art/ career/special interests or commitment and connection in relationships, is powerful in driving positive changes around eating.
Creativity
Creativity allows for brainstorming and identification of new strategies around eating that can provide consistent nourishment.
Innovation of thought
Innovation of thought brings new insights into eating patterns that aren’t immediately obvious and allows for the identification of connections in the patterns. This allows for greater possibility for understanding and positive change.
High likelihood of positively reinforcing patterns once new patterns develop
As people find better nervous system regulation around eating, they can become better nourished which increases nervous system regulation, which repeats in a positive loop.
Want to Know More? Read more?
1. The Correlation Between Neurodivergence and Eating Disorders (Psychology Today):
his article discusses the significant overlap between neurodivergent individuals and eating disorders, suggesting that neurodivergence may increase the risk of developing an eating disorder. It emphasizes the need for mental health counselors to educate themselves on this topic and consider individualized treatment approaches. [Read more] (www.psychologytoday.com)
2. Eating and Neurodiversity (The University of Edinburgh):
This project explores how eating behaviors and disorders are associated with neurodivergence, including studies on socio-emotional processing, interoception, and communication in autism and anorexia.
3. Eating Disorders and Neurodivergence (Within Health):
This article examines the relationship between autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and eating disorders. It highlights the need for more research and discusses the challenges in treating eating disorders in neurodivergent individuals.
[Read more] (withinhealth.com)
4. Nourishing Neurodivergence: Exploring the Impact of Diet and Nutrition (Neurodiversity Family Centre):
This piece explores how diet and nutrition can significantly impact the well-being and functioning of neurodivergent individuals, emphasizing the gut-brain connection and the role of dietitians in providing personalized guidance.
5. Adapting Intuitive Eating for Neurodivergent People (RDs for Neurodiversity):
The article discusses the importance of adapting intuitive eating principles for neurodivergent individuals, who may experience challenges with emotional eating and mindfulness in eating.
6. Neurodiversity and Eating Disorder Treatment for Patients (Eating Disorder Hope):
This article highlights the complexities in diagnosing and treating co-occurring neurodiversity and eating disorders, suggesting interventions like food texture exposures and coping skills for table overstimulation.