Eating Disorders Awareness Week 2022 and Autism/ASD/Aspergers

AmityAmity Administrator, Citizen
Here in Ireland it is "Eating Disorders Awareness Week 2022" run by "Bodywhys".

Long before I knew about Autism I had an eating disorder, bulemia, at the time my parents were advised by the family GP to ignore it as they considered it to be attention seeking behaviour. For me, it was about having control over something in my life, an area that I could predict... a fundamental human necessity that I had control over, food.

I look back now and wonder, how many signs did there need to be for the adults in my life to recognise that I needed help.
So much judgement and little support. Times have changed, thankfully, but I wonder by how much. There seems to be more understanding and awareness, yet I wonder how many adults in an Autistics childs life are aware of this form of self harm.


Autism & Eating Disorders

The diagnostic language associated with autism is Autism Spectrum Disorder (ASD). However, the autistic community often prefer to be identified as ‘autistic’ rather than as ‘a person/people with autism’.

Background

Mental health problems can be more common amongst autistic people, compared to the general population.

The relationship between eating disorders and autism is highly complex, with many aspects to consider. Some people may be assessed for autism at a young age, however for others, this may not occur until later in life, or when they are at a crisis point – such as an eating disorder.

Whether autism is a direct contributory risk factor for eating disorders is still an open question. Some autistic people may experience a range of food related difficulties that are challenging, but that are distinct from the primary eating disorders: anorexia nervosa, bulimia nervosa or binge eating disorder.

Challenges

Some autistic people, or parents, may describe long-standing social and communication difficulties.

  • Challenges at school and with friendships, prior to the onset of an eating disorder.
  • Social situations centred on eating and food.

Some may experience anorexia nervosa and the effects of starvation on the cognitive, emotional and social aspects of their life may, at times, draw similarities with autism. However, when someone is acutely unwell with an eating disorder, assessment for autism may prove incredibly challenging since issues such as restricted and repetitive behaviours may overlap.

Autistic people may experience more severe eating disorder symptoms, depression, and difficulties in work and the social spheres of life.

Cognitive difficulties experienced by autistic people with eating disorders include:

  • Seeing the bigger picture, not just details
  • Shifting from one action to another with ease
  • Understanding that others (who are not autistic) have distinct beliefs, desires, hopes and intentions

Food and eating difficulties

Behavioural rigidity in the context of food and consumption

  • Food cravings
  • Food refusals
  • Limited diet – a narrow focus on specific foods and an over-reliance on specific food categories (for example, refined carbohydrates). This may be associated with ARFID
  • Sensory problems that contribute to eating difficulties
  • Behaviours with significant health risks – for example, Pica, rumination and disruptive mealtime behaviours
  • Rapid eating behaviours – for example, binge eating disorder

What can help?

There is no single strategy that works for autistic people with eating disorders. Where autism is a factor, treatment will depend on the presentation of eating disorder symptoms and the person’s experience of being autistic. Variations in ability across the spectrum are important points to consider when determining what is the best course of support. Given that inflexibility is associated with autism, the persistent nature of eating disorder symptoms, and in some instances, poor introspection, therapeutic approaches need to be adapted to accommodate these challenges. It is preferable that clinicians providing treatment have knowledge of both autism and eating disorders.






Comments

  • AmityAmity Administrator, Citizen
    edited February 28
    Also from Bodywhys:

    Autism and Eating Disorders Across the Lifespan - Bodywhys webinar 03/03/21





  • AmityAmity Administrator, Citizen
    Going to move our last few comments to the lounge
  • Teach51Teach51 Citizen
    edited March 2
    Thanks Amity for this thread, I have battled with an eating disorder my entire life. I don't have ASD but I do have CPTSD and also ADD, I was in a twelve step program (Overeaters Anonymous) for 18 years, people with all eating disorders are welcome there and often find recovery if they are prepared to face their own demons and work through the steps with a sponsor. I cannot be sure but I believe that due to the toxic, abusive and neglectful environment I grew up in, binge eating developed as a self-soothing, compensatory coping  mechanism. I don't know if I have the comorbidity of OCD but I definitely have some traits, I also have a couple of friends with ASD who have OCD and food addiction (multiple addictions) and  binging. 
    My eating disorder is both emotionally based and allergy based. A binge was triggered by stress, verbal or physical abuse at a very very young age so food was the only drug available. Later on in life I struggled and still struggle with cigarettes, alcohol, sex and food addiction though I do manage to abstain from self-harming with these things it is a struggle especially during traumatic episodes. I am also allergic to flour and sugar, when I abstain from these foods I am able to maintain a relatively sane food regime.
    I believe that I have been "conditioned" to crave food during emotional distress and traumatic response, but I have acquired many tools through OA and therapy that enable me to channel my distress in a manner that guides me away from self-harm and I can work through it honestly and less reactively. Eating disorders deflate your self-esteem, promote self-disdain and self  hate, manifest as a form of control/reactive mechanism in an impossible to cope with toxic environment. How  a person with ASD would cope with a twelve step program I don't know as it requires a great deal of intimacy and emotional sharing. I believe medication administered for OCD also curbs addictions and compulsive behaviour. 

  • HylianHylian Citizen, Mentor
    I don't think that I've ever had a full on eating disorder, but I've struggled with "disordered eating" since I was around 15 (maybe earlier, but that's when it became noticeable to me?). I've met an interesting amount of autistic people online who have EDs or struggle with disordered eating. I honestly don't know if my ASD or my OCD-like issues contribute more to my problems with this, though when I was 17 and realized I actually had a "problem" is when I started to also notice the OCD-like issues, so maybe they do contribute more.
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