Eating Disorders Awareness Week 2022 and Autism/ASD/Aspergers
Amity
Administrator, Citizen
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
Autism and Eating Disorders Across the Lifespan - Bodywhys webinar 03/03/21
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.