Neurodiversity and Disordered Eating: What's the Link?

Neurodiversity And Disordered Eating: What’s the Link?

Navigating the neurotypical world as someone with neurodiversity is complicated. Add disordered eating to the mix, and life becomes a whole lot less sweet.

It’s common for neurodiverse humans to struggle with their relationship with food. This can be due to different sensory and textural sensitivities, or issues with executive function and emotional regulation. It can also show up as disordered eating, and if left untreated, can lead to an Eating Disorder.

In fact, research has found that up to 70% of autistic children have issues with feeding and eating (1).

The good news is, that recovery and freedom from the grips of an ED is possible.

The so-called light at the end of the tunnel is intuitive eating. Getting there requires time and patience. But, with the right understanding and support from those around you, it’s achievable.

Understanding the link between neurodiversity and disordered eating is important in uncovering your journey to recovery, understanding how your mind operates and finding your sweet spot with food.

What Is Neurodivergence and Neurodiversity?

This refers to the natural variation in how our brains work and how people experience, understand and engage with the world.

Neurodiversity:

The term neurodiversity refers to the natural variation of how brains work and experience our environment, across the human population. It means the natural diversity of the human brain.

Neurodivergence:

A term used to describe the neurodivergent brains as a concept. For example: employers often do not know how to integrate neurodivergence into the workplace.

Neurodivergent:

This refers to a person whose brain is different from what is deemed ‘typical’ by society. Neurodivergent people include those who are Autistic, ADHDers, dyspraxic, dyslexic, have dyscalculia, have OCD, have Tourette’s Syndrome, and more (2).

Approximately 15-20% of the global population is estimated to be neurodivergent (3). This is clue numero uno to the link between neurodiversity and disordered eating.

UNDERSTANDING AUTISM

Autism (ASD) is a developmental disorder, that impacts how someone understands and navigates the world.

Autism is not uncommon – in Australia, about 1 in every 150 people are Autistic (3).

Autistic people can struggle with social interactions and communication, and can have repetitive behaviours and interests (4).

This may look like:

Avoiding eye contact
Inability to interpret social cues
Inflexibility in changes to routine
Movements, such as flapping hands when walking
Sensory processing difficulties – e.g. sensitivity to loud noises, specific textures

UNDERSTANDING ADHD

ADHD is one of the most common neurodevelopmental conditions diagnosed in children. Despite this, more and more people are being diagnosed in later life, particularly women (5).

ADHD can show up as; inattentiveness, impulsivity, and hyperactivity (internal or external).

This may look like:

Difficulty following tasks/instructions
Daydreaming frequently, unable to focus
Distractibility
Constant fidgeting
Acting before thinking

nEURODIVERSITY AND Disordered Eating

Disordered eating is a spectrum. There are a range of behaviours, thoughts and feelings that can show up and it often varies from person to person. It may look like the following:

Frequent dieting
Weight fluctuations
Labelling foods as ‘good’ and ‘bad’.
Preoccupation with body, shape and weight
Using exercise to ‘earn’ food

These can all take a huge toll on someone’s quality of life. It can limit the ability to socialise freely, manage emotions and mental health as well as compromise physical health.

As mentioned in some cases, these can spiral into an Eating Disorder.

Neurodivergent people are more likely to develop a disordered relationship with food. Children with Autism are nearly 5 times more likely to have disordered eating than their peers(6).

The connection between neurodivergence and disordered eating has been mostly found in those with ADHD and Autism (7).

Neurodivergent individuals often have sensory and textural sensitivities. This can look like:

Avoiding certain foods
Seeking certain textures
Hypersensitivity to flavours and smells
Experiencing sensory overload when confronted with something ‘unsafe’

These can cause an unhealthy relationship with food, as food becomes something that causes anxiety and distress.

Avoidant Restrictive Food Intake Disorder (ARFID) and Anorexia Nervosa are the two most common eating disorders in Autistic humans (8). ADHD is linked to Bulimia Nervosa, Binge Eating Disorder, and Anorexia Nervosa (9).

Autism and ARFID

We all need to eat to function. We need to eat a variety of foods, regularly and adequately, to fuel our bodies.

But for some, eating can cause immense anxiety – not related to the desire to lose weight.

This link between neurodiversity and disordered eating is often seen in Autistic people and characterises the lesser-known Eating Disorder.

Avoidant Restrictive Food Intake Disorder (ARFID) is an eating disorder that does not stem from body image and weight concerns. It’s estimated that 1-5% of the global population are living with ARFID (10).

CHARACTERISTICS OF ARFID

ARFID is often characterised by the following:

Fear of choking, which may be based on a traumatic previous experience
Fear of vomiting or feeling sick
Anxiety around contamination or the cleanliness of food preparation
Avoiding certain foods due to the texture, taste and smells that may be overwhelming

Doctors may also refer to it as ‘selective eating’, but ARFID is so much more than just ‘picky eating’. It can have serious physical and psychological complications.

21% of Autistic people are living with ARFID. Evidence suggests that the two conditions may be genetically linked (10).

UNDERSTANDING THE INTERSECTIONALITY OF NEURODIVERSITY AND DISORDERED EATING

There are common ASD traits related to disordered eating, including:

Heightened sensory awareness, avoidance of foods with specific tastes, smells and textures
Unwillingness to try new foods or different brands of foods
Timing rigidity and inflexibility to eat at different times and/or locations
Preference to stick to only ‘safe’ food choices
Rituals around eating: e.g. specific foods not being able to touch on a plate (11).

A common overlap between Autism and ARFID is heightened sensory awareness toward food. For some, this can manifest in the development of ARFID. For others, it may be a manageable symptom of their Autism, and not spiral into an eating disorder.

ARFID can stem from a previous traumatic experience that can cause long-term anxiety surrounding food. This could be an experience of choking or getting sick after eating, and can cause heightened preoccupation around food. In some, this trauma can cause the development of ARFID.

Autism and Anorexia Nervosa

Unlike ARFID, Anorexia centres around the desire to lose weight, and restrict the intake of food to achieve this goal.

Characteristics of Anorexia Nervosa include:

Distorted body image
Fear of gaining weight
Over-exercise as compensation
Restriction of energy intake

In most, these symptoms come alongside an obsession of having control.

EXPLORING THE LINK BETWEEN ANOREXIA AND NEURODIVERGENCE

Around 1 in 5 women who develop Anorexia also are Autistic (12).

While Anorexia is typically rooted in the preoccupation with body weight, shape and size, in Autistic people living with Anorexia, this isn’t always the case.

Living as a neurodivergent individual in a neurotypical world is overwhelming. Dealing with the complexity of a neurodiverse mind can create anxiety, distress and as a result, maladaptive coping mechanisms.

In some instances, this coping mechanism can manifest in developing Anorexia. Anorexia can be something to focus on, something to feel in control of, something that is a safety net to cope in a world that is overwhelming and scary.

ADHD AND BINGE EATING

Around 20% of people with ADHD experience binge eating at one point in their life (13).

This is thought to occur for a few reasons.

Lower levels of dopamine are found in ADHD brains, which can result in making impulsive decisions to seeking dopamine. This often extends to eating, which can cause the compulsion to binge eat to feel good.

Dopamine is a neurotransmitter in our brains, playing a role in our ‘reward centre’, and:

Pleasurable reward and motivation
Memory
Mood
Movement
Attention (14).

Food can provide dopamine, and activate the reward centres in our brain. In someone with ADHD, dopamine-seeking behaviours are common and binge eating is one way in which this occurs.

ALL ABOUT INTEROCEPTION

A commonality between most neurodiverse individuals is difficulty with interoception.

It’s the communication pathways for internal signals and cues such as; hunger, fullness and thirst.

This is present in all sorts of neurodiverse humans! Most neurodivergent people have difficulties recognising and identifying interoceptive cues.

This may look like:

Episodes of feeling ‘out of control’ around food, eating past the point of comfort
Forgetting to eat all day, distracted
Eating beyond comfortable fullness, difficulty to identify when you are satiated
Under-eating, due to a lack of appetite

Struggling with this is not a sign of failure. It doesn’t mean you are broken and need fixing. It just means you may need some extra support in learning to recognise and respond to the signals your body is sending.

Support and Strategies

Whether it’s an eating disorder or disordered eating, it is 100 percent possible to recover.

Struggling with disordered eating can be isolating.

For many neurodivergent humans, abnormal eating behaviours can feel so connected to one’s identity. Sensory, textural, routine-oriented – the disordered behaviours are engrained in the very basis of who you are.

It’s important to know, recovery is always possible.

It can take time. It may be tiring, and at times even feel wrong. But it is essential to commit to recovery and give yourself the chance of a full, complete and happier life.

Are you, or someone you know, a neurodivergent person struggling with disordered eating? Here are some strategies you can implement today:

1. SEEK PROFESSIONAL SUPPORT

Finding a treatment team, who understand this intersection is so important in the recovery process.

This may look like:

A General Practitioner (GP)
Accredited Practising Dietitian (APD)
Psychologist
Speech Pathologist (can help with feeding and eating difficulties)
Occupational Therapist (OT) (can help with emotional regulation)

A good team will work together to provide you with the best capacity for a sustainable recovery.

2. SENSORY FRIENDLY MEAL OPTIONS

In the initial stages of recovery, we recommend building a profile of different foods that are ‘safe’ for you.

This looks like choosing foods you used to love, ones that didn’t prompt any sensory overload. With time and support, you can continue to expand your diet to include some more options. The support of a Dietitian can help with this.

3. COMMUNICATION

Rather than keeping things to yourself, talk them through, with the people who love and care for you.

No matter how scared you may be to say it aloud, it is such a powerful step towards a sweeter relationship with food.

Reach out to friends, even friends you have grown distant from. Your behaviours may have isolated you from the people you love, but it is so important to have a support network moving forward.

The Butterfly Foundation are available from 8:00 am to midnight for support, encouragement and motivation.

4. PLANNING MEALS IN ADVANCE

Working with a Dietitian to create a plan tailored to you is a game-changer in reclaiming control from an Eating Disorder.

A Dietitian will work with you to implement strategies around food planning and preparation. This may look like:

Writing a list of grocery items together, planning a regular shopping day
Providing suggestions and recipes to meet your nutrient requirements
Holding you gently accountable. This could look like checking in and asking for updates on how things are going – you are never alone!

5. EDUCATE YOURSELF

Learning more about who you are, and why you are this way is a powerful tool in overcoming disordered eating. This could look like; reading books, blog posts (hello!) or listening to podcasts.

The Intersection OF NEURODIVERSITY AND DISORDERED EATING

Life as a neurodivergent person can be tough. Living in a neurotypical world, can be scary and overwhelming. It’s no wonder there’s such a strong link between neurodiversity and disordered eating.

Existing in the world as a neurodivergent human can bring a mixed bag of emotions. When things feel hard, please remember you are not defective.

In a lot of cases, disordered eating behaviours originate as a way of feeling safe or in control. But, as much as it may feel like you are in control, you are not.

The behaviours might have served a helpful purpose for you at one point but sustaining them will only cause more harm than good. Eating Disorders are deadly.

Instead, we recommend getting support to find your sweet spot with food and discovering new ways to cope.

With both lived experience of both neurodiversity and disordered eating, the Dietitians at Sweet Spot Health are here to provide tailored strategies to meet your specific requirements.

Reach out for a free Sweet Spot Strategy Call and begin your journey to a sweeter relationship with food today.