Research has shown an overlap between neurodivergence and those struggling with eating disorders. Neurodivergence is a term used to describe folks whose minds process information differently than what society has deemed the standard, including variations in how they interpret, experience, and absorb their surroundings. Eating disorders are mental illnesses characterized by disruptions in a person’s behaviors with food and perceptions of their body.
Due to perpetuated stereotypes across media and academic institutions, eating disorder research was previously skewed to focus on Western female populations, giving a false perception of who was struggling with these disorders. However, as new research continues to evolve and awareness of the presentation of neurodivergence among marginalized populations is built, we are learning how a diverse range of populations are impacted by these disorders.
One of these populations is the neurodivergent community. There is a multitude of reasons why neurodivergent people may be at an increased risk of developing an eating disorder. They may have increased or decreased sensory sensitivities, difficulties identifying hunger and fullness cues or experience emotions more intensely.
Many of these differences are then exacerbated due to the stress of having to live in a world designed primarily for neurotypical people, which could lead to the development of an eating disorder. However, due to differences in how they process the world around them, neurodivergent folks also commonly have their own relationship with food that may appear to a neurotypical person as disordered.
But does someone whose experience of the world is privileged to align with the neurotypical society get to make this judgment call? Is it even possible to make a sweeping definition of what disordered eating looks like in neurodivergent populations?
I’ll do my best to briefly explore the nuances of disordered eating among neurodivergent populations as well as identify some parameters for when disordered eating becomes a concern.
As I mentioned, many neurodivergent individuals have a unique relationship with food due to differences in how they interpret the world around them. Folks may stick to the same foods each day, be fearful of trying new things, struggle with hunger or fullness cues, avoid going out, or forget to eat and then eat a lot at once. But is this disordered?
Disordered is a word that suggests a disruption to a person’s overall functioning. This means for eating to be disordered, it would cause increased challenges to an area of functioning. These areas of functioning could be:
Whether or not functioning is impaired for a neurodivergent individual should not be determined through a neurotypical lens. Instead, it should be seen in collaboration with what the individual reports and/or desires to see in their life moving forward.
For many clinicians, this involves pushing against the traditional methods for eating disorder treatment to see things from a more holistic and nuanced perspective because neurodivergence is a piece of the person, not a clinical symptom to treat as if to make it disappear.
One distinction between an eating disorder and disordered eating lies in how impactful a person’s eating behaviors are on their overall health, functioning, and quality of life. Diagnostic criteria require that an eating disorder significantly impact a person’s functioning in one or more areas of their life. This means that disordered eating has intensified to the point where a person’s well-being is jeopardized by the illness.
Identifying an eating disorder in neurodivergent folks may be complicated because symptoms don’t always align with the perception of eating disorders that we have from the media or society. Below is a list of some signs more specific to neurodivergent individuals:
As I mentioned, not all these behaviors have to be labeled as disordered in nature. It is more about whether these behaviors lead to impairments to an individual's well-being. For a personal look into this concept and more information on this topic, you can check out this article, where I offered some additional insights.
Early intervention can be an important factor in recovering from an eating disorder. However, reaching out for support when an individual is neurodivergent may feel more complicated because it can be challenging to find providers who have a background in eating disorder treatment and an understanding of neurodivergence.
For this reason, it can be helpful to schedule consultation calls with providers before committing to working with them. In these calls, you can ask about their experience with neurodivergent folks and how they work to take a nuanced approach to treatment beyond the traditional eating disorder interventions, which weren’t developed considering neurodivergent experiences.
References
Adrian G-S, Victoria M-M, Luis B-F. Connecting Eating Disorders and Sensory Processing Disorder: A Sensory Eating Disorder Hypothesis. Glob J Intellect Dev Disabil. 2017; 3(4): 555617
Balasundaram, P., & Santhanam, P. (2022). Eating Disorders. In StatPearls. StatPearls Publishing.
Baron-Cohen, S., Jaffa, T., Davies, S., Auyeung, B., Allison, C., Wheelwright, S. (2013). Do girls with anorexia nervosa have elevated autistic traits? Molecular Autism, 4(24), 2-8.
Biederman, Joseph MD*†; Ball, Sarah W. SCD*; Monuteaux, Michael C. SCD*†; Surman, Craig B. MD*†; Johnson, Jessica L. BS*; Zeitlin, Sarah BA*. Are Girls with ADHD at Risk for Eating Disorders? Results from a Controlled, Five-Year Prospective Study. Journal of Developmental & Behavioral Pediatrics: August 2007 - Volume 28 - Issue 4 - p 302-307 doi: 10.1097/DBP.0b013e3180327917
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