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Eating disorders

An eating disorder (ED) is a mental health condition that can affect anyone. Eating disorders can include regularly eating too much or not enough to manageg difficult emotions, or excessively worrying about body weight or shape. Eating disorders can have a significant affect your physical and mental health. Research suggests that autistic people may be more likely to experience eating disorders. With the right support, most people can recover from an eating disorder. If you are struggling with an eating disorder, the right support could help you develop healthy eating patterns and cope with the underlying causes.

What is an eating disorder?

An eating disorder is a mental health condition where you might use food and eating to cope with emotions or situations.

The NHS states: 

'An eating disorder is when you have an unhealthy attitude to food, which can take over your life and make you ill. It can involve eating too much or too little or becoming obsessed with your weight and body shape. But there are treatments that can help and you can recover from an eating disorder.'

Some of the main types of eating disorder, as classified within diagnostic criteria, are listed below: 

Avoidant and restrictive food intake disorder (ARFID) is also a recognised eating disorder and describes when someone has a limited diet in terms of range and quantity. AFRID is often driven more by sensory differences.

You may be more likely to develop an eating disorder if you have:

What are the effects of an eating disorder?

Physical effects can vary between people and diffeent disorders, but can include: 

If you have an eating disorder you may be more likely to experience other mental health conditions such as anxiety and depression. 

Eating disorders can have very serious consequences and can result in hospitalisation. Read more about eating disorders on the NHS website.

Eating disorders can be very difficult to manage and cope with. You may have feelings of shame and guilt, and this might lead to strained relationships. It is important to get help and support.
 

How common are eating disorders in autistic people?

We do not know how common eating disorders are for autistic people. Some research suggests between 4% to 23% of people with an eating disorder are also autistic. Some research suggests anorexia is the most common eating disorder amongst autistic people.
 

Why might autistic people develop an eating disorder?

For non-autistic people, issues with weight or body image are often the reason they develop an eating disorder. For autistic people, the reasons can be different and may include: 

Being misunderstood or not accepted by non-autistic people may also lead to autistic people feeling socially isolated. For some, focusing on weight might feel like a way to fit in and reduce their social anxiety.

Many autistic people eat restricted diets. This would not be considered an eating disorder unless it is significantly affecting their everyday lives.
 

How do I get help and support?

If you think you might have an eating disorder, then try to speak about your feelings to someone you trust. You can also speak to your GP about getting further help and support.

There are no national guidelines for treating eating disorders in autistic people. The treatment is the same for autistic and non-autistic people.


Therapies

The National Institute for Health and Care Excellence (NICE) recommend that children and adults with an eating disorder should have access to psychological therapies that specialise in treating eating disorders. These include individual, family and self-help therapy.

Ideally, someone with a good understanding of autism should deliver all treatments and therapies. Professionals should consider how things like sensory differences, routines and structure may play a part in your eating disorder, and how this differs from non-autistic people.

You may find certain therapies and treatment programmes, particularly group-based ones, difficult. They may involve a lot of social interaction. You might find it difficult to identify, understand and talk about your feelings around food. Support should be adapted to your specific needs. Visit our Seeking help with mental health page for more advice.

Autistic people often experience health inequalities because therapies and treatments…are set up for neurotypical people, and professionals are not able to be flexible in how they work.
Autcasts Online (2019)

Medication

NICE do not recommend the use of medication as a sole treatment for eating disorders. 

Advice and tips

You might find some of these tips from autistic people who have experienced eating disorders useful:

  • Ask for help and seek professional support
  • Keep in contact with friends and family
  • Use hobbies to distract yourself
  • Accept that recovery takes time, sometimes years, and it will be different for everyone
  • Create healthy routines around meal planning and exercise.

Read some personal accounts below:

Links, resources and article sources

Related advice and support

Anorexia nervosa: Mair Elliott and Dr William Mandy interview

Anorexia nervosa in autistic females

Autism and controlled eating

More

Eating disorder or disordered eating?

Supporting autistic people with eating difficulties

Top 5 autism tips: eating issues

Last reviewed: May 2021

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