This week is World Autism Acceptance Week. We know all too well at tastelife that eating disorders affect people from all walks of life, they do not discriminate. We asked Barbara Mitra from Worcester University to share with us, her knowledge and experience of the visible link between eating disorders and autism.
There are a lot of stereotypes about autism, ranging from portrayals of savants in films like Rain Man to those that are non-verbal. Whilst it is a huge spectrum and individuals vary, research does show that issues around eating are common in autistic individuals. These can range from eating only a few selective foods to extreme anxiety about foods and mealtimes or just a lack of interest in food itself. I know this as my own son (with a diagnosis of ASD/PDA Autism Spectrum Disorder and Pathological Demand avoidance), has had numerous issues around food. Sensory issues have included not being able to stand the smell of some foods as well as the texture or strong colours – Broccoli springs to mind.
Other issues are around mealtime and expectations – particularly sitting at the table as a family. The sensory issues extend to being hypersensitive to noise and sound which includes other people eating as well as the conversations that happen at the dinner table. We have learnt not to conform to what is expected but to be more relaxed about mealtimes. We began by letting him eat in his room or in the lounge on his own – and slowly as he has become better at handling his anxieties, he often chooses to sit with us at mealtimes. However, if we have guests eating with us, he struggles greatly with the conversations and will disappear very quickly! He hates people watching him eat!
The PDA diagnosis means that our son goes through phases of eating certain foods. Whilst fads are common, these can be quite extreme for those on the spectrum, such as just eating one type of food of a certain colour or texture. It was also more obvious when he was younger that he didn’t know when he was full and could easily overeat, particularly craving chocolates, cakes and crisps and could easily continue to consume 5 or 6 packets at one sitting.
Some children on the spectrum also eat non-foods – and I remember one time my son ate some tulips (which happened to be a mother’s day present) and we spent time on the phone trying to work out whether they were poisonous or not. Thankfully he doesn’t do this very often now that he is an older teenager.
Whilst statistics vary, some research suggest that 20% of people with anorexia are also autistic. At the same time, 70% of autistic children have issues with food or eating. I have a friend whose child had an autism diagnosis long after they had been suffering with anorexia. I think it would also be useful for those involved in treatment and recovery to be aware of the link between autism and eating disorders.
written by Dr Barbra Mitra – Senior Lecturer in Media and Culture, Joint Head of Department of English, Media & Culture
Solmi, F., Bentivenga F,. Bould, H., Mandy, W., Kothari, R., Rai, D. Skuse, D. and Lewis, G. (2021_ Trajectories of autistic social traits in childhood and adolescence and disordered eating behaviours at age 14 years: A UK general population cohort study. Journal of Child Psychology and Psychiatry. 62(10), 75-85. https://doi.org/10.1111/jcpp.13255
I realised this link years ago when my 14 year old daughter, who had only recently been diagnosed with autism, became severely anorexic. Sadly the treatment she received, which included two inpatient admissions, was not really effective as there was a very ‘one size fits all’ approach, and little acknowledgment of her autism. Now aged 29 she is weight restored but still suffering badly from bulimia and body dysmorphia. She has little faith in talking therapies as they ‘never worked before’ and she is very apprehensive about joining a group since social interaction is so challenging. I would welcome any new ideas about how to help people in her situation. It seems that there is not much out there for people on the autistic spectrum with eating disorders, even though it has long been known that they often have issues with food and eating.
Thank you for your comment – I wonder if the online groups might help if they are set up in a way that she won’t have to interact too much (such as not turning on her camera or microphone) and just listening? I hope you both find something that works and helps.
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