Eating Disorders and Autism: What Parents and Adults Need to Know

Understanding why eating difficulties can look different in autistic people

Autistic children, teenagers, and adults are over-represented in eating disorder services, yet their experiences are often misunderstood. Many report that standard eating disorder approaches do not fully reflect their needs, leaving them feeling unseen or blamed.

This article explains how autism and eating disorders can overlap, what this means in practice, and why adapted, neurodiversity-informed support is essential.

Autism does not cause eating disorders, but it can shape them

Autism is not an eating disorder. However, autistic traits can significantly influence how eating difficulties develop, present, and are experienced.

Autistic people may be more vulnerable to certain eating difficulties due to differences in:

• Sensory processing

• Predictability and routine

• Interoception (recognising hunger and fullness)

• Anxiety and emotional regulation

These factors can interact with life stressors, transitions, or trauma, increasing risk.

How eating difficulties may present in autistic people

Eating difficulties in autistic individuals do not always look like stereotypical eating disorders.

They may involve:

• Strong sensory aversions to texture, smell, or temperature

• A very limited range of accepted foods

• Anxiety-driven avoidance of eating situations

• Rigid food rules linked to safety or predictability

• Difficulty recognising hunger or fullness cues

These patterns are often present long before weight or shape concerns appear, if they appear at all.

Autism, ARFID, and eating disorders

Autistic individuals are more likely to meet criteria for Avoidant/Restrictive Food Intake Disorder (ARFID), where restriction is driven by sensory sensitivity, fear, or lack of interest in food rather than body image.

However, autistic people can also experience:

• Anorexia nervosa

• Bulimia nervosa

• Binge eating disorder

In these cases, autism may shape how the eating disorder functions and how distress is expressed.

Why eating disorders are often missed or misunderstood

Autistic people, particularly girls and women, are frequently:

• Diagnosed later in life

• Misunderstood as “just anxious” or “perfectionistic”

• Expected to engage with therapies that rely heavily on emotional insight or abstract language

As a result, eating difficulties may be addressed without recognising the underlying neurodevelopmental context.

Why standard treatment may feel ineffective

Traditional eating disorder treatments often assume:

• Flexible thinking is easily accessible

• Exposure to fear foods is primarily emotional

• Motivation looks the same for everyone

For autistic individuals, these assumptions may not hold. Sensory distress, cognitive rigidity, or communication differences can make standard approaches overwhelming or ineffective if not adapted.

What neurodiversity-informed support looks like

Effective support for autistic individuals considers:

• Sensory sensitivities and environmental factors

• Predictability, pacing, and clear structure

• Concrete, literal communication

• Collaborative goal-setting

• Reduced emphasis on weight or appearance where irrelevant

Adaptation does not mean lowering expectations. It means changing how support is delivered.

For parents of autistic children

Parents often worry that eating difficulties are being:

• Overlooked as “part of autism”

• Or over-pathologised unnecessarily

A careful assessment helps clarify whether eating difficulties are:

• Developmental

• Sensory-based

• Anxiety-driven

• Or part of an eating disorder

Understanding the driver allows support to be targeted appropriately.

For autistic adults seeking help

Many autistic adults report:

• Long histories of eating difficulties

• Feeling blamed for not “engaging properly” in treatment

• Needing to mask distress to access care

Support works best when autism is understood, not treated as a complication.

The importance of assessment-led care

Assessment-led care allows clinicians to:

• Understand the function of eating behaviours

• Distinguish sensory needs from eating disorder pathology

• Avoid one-size-fits-all treatment

This approach reduces harm and improves engagement.

How we work at The Eating Disorders Clinic

At The Eating Disorders Clinic, we take a neurodiversity-informed approach by:

• Actively considering autism and ADHD during assessment

• Adapting therapeutic and dietetic interventions

• Working collaboratively with individuals and families

• Avoiding assumptions based on appearance or weight

Our focus is on understanding the person, not forcing them into a model.

A gentle next step

If you or your child is autistic and struggling with eating, you are welcome to book a free initial call to explore whether assessment or support may be helpful.

You may also review our website before deciding