Neurodiversity + Eating Disorders
ANAD is starting an important conversation around the relationship between neurodiversity and eating disorders. We hope this page will serve as a valuable resource for provider understanding, patient advocacy, and general education.
Understanding Neurodiversity
Neurodiversity is a common term used to describe the different ways people’s brains process and interact with the world around them.
While commonly used in the context of autism spectrum disorder, it’s important to note that neurodiversity can apply to other neurological and development conditions such as ADHD, dyslexia, and Tourette syndrome.
Learn more in this video conversation with Alex Rodriguez who shares his personal experience with an eating disorder, autism, and ADHD.
Relationship Between Neurodiversity and Eating Disorders
Yes, recent studies have shown that neurodivergent individuals may be at an increased risk of developing an eating disorder. With one international study, finding that 17.2% of people with eating disorders also had ADHD, while 8.3% had an autism spectrum disorder.
When it comes to treating and supporting neurodivergent individuals with an eating disorder, it’s important to remember the importance of a personalized and humanistic approach. Neurodivergent individuals may benefit from different treatment methods and support options. Below, we share some considerations to keep in mind.
Neurodiversity + Pica
Recent research is highlighting an association between neurodivergence, particularly Autism
and Attention Deficit Hyperactivity Disorder (ADHD), and eating disorders. These patients tend to have more severe disordered eating symptoms that are sustained over a longer time frame when compared to individuals without the comorbidity. Subsequently, they are at greater risk for experiencing a prolonged course of illness and an increased risk of chronicity. Treatment outcomes tend to trail behind as well.
Some studies have reported that as many as 23% of individuals with eating disorders also have autism. Additionally, studies have demonstrated between 14 and 36% of children with autism engage in pica behaviors. Similarly, research has shown that 26% of children with intellectual disability also engage in pica behaviors. In individuals that have intellectual disability and are older than the diagnostic criteria of being over 2 years of age, pica behaviors may be considered in line with their developmental age but still require focused treatment and supervision.
Understanding the impact neurodivergence may or may not have on the individual is important
in developing the treatment plan and determining how much supervision/monitoring is warranted.
Considerations for Neurodivergent Patients
Routines can be important in managing aspects of neurodiversity. Neurodivergent patients may benefit from creating a structured routine or may need additional structure in their daily schedule at higher levels of care. They may also require additional support when having to deviate from a planned schedule or routine, such as flexibility in moving to a new schedule or routine or advance notice of upcoming changes. Also, plan to provide additional time for processing and coping ahead of any changes.
Neurodivergent patients may experience challenges with memory and attention. Encourage writing things down or explain instructions more than once, and share frequent reminders to complete tasks that may seem basic or routine like brushing teeth or bathing.
Neurodivergent patients may have sensory challenges outside of foods they eat, including sensitivity to eating and chewing sounds in the café, sensitivity to sound when around groups of people, clothing/fabric sensitivity, and sensitivity to bright lights. Allow patients to utilize noise canceling headphones or noise reducing earplugs or dimming lights in programming rooms. This can help to avoid patients becoming overwhelmed or overloaded by sensory inputs.
Neurodivergent patients may be hyposensitive or are sensory seekers and need additional sensory inputs than a neurotypical individual might. This often takes the form of stimming (i.e., repetitive movements, sounds, or fidgeting) and is used to help individuals remain calm, manage stress, or cope with uncomfortable sensory input. Patients who engage in these behaviors may appear on the outside as though they are engaging in excessive movement and may have a difficult time complying with expectations around movement. It is helpful to provide an alternative activity or outlet for these stimming behaviors.
Examples include: Providing a fidget toy, allowing breaks throughout the day to utilize stimming behaviors in an environment that won’t trigger peers, coaching on use of other coping skills to manage stress, and reducing sensory stimuli in the environment.
It is common for neurodivergent patients to experience challenges with impulse control and social skills. Staff and members of the treatment team should be aware of impulses and remember that providing frequent reminders and external incentives for managing impulses can be helpful.
When appropriate, social skills training can be useful. It is also important to utilize group reminders that they may have neurodivergent peers and that we want to be inclusive and sensitive to individual needs within the treatment community. These messages should be delivered with tact, are not shaming, and do not single out any neurodivergent individuals unless they specifically request that they are identified as such.