Autism and Eating Disorders: A Personal and Professional Perspective

As an autistic individual who has personally experienced recovery, I bring a unique perspective to my work with teens navigating both autism and eating disorders. While the co-occurrence of these conditions is common—up to 37% of individuals with eating disorders are also autistic—many clinicians and providers remain unaware of this overlap. This can significantly impact the treatment experience and outcomes for individuals with both conditions, especially when typical interventions fall short of addressing their specific needs.

For those of us with autism, the experience of an eating disorder can look different from the typical presentations clinicians may be accustomed to. Through my work, I guide teens and their families by tailoring interventions that honor each individual’s unique experiences, sensory preferences, and communication styles. Below, I share insights into how autism and eating disorders might co-present and offer essential considerations for working with this population.

How Autism and Eating Disorders May Present Together

Individuals with both autism and an eating disorder often exhibit unique behaviors and challenges that require a compassionate, individualized approach to treatment. In my work with teens, I frequently see overlapping characteristics such as:

• Sensory sensitivities: Many autistic teens have specific food aversions or preferences related to texture, smell, and color, which can complicate eating habits and contribute to restrictive eating patterns. I use sensory-informed approaches to ease mealtime anxiety and gradually expand their comfort zones.

• Rigid thinking and routines: Fixed routines and strong preferences can lead to rigid dietary habits that might resemble eating disorder behaviors but often stem from a need for predictability. I work with teens to introduce flexibility into their routines, helping them find a healthy balance that respects their need for structure.

• Difficulty identifying and expressing emotions: Many autistic individuals and those with eating disorders experience alexithymia—difficulty recognizing and expressing emotions. In therapy, I use creative strategies to help my clients build emotional awareness at a pace that feels comfortable and safe.

Treatment Outcomes and Considerations

The treatment journey for individuals with autism and an eating disorder can vary widely. Outcomes often depend on factors like sensory processing needs, the level of support available, and the degree to which treatment is adapted to the individual. It’s essential to understand these unique presentations and adapt interventions accordingly.

Adapting Evidence-Based Interventions

When working with teens who have both autism and an eating disorder, I modify evidence-based approaches to align with their individual needs. Here are three strategies I’ve found particularly effective:

1. Sensory-Informed Meal Planning: I incorporate my clients’ sensory preferences into meal planning, using familiar foods and providing a comfortable environment. This allows them to approach meals with less anxiety and greater comfort, eventually building confidence to try new foods.

2. Routine Flexibility Training: Routines can provide comfort, but overly rigid eating schedules can hinder progress. I help my clients find a middle ground, integrating flexibility into routines without disrupting the predictability that many autistic individuals find reassuring.

3. Collaborative Cross-Specialty Support: Working with occupational therapists, sensory integration specialists, and other professionals enhances the support system for my clients. Cross-collaboration ensures that each aspect of their needs is met in a coordinated way.

By drawing on both my personal journey and professional expertise, I strive to create a treatment experience that honors each teen’s individuality. For clinicians, understanding and adapting to these unique needs can be transformative, paving the way for more inclusive and effective care. Together, we can support autistic teens in achieving recovery that respects their full spectrum of needs.