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The connection between eating disorders and Autism has been on the radar since at least the 1980s. Here's what Autistic individuals, parents, and professionals need to know. *This article talks about eating and food issues, please consider this a blanket content warning.* Please note that feeding and eating disorders are complex. This post can only act as an overview and a starting point for more research. Please contact a health professional if you have concerns about eating for yourself or your child.
Autistic children and adults are known to have patterns of restrictive eating. In some cases, it can be extreme where a child or adult only eats a handful of foods. First, it's important to understand the difference between being a selective or "picky" eater and having an eating disorder.
Where is the line between selective eating, eating disorders, and feeding disorders?
The most important factor to consider here is an individual's health, comfort with eating and, in the case of a child, growth. Feeding and eating disorders impact a child's nutrition and growth. If a child or adult is having health concerns, vitamin deficiencies, or is not growing and gaining weight on a glide path, this is cause to seek medical intervention. If an adult is having health concerns or vitamin deficiencies or is having distress around body image or eating, this is cause to seek intervention. I don't include weight here because this is highly variable and may not be linked to health. Please see Health at Every Size for more information about this. If a child or adult is highly selective in what they eat but are growing, are getting enough nutrition (this can be determined through testing or a food analysis by a registered dietician), and are healthy, the selective nature of their eating habits may be a common part of their makeup as an Autistic person.
Common feeding disorders seen in Autistics include Avoidant Restrictive Food Intake Disorder (ARFID) and pica (the ingestion of non-food items). Pica is always a concerning issue that requires vigilance to prevent injury. ARFID was referred to in the DSM as selective eating disorder in the past. ARFID might sound like Autistic eating because most Autistics are avoidant and/or restrictive in their eating habits, but what makes the difference--what makes it disordered--is the impact on health and growth, and internal distress. Feeding disorders differ from eating disorders in motivation. Both selective eating and feeding disorders are often about sensory issues. Eating disorders are coping methods with internal states of distress such as body dysmorphia
If you aren't sure about your or your child's health (or growth in the case of a child), ask your physician.
ARFID might sound like "Autistic eating" because most Autistics are avoidant and/or restrictive in their eating habits, but what makes the difference--what makes it disordered--is the impact on health and growth and internal distress.
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