Eating Disorders and Autistic Spectrum Disorder – what’s the link?
Why has my daughter with an eating disorder (ED) been diagnosed with an Autistic Spectrum Disorder (ASD)?
It isn’t uncommon for a teenage girl to be admitted into hospital with an eating disorder for refeeding and treatment to later be diagnosed with an Autistic Spectrum Disorder.
Parents can feel really baffled by this. So what’s it all about?
Traits within ASD and ED often overlap.
- Rigidity of thought. Sticking to rules is common in both ED and ASD. It happens that the young person with ASD has applied some rules to food to keep their weight at a set point. Unfortunately then deviating from these ‘rules’ is extremely difficult as young people with ASD struggle immensely to understand the rationale or logic to changing rules. As weight plummets cognitive ability also declines leading to distorted thinking and married together, the two can be tricky indeed.
- Empathy and understanding. Often a parent will struggle to understand why their child is ‘hurting them’ by not eating. In reality a child with ASD and ED cannot empathise or understand how their behaviour makes a parent think and feel. This concept is called theory of mind.
- Social communication. Often not eating is a form of communication. Having ASD can make communicating your thoughts and feelings particularly tricky. Food can communicate how you’re feeling more powerfully. When you combine this with rigidity of thought and difficulty with empathy and understanding it can be very unhealthy indeed. Interpreting social information can also be tricky. Society says being thin is good. Therefore I must be thin. Therefore I just follow rules to remain thin. Society says not being thin is bad. Not seeing the whole picture here such as maybe societies views are unhelpful or wrong or maybe body acceptance is good is very difficult for someone with ASD. Thinking can be more linear and pragmatic.
Supporting a young person with ASD to eat again can feel like a mountain to climb. They have developed a myriad of strict rules around eating and exercise. However this can be reversed. Using clear boundaries and ‘rules’ to combat the eating disorder can work in its favour. Using language such as ‘look at how this is affecting you mother’ will prove less effective as the young person is unable to do this.
Seek advice and support from your clinical team specifically around ASD and ED and how the two relate. Try to view the world through a very different lens, your childs lens of social demands, rigid cultural expectations and complex pressures. Over time it becomes clearer how the two correlate