Eating disorders: Get the facts and supports

With the rising awareness of both eating disorders and neurodiversity, it’s important to acknowledge that autistic and ADHD individuals are four times more likely to develop an eating disorder compared to the general public.

The question is why?

For many clinicians and individuals, the connection is most obvious in quiet, everyday moments: a young person who eats only a narrow range of foods because of overwhelming sensory discomfort, someone whose strict food routines provide relief from anxiety and unpredictability, or an adult who cycles between forgetting to eat and bingeing, unsure why regulation feels so difficult.

These experiences are rarely about body image, and therefore are often overlooked within traditional eating disorder narratives.

In Ireland, more than 1 in 20 people will develop an eating disorder in their lifetime, with recent figures showing diagnoses have increased by more than 30% in the last year.

This highlights both the scale of the issue and the urgency of understanding risk factors, including neurodivergence.

Neurodivergent is an umbrella term that covers a variety of presentations including autism, ADHD, Tourette’s syndrome, and dyslexia. Within the neurodiversity paradigm, these presentations are reframed, no longer as disorders that need to be fixed, but as natural variations in the human brain, body, and behaviour. Simultaneously, this does not negate the very real needs neurodivergent individuals may have or the supports required for them to interact with society on an equal level to their non-neurodivergent counterparts.

Meanwhile, eating disorders manifest in various forms including anorexia, bulimia, orthorexia, binge eating disorder, and ARFID (avoidant/restrictive food intake disorder).

They affect people of all ages, genders, sizes, and neurotypes. While they can have physical consequences, they are classified as mental health conditions due to the profound emotional and psychological impact they have on people’s lives.

Autistic and ADHD individuals are about four times more likely to develop an eating disorder compared to the general population.

For many neurodivergent people, food and disordered eating is not just about body image, but also sensory sensitivities, routine, predictability, control, anxiety reduction, and emotional regulation. Additionally, neurodivergent individuals are more likely to have experienced trauma, and eating disorders can develop as a way of coping with this.

For autistic people, an eating disorder can provide structure - a routine or a set of rules to follow - which is deeply reassuring to someone who has difficulty with change and uncertainty. For individuals who are socially isolated, focusing on food or body image can also provide a pathway to social connection and belonging. Furthermore, deep diving into food, calorie counting, or diets can become a special interest that is hard to switch off for the autistic monotropic brain. None of this, is about being thin.

From an ADHD perspective, a key contributor is dopamine dysregulation, and food can be a way of managing this. Dopamine, the brain’s feelgood chemical, is central to the brain’s reward system - it helps regulate mood, motivation, and pleasure. With lover levels of dopamine, people with ADHD turn to food as a way to help regulate this or their emotions (or often both!) This can be compounded by difficulties in organisation and time management, leading to irregular meal times. Which can then be further exacerbated by not noticing hunger or simply forgetting to eat. This makes it all too easy to fall into binge eating cycles.

For both autistic and ADHD individuals, it’s important to emphasise these characteristics do not equate to an eating disorder, nor should they be pathologised when they are not causing harm. Everyone is wired differently.

However, understanding how these factors may contribute to disordered eating, exacerbate it, or complicate recovery is crucial in terms of eating disorder recovery.

In practice, this means it is essential that neurodivergent individuals with eating disorders seek treatment from professionals and organisations with adequate understanding of both eating disorders and neurodiversity. For while certain neurodivergent traits may interact with the disorder, treatment should avoid pathologising neurodivergence itself, and recognise that not all atypical eating behaviours require intervention.

It is also important to remember that many neurodivergent individuals remain unrecognised or undiagnosed. Additionally, eating disorder symptoms can mask neurodivergent traits, yet identifying the missing piece of a neurodivergent brain, can significantly improve treatment outcomes.

Increasing neurodiversity awareness, and recognising the diverse presentations of autism and ADHD, plays a role in improving mental health outcomes for these individuals. Autism and ADHD manifest differently in everyone, and are often unrecognisable unless you know the person well.

Ultimately, regardless of neurotype, eating disorders are not a choice. They often develop as coping strategies for stress, trauma, anxiety, and more. Living in a culture that pathologises larger bodies while idealising smaller ones creates fertile ground for disordered relationships with food. As with all mental health difficulties - listen before you judge.

Eating disorders can devastate lives and minds, yet recovery is possible with the right support. If you or someone you know is struggling with food, body image, or mental health, please reach out.

Eating Disorders Awareness Week runs from February 20.

Resources

• Bodywhys - The eating disorders association of Ireland: www.bodywhys.ie
• Peace - Support for eating disorders and autism: www.peacepathway.org
• NEDIC - Resources for neurodivergent individuals with an eating disorder: https://nedic.ca/neuroaffirmed/community/
• Wildheart Wellness - Mirin Mooney is a neurodivergent-affirming trauma informed psychotherapist: www.wildheart-wellness.com