This blog post is about how eating disorders show up specifically in neurodivergent individuals as well as how neurodiversity-affirming eating disorder therapy can be so helpful.
According to the National Alliance for Eating Disorders, almost 1 in 5 individuals diagnosed with avoidant/restrictive food intake disorder (ARFID) are also autistic. Furthermore, individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD) are four times more likely to have an eating disorder. If you are a neurodivergent person struggling with an eating disorder, it may be helpful to understand why eating disorders are more common among neurodivergent people, as well as how a neurodiversity-affirming therapist at Best Within You Therapy & Wellness can offer unique support. We provide neurodiversity-affirming eating disorder therapy and neurodiversity affirming therapy in Savannah, Atlanta, and Online.
Neurodiversity-Affirming Eating Disorder Therapy: How Do Eating Disorders Manifest Among Neurodivergent People?
Neurodiversity refers to the scope of natural variation in the human brain. These variations can impact how neurodivergent people experience daily life which can, in turn, lead to unique experiences with mental health challenges. For further information about neurodiversity, see Dr. Laura Riss’ previous blog about neurodiversity-affirming therapy.
Eating disorders among neurodivergent people often look different from traditional descriptions, and they often emerge for neurological, sensory, or emotional reasons rather than body-image concerns. Here’s a deeper look at why eating disorders are so common in autistic individuals, people with ADHD, and those with sensory or emotional regulation differences.
Sensory Sensitivities and Food Avoidance
If you have intense reactions to textures, tastes, smells, or food temperatures, eating can be overwhelming. You might rely on “safe foods” or avoid foods that feel unbearable, not because you want to restrict but because your body is saying “this is too much.”
This can lead to:
- Nutritional gaps
- Limited variety
- Anxiety around trying new foods
- Shame when others misinterpret your needs as picky or difficult
ARFID: Often Misunderstood, Especially in Neurodivergent People
Avoidant/Restrictive Food Intake Disorder (ARFID) is a disturbance in eating behaviors, which can include selective eating and low appetite, and is extremely common among autistic individuals and those with sensory issues.
ARFID often develops from:
- Sensory overwhelm
- Fear of choking, vomiting, or adverse physical reactions
- Anxiety about unfamiliar foods
- Low interoceptive awareness (not feeling hunger cues)
- Strict routines or preference for sameness
Unlike many other eating disorders, ARFID is not driven by or related to weight or body image, but many people are treated as though it is, leading to invalidation and ineffective care.
A neurodiversity-affirming therapist understands this important distinction and adapts treatment accordingly. They can combat misconceptions about their clients’ diagnoses and provide support that reflects the specific needs of their client.
Restriction as a Form of Control or Safety
For some neurodivergent individuals, restriction of food intake becomes a way to:
- Reduce sensory input
- Create predictability and structure
- Manage anxiety or emotional overwhelm
- Avoid confusing hunger signals
- Cope with burnout from masking (active suppression of traits associated with neurodivergency)
Restriction can resemble symptoms of anorexia nervosa, but the underlying reasons a neurodivergent individual engages in restriction may differ from the reasons common among neurotypical people with anorexia. For neurodivergent people, engagement in disordered behaviors may be less driven by appearance and more driven by regulation, control, and survival.
ADHD and Binge Eating
Recent research has found higher rates of binge eating among individuals with ADHD. If you are living with ADHD, you might:
- Forget to eat for hours
- Feel suddenly starving
- Struggle with impulsive eating
- Use food for dopamine and emotional regulation
- Eat while multitasking and lose track of fullness
A neurodiversity-affirming therapist understands that these patterns are neurological, not moral failures, and can help their client do the same.
Emotional Regulation and Food as a Coping Strategy
Many neurodivergent individuals experience emotions intensely but have difficulty identifying or expressing them. As a result, food can become:
- Grounding
- Soothing
- A distraction
- A routine
- A way to cope with overwhelm
Without judgment or shame, therapy for eating disorders and neurodiversity can help you build safe, alternative coping skills.
Masking, Trauma, and Eating Behaviors
If you’ve spent years masking, trying to “act normal,” or pushing through sensory discomfort, you may have learned to override your body’s signals. This disconnection can contribute to:
- Ignoring hunger
- Restricting until you “feel nothing”
- Binge eating once you finally relax
- Feeling unsafe around food or meals
A neurodiversity-affirming therapist specialized in eating disorders helps you reconnect with your body gently and at your own pace.
How a Neurodiversity-Affirming Eating Disorder Therapist Can Help with an Eating Disorder
A neurodiversity-affirming therapist will approach eating disorders through a neuro-inclusive lens. In practice, this means that instead of focusing solely on body image or willpower, they will also consider:
- Sensory needs
- Nervous system regulation
- Dopamine and impulsivity
- Routines and rigidity
- Emotional intensity
- Interoception differences
Neurodiversity-affirming eating disorder treatment is collaborative, compassion-based, and paced according to your nervous system. At Best Within You Therapy & Wellness, we aim to provide just that. You can reach out to schedule an appointment or complimentary phone consultation.
Thank you to Best Within You Therapy & Wellness intern Judith Crandall and licensed Psychologist Dr. Laura Riss for writing this blog post.
