5 things you should know about eating disorders and neurodivergence

A person is ‘neurodivergent’ when their mind functions differently to ‘typical’ societal expectations (e.g., ADHD, autism, dyslexia, etc).

Eating disorders are overrepresented among neurodivergent people, let’s talk about it!

1) Neurodivergence and eating disorders overlap, but this is often overlooked.

Neurodivergent people are at high risk of developing an eating disorder. Research identifies clear links between them. There’s a growing body of research suggesting that this connection rests on sensory processing (Cobbaert & Rose, 2023).

One study estimated up to 37% of people diagnosed with anorexia are also autistic (Cobbaert et al., 2024). Across many studies, the prevalence ranges between 20 and 37% (Cobbaert et al., 2024).

ADHD is also associated with high risk of developing an eating disorder. One study in 2017 showed that 37% of those with a diagnosis of anorexia and 35% of those with bulimia also had ADHD (Cobbaert et al., 2024).

Emerging research links disordered eating and giftedness, intellectual disability, and Tourette’s syndrome (Cobbaert et al., 2024).

Unfortunately, there’s limited data about other forms of neurodivergence and eating disorders. There is still much work to do in research, advocacy and education.

2) Neurodivergence is under screened and underdiagnosed, just like eating disorders.

Certain forms of neurodivergence are under screened, underdiagnosed and misdiagnosed.

This is especially true for people assigned female at birth (AFAB), Aboriginal and Torres Strait Islander people, and people from migrant and refugee backgrounds.

This overlaps with eating disorders which are also under screened, underdiagnosed and undertreated.

3) Receiving a diagnosis can support eating disorder recovery.

Receiving a diagnosis can support someone to form a positive neurodivergent identity. This can foster connection with community and self-advocacy, which supports eating disorder recovery.

Positive neurodivergent identity might be a protective mechanism for eating disorder development. This insight is important for both carers and consumers.

If you’re a carer, one of the most helpful things you can do is acknowledge your loved one’s diagnosis or assist them in seeking one. Support with meeting their access needs is also incredibly valuable.

If you’re neurodivergent and experiencing an eating disorder, consider using disability advocacy services. These services can help you have your access needs met in healthcare settings.

Disability Advocacy Network Australia – Find an advocate

4) Neurodivergence has a genetic basis.

In healthcare settings, practitioners should consider the potential neurodivergence of parent(s).

This is especially important for family therapy, a common treatment for young people with anorexia and bulimia.

Working with neurodivergent families holistically shows positive outcomes (Cobbaert & Rose, 2023). This approach might also support a positive neurodivergent identity for the entire family.

Considerations like this assist with recovery efforts for children and young people.

5) Neurodiversity-affirming care is important.

Neurodivergence is associated with a broad range of strengths which can support recovery.

A neurodiversity-affirming approach to eating disorder care recognises the natural range of neurotypes. It also seeks to relieve forces of marginalisation that the neurominority might experience.

Neurodiversity-affirming care avoids harmful intervention strategies.

For example, identifying an eating disorder may require a different approach.

Common screening tools for eating disorders are useful for a wide range of people. However, modifications might help clinicians spot an eating disorder earlier.

Screening considerations include, but are not limited to:

Age

Research indicates that eating disorder onset can happen at a younger age for neurodivergent children.

Body Image Issues

Struggling with body image can be a sign of eating disorders. For neurodivergent people, this isn’t always the case.

A neurodivergent person might experience an eating disorder without reporting body image issues. Examples include PICA, orthorexia, rumination, and avoidant/restrictive food intake disorder.

Neurodiversity-affirming care is person-centred care. This benefits everyone.

In eating disorder treatment, neurodiversity-affirming care recognises that neurotypical treatment plans might not work for neurodivergent individuals.

When addressing an eating disorder, it’s important to adopt a strengths-based approach which is neurodiversity affirming and supports accommodations. This means identifying ways to work with rather than against an individual’s neurodivergence.

Considering the sensory environment is essential! Accommodations could include dimmable lighting, a quiet space, noise-cancelling headphones, frequent breaks, alternative seating options, and distractions like a fidget toy or iPad.

Example: adapting the eating environment

Social eating is a common goal within neurotypical eating disorder recovery. This is not always helpful for neurodivergent individuals, who may prefer to eat alone for a variety of reasons. For instance, someone using noise cancelling headphones at mealtimes may find it easier to do so when eating alone.

Preferences are unique to the individual. There is not a single approach that will work for everyone, but there is an approach out there that will work for everyone.

Terminology

Neurodiverse: a group composed of a mix of neurotypical and neurodivergent individuals. For instance, you might say that the population of Australia is neurodiverse.

Neurodiversity: the natural diversity of human minds, inclusive of neurodivergent and neurotypical individuals.

Neurodivergent: an individual-level identifier for those whose mind’s function differently from societal standards of ‘typical.’ This term is inclusive of a broad range of neurotypes. Neurodivergent individuals are part of the neurominority.

Examples of neurodivergence

A non-exhaustive list: ADHD, autism, dyslexia, Tourette’s syndrome, dyscalculia, OCD, apraxia, misophonia, dysgraphia, dyspraxia, and synaesthesia.

Neurotypical: an individual-level identifier for those whose mind functions within the ‘typical’ societal standards. Neurotypical individuals are part of the neuromajority.

Things to keep in mind:

The term ‘neurodivergent’ is not a replacement for terms like autistic or ADHD. Friendly reminder that autistic isn’t a bad word!

It’s incorrect to refer to a group of neurodivergent individuals as neurodiverse. Neurodiversity is a term used to describe a group of individuals whose neurotype differs from each other. For example, you might say that the state of Victoria has a neurodiverse population.