Understanding the Link Between Autism and Eating Disorders
Autism and eating disorders can overlap in complex ways. For some autistic people, difficulties with food, body image, eating routines or control around eating are not simply about “diet culture” or wanting to change appearance. They may also be connected to sensory sensitivity, anxiety, predictability, interoception, masking, trauma, burnout and the need to feel safe.
Research increasingly suggests that autistic traits are overrepresented in people with anorexia nervosa, and that autism and avoidant/restrictive food intake disorder, or ARFID, commonly co-occur. Two recent meta-analyses published in the International Journal of Eating Disorders highlight this overlap, while also emphasising that the relationship is complex and does not mean autism “causes” eating disorders (Inal-Kaleli, et al., 2025; Sader, et al., 2025).
This does not mean autism causes eating disorders. It means autistic people may face specific vulnerabilities that need to be understood properly.
1. Sensory sensitivities can make eating harder
For many autistic people, food is a sensory experience first.
Taste, texture, smell, temperature, colour, sound, unpredictability and food mixing can all feel overwhelming. Some foods may feel genuinely intolerable, not because someone is “fussy,” but because their nervous system experiences the food as unsafe or aversive.
Research has linked sensory processing differences in autism with eating behaviours across the lifespan, and reviews of ARFID and autism highlight sensory sensitivities, food preferences, rituals and routines as important factors.
Sensory processing differences + eating behaviours across the lifespan
Nimbley, E., Golds, L., Sharpe, H., Gillespie-Smith, K., & Duffy, F. (2022).Sensory processing and eating behaviours in autism.European Eating Disorders Review, 30(5), 538–559.
ARFID review highlighting sensory sensitivity as a key presentation
Menzel, J. E., Reilly, E. E., Luo, T. J., & Kaye, W. H. (2024).Avoidant/Restrictive Food Intake Disorder: Review and Recent Advances
This can increase vulnerability to restrictive eating, food avoidance, narrow “safe food” lists, nutritional compromise, shame around eating, and social withdrawal around meals.
2. Predictability and routine can become food rules
Autistic people often rely on routine and predictability to reduce overwhelm. This can be adaptive and supportive.
However, in the context of stress, anxiety, trauma or body image distress, routines around food can sometimes become rigid. Eating at the same time, eating the same foods, using specific plates, following strict rules, avoiding unexpected meals, or feeling distressed when plans change may start as regulation strategies but become harder to shift over time.
In eating disorder recovery, this matters because treatment often asks people to tolerate uncertainty, flexibility and change, which may be particularly difficult if predictability has been a core survival strategy.
3. Interoception differences can affect hunger, fullness and emotions
Interoception is the ability to notice internal body signals, such as hunger, fullness, thirst, nausea, pain, tiredness, anxiety or needing the bathroom.
Many autistic people experience interoception differently. Some may not notice hunger until it becomes extreme. Others may feel body signals intensely but struggle to interpret them. This can make regular eating, emotional awareness and body trust more difficult.
A review on interoception and the overlap between autism and eating disorders suggests that atypical interoception may contribute to the co-occurrence of feeding and eating disorders with autism (Adams, et al., 2022).
This is one reason why simply telling someone to “listen to your body” may not be enough. Some autistic clients need more structured, practical and sensory-informed approaches to eating.
4. Masking and burnout can increase risk
Many autistic people spend years masking, consciously or unconsciously hiding autistic traits to appear more socially acceptable, capable or “normal.”
Masking can be exhausting. It can also disconnect people from their needs, preferences, sensory limits and emotional signals. Over time, this may contribute to shame, anxiety, perfectionism and burnout.
For some people, food and body control become a way to cope with feeling overwhelmed, out of control, socially unsafe or disconnected from themselves. Eating disorder behaviours may offer temporary relief, structure or numbness, but they usually make life smaller over time.
5. Social difference and bullying can affect body image
Autistic people may experience bullying, exclusion, misunderstanding, criticism, or pressure to change who they are. For some, body image distress becomes tied to a deeper wish to be accepted, less visible, more “normal,” or less judged.
Eating disorders can sometimes develop around the belief that changing the body will reduce rejection, shame or social threat.
This is why eating disorder treatment for autistic people should not only focus on food and weight. It also needs to consider identity, belonging, sensory safety, trauma, stigma and self-acceptance.
6. Standard eating disorder treatment may need adapting
Autistic people can and do recover from eating disorders, but treatment may need to be adapted.
Helpful adaptations may include:
using clear and direct communication
supporting sensory needs around food and clothing
using predictable session structures
working with preferred foods carefully and respectfully
addressing and exploring interoception differences
avoiding shame-based or compliance-focused approaches
making space for autistic identity and burnout
involving dietitians, GPs and psychiatrists where needed
distinguishing eating disorder rules from sensory needs and genuine accessibility needs
A systematic review of overlap between eating disorders, autism and ADHD noted frequent association, while also highlighting the complexity of determining how symptoms overlap across conditions (Nickel, et al., 2019).
In other words: formulation matters. A neuroaffirming approach asks, “What function is this behaviour serving?” rather than assuming every food-related difficulty is motivated by body image.
Neuroaffirming eating disorder support
If you are autistic and struggling with food, body image, binge eating, restriction, ARFID, compulsive exercise or recovery burnout, you are not “difficult” or “failing treatment.” You may need care that understands both eating disorders and neurodivergence.
At recoverED Clinic, we provide compassionate, evidence-based eating disorder therapy for adults, with a trauma-informed and neuroaffirming approach. We support people experiencing eating disorders, disordered eating, body image concerns, autism, ADHD, AuDHD, anxiety, OCD traits, trauma and burnout.
If food, body image or eating disorder recovery feels more complicated because of autism, ADHD or AuDHD, recoverED Clinic offers eating disorder therapy in Melbourne and via telehealth across Australia. You are welcome to contact us to discuss whether our approach may be the right fit.
Other Peer-reviewed research:
Helpful organisations that support Eating Disorders in Australia:
Disclaimer
This blog is for general educational purposes only and does not constitute medical, psychological, diagnostic, or therapeutic advice. It should not be relied upon as a substitute for personalised care from a qualified health professional.
Reading this blog does not create a psychologist–client relationship with recoverED Clinic or its clinicians. If you have concerns about your mental health, eating behaviours, physical health, or safety, please seek professional support. In an emergency, call 000 or attend your nearest emergency department. You can access a list of Australian crisis Helpines here.
This blog was created with the support of AI tools for clarity and structure and has been reviewed and edited by our team.
