Many Autistic adults and children face difficulties with eating. In fact, around 70% of Autistic children have been found to struggle with eating (Mayes & Zickgraf, 2019). These difficulties stem from several aspects of the Autistic experience, including sensory differences, executive dysfunction, interoception differences, routines, and more. This article will highlight and explain some of these challenges.
One of the ways that Autistic people can struggle with food and eating relates to our sensory experiences.
The textures, smells, flavours, and other aspects of food items can be overwhelming to an Autistic person. For example, I cannot and will not eat raw banana because of the texture. If I tried to eat one, I would very likely gag, and possibly throw up just because the texture feels so bad to me. Here is an excellent graphic that encapsulates how many Autistic people feel about certain foods and textures:
Image credit: Feeding Littles
The heightened sensory experience of the Autistic person is one of the reasons they may prefer to eat the same food - because they know it is safe from a sensory perspective.
Many Autistic people have “safe foods” that we know we will be able to eat time and time again. If you are a parent, knowing your child’s safe foods and keeping them well stocked is a great way to ensure your child is eating something, even if it’s not exactly what you had planned for them to eat. After all, fed is best.
Another reason Autistic people like to have safe foods relates to executive functioning difficulties.
When an Autistic person is overwhelmed, it means that the emotional part of their brain is overactive and the part of the brain that controls things like organisation, planning, and more complex tasks shuts down. This is also one of the reasons many people struggle to remember things they say in anger! Some Autistic people forget to eat because of these executive functioning difficulties. A great way to ensure you are eating enough is to schedule mealtimes into your day and create visual schedules that everyone can see.
Sometimes, Autistic people forget to eat and drink because their bodies don’t tell them they are hungry or thirsty. The ability to know what is going on inside your body is called interoception and is something that many Autistic children and adults struggle with.
For example, they may not realise they need to go to the toilet until they are absolutely busting! Or they may not realise they are dehydrated or hungry, and not eat for long periods of time. This is especially true when they are hyperfocused on a task! There are ways to improve interoception including yoga, exercise, meditation, and deep breathing. Though interoception can be improved, it may still continue to impact an Autistic person throughout their life. Having a regular routine and visual and/or auditory reminders or cues can go a long way to help someone whose struggles to get messages from their body. I use calendar reminders to create appointments for meals. I also know of people who use coloured lights on a timer to change colour every hour to remind them to stretch, have a sip of water, or go to the loo. There are many ways to do this, so you can be creative and tailor schedules to suit each individual. These schedules can also assist with time-blindness and PDA (pathological demand avoidance) that often accompany neurodivergence. I will write more about that in a separate article.
A significant part of eating that many Autistic people find challenging is the social aspect of eating.
Considering all the challenges that have already been listed, imagine trying to deal with all of that and navigate a social experience! Many Autistic people find socialising difficult by itself, and adding food to a social situation may be enough to cause overwhelm, a shutdown, or a meltdown. In these situations, it can be easier just not to eat at all. And then, because we are not always super in tune with our bodies, we may forget we’re hungry until we’re absolutely starving an hour before dinner time…
Eating Disorders
There are some psychiatric disorders relating to eating and feeding that are more common in Autistic people than the general population. Some of the features of Anorexia Nervosa cross over with Autistic traits, for example, perceived rigidity and rule setting. For this reason, many Autistic people - in particular female and AFAB (assigned female at birth) Autistics - are diagnosed with Anorexia. Furthermore, the differences in interoception and sensory experiences can also mean that an Autistic person might mistake anxiety for a need to vomit. This is especially true within an uncomfortable or unknown social setting.
Avoidant/restrictive food intake disorder (ARFID)
Avoidant/restrictive food intake disorder (ARFID) is another psychiatric disorder that is common within the Autistic community. It is defined as a persistent failure to eat enough food to meet energy and nutritional requirements. Unexplained weight loss or trouble gaining weight are also features of ARFID, which is one of the reasons it is commonly misdiagnosed as Anorexia. We know that ensuring children are meeting their nutritional and dietary needs is important to parents and caregivers.
It is easy to understand the pressure and distress parents can feel when their child isn’t getting enough nutrients. It is also important to highlight just how complex eating can be, and how often food avoidance or aversion is misunderstood.
As described above, eating can be a very difficult task for Autistic people for a variety of reasons.
As each Autistic person is different, some Autistics will relate to all of these difficulties, some with just a couple, one, or even none! Remember, each Autistic trait exists on a spectrum. Some Autistics eat the same three meals each day, and some Autistics (myself included) are foodies and are novelty-seeking, exploratory eaters. If someone isn’t eating, there is a reason why. I recommend against placing a requirement to eat when a child has indicated they don’t want to. Children of all neurotypes are unable to effectively regulate their nervous systems, and forcing them to eat something when they don’t want to can be quite traumatic. This is true even when you are just trying to help. A child doesn’t yet have the capacity to understand the complexities of nutrition, nor do they understand why adults worry about it, or why they are made to finish their plate at dinner.
When you are trying to assist someone with eating, it is important to treat them as an autonomous individual and try to understand their perspective and reasoning.Even if it doesn’t make sense to you, try to empathise with them by imagining having difficulties like these yourself.
No one is just a “picky eater” for the sake of it. Behaviour is always information.
The next time your tummy rumbles, try to imagine that you didn’t get those messages from your body and that you had to wait another four hours to eat! Or imagine that your favourite fruit suddenly feels like you’re eating a slug… You’d hate for someone to force you to eat that, and I bet you would protest about it too.
The most important thing when dealing with someone who is having difficulties with food is listening to them and validating their experience. Doing this builds connection, trust, and will do a lot to help someone feel supported. This is not an exhaustive list of all the ways eating can be difficult for Autistic people. If you would like to learn more, we encourage you to reach out to Autistic people with lived experience of these issues. There is no better way to learn about the Autistic experience than from Autistic people.
Author: Effie Garner
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