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Eating Disorder Treatment for Neurodiverse Patients
Contributor: Jessica Steinbach MPH, RD at Montecatini Eating Disorder Treatment Center
Co-occurring disorders are often addressed in eating disorder treatment at every level. Dietitians, therapists, and other members of the treatment team work to recognize how the complexity of each individual case plays into eating disorder behaviors and the presence of disordered eating. Some co-occurring disorders are more commonly observed in those struggling with eating disorders, such as anxiety, obsessive-compulsive disorder, and substance abuse disorders [1], but what about neurodiversity and eating disorder treatment?
The more commonly researched and recognized disorders have general guidelines for how to concurrently address both in treatment. However, a plethora of other disorders have been observed in those struggling with eating disorders, and currently lack adequate representation and proper resources for appropriate among the dietetics community.
One population that is currently underrepresented within the field of dietetics are those who fall within the neurodiverse community. Neurodiversity represents the idea that the ways that humans interact socially, mentally, and cognitively can vary drastically from person to person.
This term is often used in relation to those diagnosed with autism spectrum disorders (ASD). ASD is commonly diagnosed by the presence of varying associated symptoms such as difficulties in social situations, rigidity in thinking, sensory stimulus sensitives, and preference for routine [2].
Similar behaviors such as social isolation during meals, over-stimulation at dining tables, hyperawareness of the body, rigidity with eating behaviors, and avoidant/restrictive eating are often seen in those diagnosed with both neurodiversity and eating disorders.
The similarities in behaviors of those diagnosed with eating disorders, specifically anorexia nervosa (AN), and those on the spectrum have resulted in numerous studies that have explored the co-occurrence of the two. Findings suggest that up to 52.5% of patients diagnosed with anorexia nervosa meet the clinical cut-off for ASD [3]. In comparison, only 4.7% of patients diagnosed with an eating disorder were also diagnosed with ASD [4].
Inconsistencies in diagnostic tools, the commonality between behaviors and other co-occurring disorders such as bipolar disorder and depression, and the vast range of symptom severity make co-occurring diagnoses very difficult. However, proper diagnosis is imperative for appropriate treatment plans for neurodiverse patients and clients.
Interventions tailored to address the intersection between eating disorders and ASD could be instrumental in diversifying the field of dietetics and improving the quality of care for patients who do not present as neurotypical.
These interventions may include food texture exposures/support, increased education regarding coping skills for table overstimulation (noise-canceling headphones, dimmed lighting during meals), and extensive planning for potential mealtime schedule disturbances.
Additional support for neurodiversity and eating disorder treatment may include how to broaden the food choices of children on the spectrum to decrease the development of food avoidance in adulthood and support regarding how hyperawareness of one’s body can make navigating the world more challenging. More research and awareness of the intersection between the two will improve the field of dietetics and provide better access to care for everyone who seeks it.
Resources:
1. Chavez, M., & Insel, T. R. (2007). Eating disorders: National Institute of Mental Health’s perspective. The American psychologist, 62(3), 159–166. https://doi.org/10.1037/0003-066X.62.3.159
2. Faras, H., Al Ateeqi, N., & Tidmarsh, L. (2010). Autism spectrum disorders. Annals of Saudi Medicine, 30(4), 295–300. https://doi.org/10.4103/0256-4947.65261
3. Westwood, H., & Tchanturia, K. (2017). Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Current psychiatry reports, 19(7), 41. https://doi.org/10.1007/s11920-017-0791-9
4. Nickel, K., Maier, S., Endres, D., Joos, A., Maier, V., Tebartz van Elst, L., & Zeeck, A. (2019). Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Frontiers in psychiatry, 10, 708. https://doi.org/10.3389/fpsyt.2019.00708
About the Author:
Jessica Steinbach, MPH, RD, is a registered dietitian with a master’s degree in public health from Loma Linda University. She focuses her efforts and career on providing a HAES – aligned approach to working with individuals who suffer from eating disorders and disordered eating.
She is passionate about working with neurodiverse and queer individuals and helping them navigate their struggles with how their identities impact their relationship with food and their body.
About Our Sponsor:
At Montecatini Eating Disorder Treatment Center in Carlsbad, California, we provide comprehensive care for adolescent girls and adult women who are struggling with eating disorders.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Reviewed & Approved on May 1, 2020, by Jacquelyn Ekern, MS, LPC
Published May 1, 2020, on EatingDisorderHope.com
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
