Note: In this blog, we use identity-first language (e.g., “an autistic individual”) to reflect those who embrace autism as an identity category – a diverse way of perceiving and interacting with the world (Taboas et al., 2022; Bury et al., 2020). However, we recognize that this language may not be suitable for everyone in the community. Whenever possible, please ask individuals about the language appropriate for them.
Living with and treating an eating disorder may be complicated by the presence of a co-occurring condition, particularly when the condition shares characteristics with an eating disorder. One such condition that shares some psychopathology with a disordered eating mindset—and is frequently seen alongside an eating disorder diagnosis—is autism spectrum disorder.
There are a number of factors that increase the risk of disordered eating or an eating disorder in an autistic individual. By looking at the nature of both eating disorders and autism spectrum disorders, we can better understand their relationship and improve the detection, care, and treatment of both conditions.
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by food avoidance or restriction that results in nutritional deficiencies and interferes with daily functioning. As in anorexia, ARFID can lead to significant weight loss or a failure to gain weight. It does not include concerns about body weight and shape, however. Instead, ARFID primarily manifests as avoidance related to the sensory properties of food and fear about eating.
Previously known as selective eating disorder (SED), ARFID was introduced in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The following criteria must be met for an individual to be diagnosed with this eating disorder:
People of all ages, races, sexual orientations, genders, socioeconomic statuses—all other demographic categorizations—can experience Avoidant/Restrictive Food Intake Disorder (ARFID). However, the eating disorder is especially common in children and young adolescents.
Because ARFID is particularly common in younger populations, it is essential for all parents to be aware of the warning signs. If a child is showing signs of AFRID, getting them help as soon as possible is the best thing you can do for them.
In this blog, we will cover the definition of ARFID, the risk factors, the signs and symptoms to look for in children, and treatment options.
With the prevalence of diet culture and restriction-based diets like paleo, keto, and whole 30, it can be challenging to identify when restrictive eating becomes disordered. While certain restrictive diets can be healthy and not imply further eating disorder concerns, other restrictive eating patterns can be a warning sign of an eating disorder. To understand when eating becomes disordered, it’s important to be aware of the five ways to identify problematic restrictive eating.
An obvious way to identify restrictive eating is if an individual is refusing to eat certain foods. While not eating certain foods is restrictive, it is not always a red flag, which is why it is important to understand why the food is being restricted. For example, if a person abides by a vegan diet and refuses to eat meat or dairy, that could be healthy for them or it could be a sign of disordered eating. To understand which it is, it is important to ask why an individual is eliminating certain foods. For example, if someone refuses to eat dairy because they are lactose intolerant, that is restrictive and it is a healthy choice for them because if they ate dairy, they would feel ill. If someone avoids dairy, but when asked why responds by saying that it has too many calories or causes fat, that may be a sign of disordered eating.
As a field, we are beginning to understand that males are at a high-risk for eating disorders and that it is crucial to understand how males present with eating disorders and how we can treat them. Realizing that men have eating disorders is extraordinarily important. Eating disorders are serious and potentially life-threatening and unfortunately, they are often overlooked and trivialized.
The reality of the eating disorder world is that the diagnoses of eating disorders have historically been based on women. Studies to define what eating disorders are have been done primarily with women. The criteria used to describe eating disorders has been normed to women. The professional field is primarily women and treatment is often designed with a gender bias. However, we are very aware that men (and people of all genders) can get eating disorders and that more men are presenting with symptoms and entering treatment. As a result, we have a lot of work to do to truly understand how males present with eating disorders.
To give an example of how eating disorder treatment is normed to women, we can look at current eating disorder screening tests. Typically, there are statements such as these where a client can answer yes or no.
Eating disorders are real, complex illnesses that can cause serious harm. Eating disorders are characterized by a disturbance in an individual’s eating and food behaviors or self-perception. Common warning signs of eating disorders are extreme weight changes, altered eating behaviors, or an intense fixation on food and body talk. Eating disorders are biologically-based brain illnesses that are affected by environmental, social, and psychological factors. This means that illness is not caused by one specific factor, but rather by a series of factors in an individual’s unique life experience.
Due to the complexity of eating disorders, the DSM-5 divides eating disorders into the following five categories:
Anorexia Nervosa. Anorexia is noted by extreme food restriction that causes dramatic and prolonged weight loss. It often presents with body dysmorphia and a genuine fear of food.
Avoidant/Restrictive Food Intake Disorder (ARFID). ARFID includes feeding or eating disorders that involve a lack of interest in or an avoidance of certain foods that result in a failure to meet nutritional needs. ARFID, unlike anorexia, does not include a drive for thinness.
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