Livia Sara - 2025 Writers series
Distinguishing Autistic Traits from Eating Disorder Behaviours
Anyone who’s autistic or knows someone who is may recognise that our relationship with food isn’t always straightforward. From sensory sensitivities to routine preferences, mealtimes tend to be a prominent source of anxiety for those living on the spectrum. The overwhelming nature of certain food textures, the disruption of unexpected menu changes, and the complex social dynamics around eating can all create significant distress in daily life.
But what happens when this food-related anxiety becomes so extreme that it manifests as anorexia? I’ve walked this path myself — first as someone struggling with an eating disorder while unaware of my autism, now as a lived experience expert. By turning my MESS into my MESSage, I’ve found my purpose in helping autistic individuals and their caregivers discover freedom by learning how to use autistic traits to their advantage in ED recovery.
A cornerstone of this work is disentangling autism from the eating disorder. But how do we do that? In this article, you’ll learn why traditional treatments often fail autistic individuals, the critical distinction between autistic traits and ‘ED behaviours’, and a framework for understanding how to challenge the eating disorder in a way that respects the neurodivergence.
When Treatment Becomes Invalidation
‘That’s your eating disorder talking’, my therapist said firmly when I expressed wanting to look at the restaurant menu before our scheduled meal outing. She believed that I was trying to plan the ‘safest’ option so that I could limit my caloric intake. In reality, I was attempting to reduce my anxiety about the unknown — an autistic trait that existed long before my eating disorder developed.
‘I’ve always been this way, I promise it’s me!’ I replied, hoping that an elaboration of my request would warrant her understanding. But my therapist’s expression hardened. ‘We need to challenge these behaviours, not accommodate them’, she insisted, dismissing my lifelong experience with a wave of her hand.
This moment is a shining example of how traditional eating disorder treatment can harm neurodivergent people. Most providers in the eating disorder field are operating from neurotypical frameworks, often causing them to misidentify autistic traits as ‘eating disorder behaviours’ to be eliminated. When I requested predictability through menu planning, it was labelled a disorder. When I dissociated during group therapy, it was labelled ‘treatment resistance’. And when I counted the number of chocolate chips that went on my pancakes, it was pathologised as obsessive behaviour.
As well as overlooking autism, traditional ED treatment models focus on ‘normalising’ eating behaviours, assuming neurotypical sensory processing and executive functioning abilities. Patients are pushed towards goals like making spontaneous food choices, eating intuitively without meal planning, eating a wide variety of foods and tolerating mixed textures on a plate—expectations that tend to contradict autistic neurology.
When the very system that’s supposed to help aims to eliminate your autism, it creates profound trauma. Repeatedly being told that your natural ways of navigating the world are ‘disordered’ damages your sense of trust and safety. This invalidation reinforces the core belief that you are somehow wrong or broken, which strengthens the eating disorder’s grip. Why? Because the eating disorder is the escape hatch, something to rely on when your authentic self is threatened.
This complex interplay creates a significant challenge in treatment: On the surface, many autistic traits can appear identical to eating disorder behaviours. A clinical eye untrained in neurodiversity might see only restriction, rigidity and rituals, missing the crucial differences in the behaviours’ origins and purpose. So how do we distinguish autistic traits from eating disorder behaviours when they can look so similar on the surface? The answer lies in the word ‘intention’.
The Power of Intention in Neurodiversity-Affirming Eating Disorder Recovery
In my work with neurodivergent individuals, I’ve discovered a simple yet powerful truth: eating disorder behaviours are always rooted in fear, while autistic traits are always rooted in love. This distinction is our compass when navigating recovery in a neurodiversity-affirming way.
When you make a decision about food or movement, that decision can come from one of two places: a place of fear or a place of love. The aforementioned restaurant menu scenario perfectly illustrates this distinction. If someone were to check the menu before dining out in order to plan the ‘healthiest’ option or to work out ways in which the calories in the meal would need to be compensated for, the action would be rooted in fear. If checking a menu reduces overwhelm — and in fact may even create space for an autistic person to plan a food that challenges their eating disorder — the action stems from love. In other words: same behaviour, different intention.
Another example is pacing. Similar to rocking or hand-flapping, pacing is a common way in which autistic people regulate their nervous systems. In eating disorder treatment, these behaviours are often redirected due to the assumption that they’re about burning calories. When treatment providers misinterpret these regulatory behaviours as ED driven and try to eliminate them, they inadvertently create more distress. While the behaviour is the same, the intention behind the movement makes all the difference. Pacing to regulate sensory overwhelm comes from a place of love and self-care, while pacing to burn calories comes from the eating disorder’s fear-based drive. Without these natural coping mechanisms, autistic individuals often turn to the eating disorder to manage their heightened anxiety.
Understanding the distinction between autistic traits rooted in love and eating disorder behaviours rooted in fear is a cornerstone of neurodiversity-affirming ED recovery. Rather than fighting the autism by trying to squeeze neurodivergent individuals into neurotypical boxes, effective treatment creates accommodations that respect neurodivergence while challenging the eating disorder. This might look like maintaining predictability around mealtimes while incorporating challenging foods, or allowing for sensory regulation while addressing harmful compensatory behaviours. By asking, ‘Does this behaviour stem from love or fear?’ both providers and autistic individuals gain a powerful tool for navigating ED recovery in a way that honours the whole person.