Keeley talks about autism and anorexia
Autism vs. Anorexia: A Personal Journey
Experiencing an eating disorder is challenging for anyone, but when paired with autism, it can feel like a recipe for disaster. Five years ago, I was diagnosed with anorexia nervosa. At the time, I was also on the waiting list for an autism assessment, but this was not considered when I started treatment for anorexia nor when I eventually received my autism diagnosis.
I was given a one-size-fits-all approach to treatment—something that may work for many neurotypical people but not for the neurodiverse. Autism and anorexia share a common thread: the need for control. In my case, the two fed off each other, making my anorexia more extreme and my autism more rigid. It became a vicious cycle, one that was difficult to break. The routine my autism clung to made change unthinkable, and anorexia used this rigidity to convince me that maintaining control by restricting food was the right—and only—thing to do.
The Challenge of Change
One of the most challenging aspects of my recovery was changing my diet. My dietician expected me to make changes overnight, which felt utterly unattainable. For me, change requires time, careful thinking, and persuasion. But to the treatment team, my hesitation was seen as anorexia talking, as if I was being reluctant or unwilling to help myself. This couldn’t have been further from the truth. I knew I was in the depths of a mental health crisis, where my emotions and anxieties were heightened, but my autism simply wouldn’t allow for sudden change.
To complicate matters, I also have ARFID (Avoidance Restrictive Food Intake Disorder), which means I have a limited range of 'safe foods' that I can eat. Certain sensory aspects of food are overwhelming for me. I was diagnosed with ARFID before anorexia, and while the eating disorder team was informed, this was overlooked. Once again, I was labelled as "reluctant."
The Impact of Black-and-White Thinking
Growing up, many of us were taught the basics of healthy eating—five fruits and vegetables a day, limiting fatty and sugary foods, and maintaining a balanced diet. I remember being shown the food triangle, which outlined how to eat healthily. This stuck with me, and due to my autism’s black-and-white thinking, it became an all-or-nothing mindset. If I couldn’t eat those "healthy" foods, I felt guilty, even bad. I didn’t realise at the time that my ARFID was the cause of my limited diet.
At my first dietician appointment, I was faced with the food triangle again, which left me feeling even worse. I felt like I had failed, and this only intensified my anorexic thoughts. The solution anorexia found? Eat less to counteract my perceived unhealthy diet.
A Call for Understanding
In my experience, eating disorder professionals need to develop a deeper understanding of the connection between autism and eating disorders. Each person is different—especially every autistic person. Treatment must be tailored to the individual, with compassion and flexibility, to foster a faster, kinder recovery.
I’m proud to say I’m in a much better place today. I know I may never fully recover, but I’ve made peace with that. I’m now a qualified teaching assistant, and I’m continuing my journey by studying for a foundation degree in education.
Looking back, I believe an earlier autism diagnosis could have prevented my need for control from spiralling into an eating disorder. I want to be a voice for autistic women, young and old. We may be hidden, but with the proper knowledge and understanding, we can be unmasked and supported to live authentically.
Final Thoughts
If there’s one message I hope to convey, awareness and understanding are crucial. Autistic individuals are often misunderstood, especially in situations like mine where the complexities of co-occurring conditions, such as anorexia, complicate things further. With a better understanding and more autism-informed care, I genuinely believe recovery can be more accessible and compassionate for those who need it most.
