What is anorexia?SIMPLIFIED EXPLANATION
Anorexia is when a person wants to lose weight so much that they stop eating properly. It's an eating disorder, and autistic people are more at risk, especially those who are assigned female at birth (AFAB).
What is anorexia?
Anorexia is an excessive fear of gaining weight due to a poor impression of one’s own body size. The anorexic person will create very strict dietary rules, resulting in significant weight loss that is unhealthy for the body.
Anorexia is linked to culture. Very thin bodies are seen as more beautiful and healthy in most northern cultures. People with anorexia want to have thin bodies to be seen as healthy and beautiful.
Link to autism
Autistic people and those who experience periods of anorexia have some things in common:
- Loving routines
- Being disciplined
- Sticking to their own ideals
- Seeing details before the set
- Following rules
- If there are no rules: creating their own rules
- Loving regularity
- Disliking change
All of these elements can be neutral or positive qualities. There’s nothing wrong with having these different traits, and it doesn’t mean that an autistic person with all these traits is anorexic. However, these elements can make a person vulnerable to anorexia if they consider thinness to be a rule. If, in addition, the person is anxious or has difficulty making friends, then they are at great risk of experiencing a period of anorexia.
How anorexia manifests itself
If a person believes that thinness is a rule, or even that thinness is a rule they need to follow in order to make friends or find a lover or sweetheart, they will start creating life rules to stay thin.
Many people do this without being anorexic; most people have tried a “diet” at least once in their lives. But a person who likes routine, is disciplined and follows the rules can stay on a diet for a long time, adding more and more constraints.
Many autistic people have food sensitivities that create food rigidities. In a period of anorexia, the person will no longer eat enough to maintain their weight. This has serious health consequences. Some people without medical supervision may even starve to death while following their rules.
Treatment of anorexia
Treatments for anorexia have been designed for allistic (non-autistic) people in periods of anorexia. It’s a good thing these treatments exist, since between 90 and 95% of people with anorexia are not autistic. However, following the “allistic” version of the treatment can be detrimental to autistic people with anorexia.
Attention
Treating anorexia is different for autistic people. Failure to respect these differences will hinder recovery.
Things that can harm autistic people
- Group therapy
- Confiscate stim objects
- Prevent repetitive movements
- Remove access to quiet areas where the person is alone
- Forcing the testing of new recipes
- Changing eating routines often, quickly and drastically
- Forcing the person to accept the same dietary diversity as a neurotypical.
In fact, the goal of typical anorexia nervosa treatment is to get the person to have a neurotypical diet. The goal of anorexia nervosa treatment for an autistic person should be to bring the person to the diet of a healthy autistic person.
Elements in the treatment of anorexia in autistic people
- Individual meetings with a professional trained in eating disorders and autism
- Clarifying rules and expectations
- Starting by introducing foods that the person enjoyed before her anorexic period
- Suggesting a few foods
- Aiming for a sufficiently diversified diet
- Higher-calorie foods rather than large portions
- Respecting personal convictions when choosing food (e.g. eating vegan or halal)
- Sensory "diet" before the meal (e.g. dim lights, plugs, leave the person alone)
- Using compartmentalized plates
For further information:
Vocabulary
- Anorexia nervosa: This is the name given to anorexia in the DSM-5 diagnostic book.
- Anorexics: people who will experience at least one period of anorexia in their lives.
- Anorexia period: period during which fear of gaining weight and dietary restrictions cause rapid weight loss and health problems.
Need help?
ANEB HELP AND REFERENCE LINE (Quebec): : 1-800-630-0907 ANEB website: https://anebquebec.com/en
