Bulimia and autism

What is bulimia?
SIMPLIFIED EXPLANATION

Bulimia is eating a lot of food in a short space of time, even if you're not hungry, even if your stomach hurts, and even if it makes you sick. Bulimia is dangerous to health. Eating too much on special occasions is not bulimia. Bulimia is difficult to control and requires professional help to overcome.

What is bulimia?

Bulimia is an eating disorder that manifests itself in binge eating episodes. A bulimic attack is :

More precisely, people who are having a bulimic attack will continue to eat even if they feel their belly is too full and that it’s painful.

Warning

Losing control and eating until you're sick isn't always a bulimic attack. Indigestion after overeating at a birthday party, Christmas Eve or any other party where the main objective is to eat in a group can happen to anyone. A bulimic attack occurs when there is no context inviting you to eat more than usual. Often, bulimic crises occur when the person is alone.

Anorexia and bulimia

Sometimes anorexics also experience bulimic crises. People with anorexia are very afraid of gaining weight. Binge eating will frighten these people, as it can cause them to put on a lot of weight. A person with anorexia who experiences binge eating will then engage in behaviors to compensate for eating more than usual. Compensatory behaviours can be :

Link to autism

In general, autistic people without any intellectual disability have more bulimic traits than neurotypical (non-autistic) people, putting them at risk of bulimic episodes. However, there are few studies on the possible links between bulimia and autism. When providing therapeutic support to autistic people with bulimic episodes, the following points should be taken into account:

Emotions and bulimic crises

Bulimia is often directly linked to anxiety, grief and other emotions. It’s already harder for a person with autism to identify and manage their emotions, so this adds an extra challenge.

Danger of bulimia

Bulimia presents significant health risks and cannot be taken lightly.

Getting help

People with bulimia cannot simply decide to stop. They may be able to do so for periods of time, but the reflex to binge eat can return with a vengeance, especially when a disruptive event occurs. Professionals can help the person identify triggers and ways to reduce or even stop the binges. In the case of an autistic person, a psychological education service can be of great help.

References

Demartini, Benedetta, Veronica Nisticò, Vincenzo Bertino, Roberta Tedesco, Raffaella Faggioli, Alberto Priori, et Orsola Gambini. « Eating Disturbances in Adults with Autism Spectrum Disorder without Intellectual Disabilities ». Autism Research 14, no 7 (july 2021): 1434‑43. https://doi.org/10.1002/aur.2500.

Psychomédia., Hyperphagie boulimique: définition, symptômes, diagnostic (DSM-5)., 2015, http://www.psychomedia.qc.ca/psychologie/2015-03-07/hyperphagie-boulimique-criteres-diagnostiques-dsm-5

Tchanturia, Kate. « What We Can Do about Autism and Eating Disorder Comorbidity ». European Eating Disorders Review 30, nᵒ 5 (septembre 2022): 437‑41. https://doi.org/10.1002/erv.2942.

Catherine Bouchard-Tremblay

Science popularizer