The Connection Between Anorexia and Autism

The Connection Between Autism and Anorexia: A Gentle Exploration of Why So Many Autistic Girls Go Undiagnosed

Navigating the world as an autistic girl can be an experience full of beauty, sensitivity, and depth. But it can also be filled with challenges, often ones that are invisible to those around us. Many autistic girls grow up feeling different but unable to name why. And sadly, many are not diagnosed until much later in life, sometimes only when they find themselves in the middle of a mental health crisis like anorexia.

It’s important to remember that autism doesn’t always look like what we’ve been taught to expect. For some, autism is more about the way we process the world and our sensory experiences, rather than overt social differences or behaviors. It’s easy to overlook these subtle traits, especially in girls, who tend to mask their challenges more than boys. Because of this, many autistic girls, particularly those who have not been diagnosed, often face a mental health crisis before they receive the support and clarity they truly need.

In this post, I want to talk about why anorexia often surfaces in autistic girls who are undiagnosed, and how restrictive eating is sometimes misunderstood.

We’ll look at how anorexia differs from other types of restrictive eating, such as ARFID (Avoidant Restrictive Food Intake Disorder), sensory-related eating preferences, and food cycles that many autistic individuals experience.

Most importantly, I want this post to offer a sense of understanding, recognising that we are all doing our best to navigate a world that wasn’t made with our needs in mind.

Autistic girls often go undiagnosed for a long time because they tend to mask their true selves to fit in. They might try extra hard to appear neurotypical, picking up on social cues and mimicking behaviours they don’t quite understand, but it leaves them feeling exhausted, anxious, and isolated. It’s not that they don’t want to fit in, it’s just that sometimes the world asks for things that feel impossible.

When it comes to food, this is where things get even trickier. Many autistic girls experience heightened sensory sensitivities, and the idea of eating can feel like navigating a minefield. The textures, smells, and even the temperature of food can be so overwhelming that eating becomes an exhausting, anxiety-inducing task. What starts as a simple preference to avoid certain foods can evolve into more restrictive eating behaviours that are misunderstood.

Without an autism diagnosis, these eating habits may be seen simply as an “eating problem,” but for many autistic girls, these behaviours are a response to the sensory overload they experience every day. Sadly, this lack of understanding can sometimes lead to further isolation, feelings of shame, and a downward spiral that may culminate in an eating disorder like anorexia.

For autistic individuals, food can be a sensory minefield. Some of us are hypersensitive to certain textures or tastes, making eating a distressing experience. For others, it might be the opposite; we might crave intense flavours or repetitive eating habits to compensate for sensory input. Food becomes a way to either avoid discomfort or seek out sensory stimulation.

Many autistic people experience what’s called food cycles, where they may only eat the same few foods for long stretches of time. This isn’t a choice to “be picky” or difficult—it’s often a response to sensory preferences. The texture of one food might feel safe, predictable, and comforting, while others feel overwhelming and unmanageable. These cycles can be misinterpreted as unhealthy or restrictive, but for autistic individuals, they are often a way of making the world feel more manageable.

Unfortunately, when these preferences are not understood, it can lead to misunderstandings. Parents and caregivers might see a limited diet and worry, “Why won’t they eat anything else?” But for an autistic person, the answer is often tied to sensory overload and the need for predictability. The need for the food to taste the same with each bite. And when we don’t have the language to explain why certain foods feel safe, it can leave us feeling isolated, misunderstood, or even ashamed.

For autistic girls who aren’t diagnosed or who feel like their differences are not understood, the pressure to conform can be immense. Society often has a very narrow idea of what it means to be a “girl” or a “woman,” and these ideals include unrealistic expectations around appearance and body size. This pressure to conform can be overwhelming, especially when navigating a world that feels unpredictable or overstimulating.

For some autistic girls, eating becomes a way to gain control in a world that feels chaotic. What starts as a way to avoid certain foods because they’re unpleasant or overwhelming may evolve into more restrictive eating behaviors, driven by the desire to control food intake. And as they begin to feel the weight of societal expectations, their restrictive eating may become more tightly linked to body image concerns.

But here’s the thing: it’s not about being “difficult” or “rebellious.” It’s about seeking control over something that feels too overwhelming to manage. When we don’t have the tools or the understanding to process our sensory needs, anxiety, or social struggles, we might turn to something like eating to make sense of it all.

The key to helping autistic girls who are struggling with restrictive eating or anorexia is understanding. Not just understanding eating habits, but understanding the full scope of the experience. Autism isn’t a disorder that needs to be “fixed.” It’s a way of being that needs to be understood, respected, and supported.

Rather than focusing solely on the restrictive eating behaviors, it’s important to look at the whole person, the sensory preferences, the need for structure, the social challenges, and the emotional complexities. When we approach eating disorders with a neuroaffirming lens, we can help autistic individuals find balance and healing, rather than perpetuating shame or misunderstanding.

If you or someone you know is struggling with anorexia or restrictive eating, it’s okay to ask for help.

Seek out professionals who understand the intersection of autism and mental health. Find support from others who understand that the world isn’t always designed for neurodivergent individuals, and that our needs, whether sensory, emotional, or social, are valid.

We all deserve to live in a world that understands and supports us for who we truly are, without judgment, shame, or misunderstanding. Let’s start by extending that same compassion to ourselves and to those who need it most.

For some autistic girls, eating becomes a way to gain control in a world that feels chaotic. What starts as a way to avoid certain foods because they’re unpleasant or overwhelming may evolve into more restrictive eating behaviours, driven by the desire to control food intake. And as they begin to feel the weight of societal expectations, their restrictive eating may become more tightly linked to body image concerns.

In some cases, the pressure intensifies when an autistic girl is prescribed medications like SSRIs (selective serotonin reuptake inhibitors). While these medications can be life-changing for managing anxiety and depression, many of them come with potential side effects, including weight gain. For some autistic girls, the fear of gaining weight because of medication can amplify existing anxieties about food and body image. This fear may worsen their relationship with eating, especially if they feel they have no other way of gaining control over their bodies in a world that often feels out of control.

For those individuals with demand avoidance profiles, the demand to make food, the demand to eat as society says we should with three square meals and two snacks per day can become overwhelming.

The autistic relationship with food is complex, ever changing and requires compassion and understanding from those supporting them.