In recent years, there has been an increase in cultural awareness surrounding Neurodiversity. The term encompasses conditions such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), dyslexia, and Tourette’s Syndrome to name a few. It emphasizes that neurological differences are natural variations of the brain rather than deficits.
At Center for Discovery (CFD), we recognize that neurodivergent individuals require treatment approaches that address potential sensory processing issues, executive functioning difficulties, and social engagement challenges that may be impacting their relationship with food and their bodies. For this very reason, we have launched a Neurodivergent+ Affinity Group! The goal of this group is to foster an environment that helps reduce experiences of isolation, promotes a sense of belonging, and helps patients recognize their unique strengths, while offering eating disorder treatment through an affirming lens.
*The Neurodivergent+ Affinity Group is for anyone that self-identifies as Neurodivergent+ and does not require an “official” diagnosis.
Eating Disorders Within the Neurodivergent+ Community
Recent research indicates that there are many links and factors that contribute to the high prevalence of eating disorders within the Neurodivergent+ community. However, we don’t need research to understand that food preparation and eating are highly sensory based activities we do every day.
Sensory Processing
Neurodivergent+ people engage with their senses differently than “neurotypical” people, which sometimes can aid or hinder their meal experience. For example, some Neurodivergent+ people might have an acute sense of taste and therefore prefer “bland” foods. On the other end of the spectrum, some Neurodivergent+ people may experience a reduced sense of taste and prefer to add hot sauce to everything so they can feel something when they eat!
Another example is food choices. A packaged cookie is often the same: crunchy, crumbly and sweet. A strawberry, however, can be soft, somewhat crunchy, sweet or even sour. The taste and texture change based on the fruit or specific food group. That type of unpredictability can make it difficult for Neurodivergent+ people to engage with certain foods. These differences can make eating a challenge, but it’s also empowering to discover which foods work best for you and your nervous system.
Executive Functioning
Researchers have hypothesized that impulsivity, inattention, and inconsistent interoceptive cues may play a role in the high prevalence rate of eating disorders within this population. Specifically, Neurodiversity can impact one’s executive functioning, which refers to our ability to navigate everyday care tasks. This could include time management, object permanence, task initiation and completion, emotional regulation, and more.
When we consider the steps involved in nourishing oneself, we notice that the “simple task” of eating becomes a complex web of tasks that hinge on one another. For example, the process of being able to nourish ourselves may begin several steps prior to eating. Let’s explore an example of how one decision (the choice to eat) prompts dozens of other decisions to be made.
Decision-Making
First, is there food available and do we remember that it’s there, or do we need to procure food? Is grocery shopping sensorily overwhelming? Do we have a list? Do we remember to bring the list? Do we become overwhelmed and leave the store early? Is ordering food financially accessible?
Let’s say food is available at home. Is the available food palatable? Are the necessary tools and dishes available to prepare the food? Do we have enough time and energetic capacity to prepare the food? Once the food is prepared, is our eating environment supportive of our sensory needs? Do we become distracted by the environment and notice other tasks that compete for our attention? After eating, do we have the time and capacity to store any remaining food or ingredients and clean the items used in prep? Can we feasibly repeat this process multiple times per day?
Now, consider the effects of an eating disorder on this process. An eating disorder may further disrupt our ability to feed ourselves, adding layers of guilt and shame. It may also increase medical risks due to inconsistent nourishment patterns. An eating disorder may commonly complicate our ability to decide what, how much and when to eat. In some situations, individuals may use eating disorder behaviors as a sensory coping skill that may be simultaneously regulating and distressing.
Treatment for Eating Disorders in Neurodivergent Individuals
This is why, at CFD, we individualize treatment for our patients. Our Consistent Attuned Relational Eating (CARE) plans and Neurodivergent+ Affinity Group are carefully designed to support specific sensory and nourishment needs. CARE plans are co-authored by patients and dietitians to ensure that nourishment patterns consider each individual’s schedule, energetic capacity and sensory needs. Additionally, plans are flexible to support nervous system activation changes.
Patients receive further support in CFD’s Neurodivergent+ Affinity Group by discussing ways to make nourishment more accessible. Group members learn how to remove the morality surrounding care tasks and food choices. They also discuss ways to manage sensory needs through each step of nourishing oneself. Using the community space focus on shared lived experiences decreases isolation and shame.
Whether or not you have a formal neurodiverse diagnosis, all patients can find support in learning more about their own individual process of nourishment and their personal sensory system. CFD’s virtual programs are skilled in providing comprehensive, individualized care. Perhaps you’re struggling with procuring, preparing or storing food. Maybe you experience distress related to which foods to eat, when, and in what quantities. You may be interested in exploring your sensory needs while eating. Or, you might even be navigating hunger, fullness or the lack thereof. Virtual CFD can support you. Reach out to us today!
For reference and further reading, visit:
Monica Starck, MS RDN, CD (she/her) is a Senior Dietitian with the Path to Peace team, where she enjoys exploring the intersection between neurodivergence and eating disorders. She also leads the Neurodivergent+ Affinity group to support patients in increasing nourishment accessibility.
Hannah Rousselot (she/her) is the Case Manager for all of virtual CFD programming. She has been with CFD for 2 years. She lives in Los Angeles with her cat, Juniper. She is currently in Fullerton University’s Masters in Counseling program and intends to become an eating disorder specialized LMFT. Her biggest goal is to help those struggling see that not only is recovery possible, it is also so worth it.
Lindsay Birchfield, MS, RD, CEDS-C (they/them), or “LB” as many of their colleagues refer to them, is CFD’s National Director for Virtual Programming & Innovation. A meaningful part of their role includes overseeing CFD’s Virtual Path to Peace IOP that treats the nuances of bingeing and the deceptiveness of diet culture. LB has worked in the eating disorder field since 2012 specializing in gender affirming healthcare, somatic interventions, and trauma informed nutrition therapy. LB firmly believes that healing happens inside of relationships, thus they’ve invested efforts in both their private practice, Transnourishment, and Path to Peace to be a more accessible program that seeks to foster authentic connections around shared lived experiences.