Autism Food Challenges

April 3, 2023

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You may have heard of disordered eating in autism spectrum disorder (ASD), but do you understand what it is? It’s important to be informed about the different categories – such as food rumination – that can exist within this condition. Let’s look closely at how they affect those with autism.

Categories of Disordered Eating on the Autism Spectrum

If you have a loved one on the autism spectrum, you may be familiar with disordered eating. Disordered eating is when someone has an unhealthy relationship, both with food and their body, which can lead to poor physical health and emotional distress. 

Studies estimate that around 70% – 90% of children with ASD have issues with food or eating, making it a common problem among those on the spectrum. Each category of disordered eating has its own unique challenges and difficulties, so it’s essential to be aware of them when caring for someone with ASD. 

With proper support and understanding of the following eating disorders, your child on the spectrum can learn to manage their relationship with food more healthily.

1. Behavioral Rigidity

Behavioral rigidity is typical in many mental health conditions, including autism. In a nutshell, it means someone has a hard time adjusting to new or different things. When it comes to food, this can show up as cravings for certain foods, refusal of certain foods, and having a very limited diet. 

Rather than being driven by body image issues common in eating disorders, these behaviors related to autism are often put into the same category as Avoidant/Restrictive Food Intake Disorder (ARFID). 

You’re not alone if you’ve never heard of this disorder. Basically, it’s when someone has a hard time eating certain foods or textures. Treatment for this type of disordered eating relies on behavioral techniques like “escape extinction.” 

This is where you repeatedly give the child the food they struggle to eat over and over again until they learn to accept it. Our next category of disorder has to do with our senses.

2. Sensory Abnormalities

If you’re on the spectrum, your senses may work differently than others. This means that things like hearing, sight, touch, and smell can be affected in ways that make eating challenging. 

Because children with autism experience food differently, they are affected by many characteristics of it, including the:

• Size of each bite
• Texture of different foods
• Taste
• Color
• Shape 
• Temperature

These factors can make it challenging for children with ASD to get daily nutrients. Proof of this comes from science, where studies show people with autism don’t identify specific tastes as well as others – like bitter, sweet, or sour. 

Interestingly, children with ASD could still tell when something was salty in the same way as those without autism, which could explain a shared love of potato chips!

However, some eating behaviors are not so funny and can produce serious consequences. 

3. Behaviors With Significant Health Risks

The third category in our list includes behaviors that can be very dangerous for your child’s health – so they’ll need lots of help and support to manage them. This group of behaviors includes things like:

• Pica. A disorder in which an individual eats non-food items, such as dirt, paint chips, or paper.
• Rumination. A type of disordered eating in which people repeatedly chew and swallow food without fully digesting it 
• Disruptive mealtime behavior. Behavior in which a person with autism engages in disruptive or inappropriate behaviors while eating, such as spitting food out, leaving the table during meals, and refusing to eat.

All of these behaviors can have severe consequences if they’re not managed properly, so if you think your child is exhibiting any of these behaviors, it’s vital to speak with a healthcare provider. Now let’s examine rumination more closely.

Rumination

A less common but equally serious type of disordered eating for children with ASD is food rumination. This condition causes people with autism to regurgitate and rechew their partially digested food – sometimes over and over again. 

While this could be a sign of underlying health issues or anxiety in some cases, it’s not always clear why this might happen, particularly for kids with autism.

Due to the difficulty in clinically identifying this condition in nonverbal children and people with ASD, estimates for how many people are affected by food rumination don’t agree. Studies suggest that rates are somewhere between 6% and 10%. 

Fortunately, there are a few approaches to treating food rumination in individuals with autism. These include: 

• Supplemental feedings to break the regurgitation cycle. The strategy of offering alternative food sources in addition to regurgitated food. 
• Use of preferred stimuli. This tactic involves providing a positive or pleasurable activity or item when the individual begins exhibiting rumination behavior to divert their attention away from it. 
• Emphasis on overall increased or alternative stimulation. This approach focuses on offering other activities that provide sensory input and rewards for individuals with autism, which can be used as a replacement for ruminating behaviors. 

You should discuss all these techniques with your doctor to find out what works best for you or your child’s needs and lifestyle. With the proper support and treatment, you can effectively manage food rumination for your child with autism. 

Sometimes, how you eat is just as important as what you eat, and we’ll look at that next.

Rapid Eating Behaviors

Eating quickly is often associated with risks such as choking, weight gain, and difficulty feeling full. For people on the autism spectrum, these dangers can also lead to indigestion and social isolation. 

Recent studies have found that a high body fat ratio is linked to rapid eating habits and may be caused by insulin resistance. Binge eating disorder (BED) was officially added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, making it the most common eating disorder in America today. 

To receive a diagnosis of BED, an individual must not display any behaviors that compensate for the rapid eating, such as those found in anorexia nervosa or bulimia nervosa.

Conclusion

Disordered eating in autism is a complex and often misunderstood issue. This article has discussed the three categories of disordered eating among those with autism: behavioral rigidity, sensory abnormalities, and behaviors that could cause health risks. 

It’s important to understand that these behaviors are not just “picky eaters” but have deeper psychological and physical roots that must be addressed. 

The key takeaway from this article is that it is essential for parents and caregivers of those with autism to be aware of the signs and symptoms associated with disordered eating so they can intervene early on if needed. 

If you suspect your child might be experiencing disordered eating, we encourage you to speak with a qualified healthcare provider who can help determine the best course of action.