Supporting Neurodivergent Young People With Eating Disorders: A Guide For Parents And Carers
The overlap between neurodivergence and eating disorders is an increasingly recognised space. If your child is neurodivergent, for example is autistic or has Attention-Deficit/Hyperactivity Disorder (ADHD), and is struggling with an eating disorder, you’re not alone. OR, your child may not be diagnosed as neurodivergent, but you see traits and wonder about the intersection with developing an eating disorder.
Neurodivergent individuals – especially those with autism and/or ADHD – are significantly overrepresented in eating disorder populations, yet their needs are often misunderstood in traditional treatment models.
This blog – from EDFA volunteer and carer Karina Smith, parent of a neurodivergent young adult who has recovered from Anorexia Nervosa – aims to help you understand why this overlap exists, the treatment challenges, and how you as a parent or carer can be an advocate and offer meaningful support.
Why are neurodivergent individuals more vulnerable to eating disorders?
The link between autism, ADHD, and eating disorders is well-established:
- People with Autism can represent 37% of those diagnosed with Anorexia Nervosa (AN). Many experience ARFID (Avoidant/Restrictive Food Intake Disorder), with an estimated 21% affected, compared to 0.3% in the general population
- People with ADHD are three to six times more likely to develop an eating disorder. Factors such as impulsivity, inattention, emotional distress, and dopamine dysregulation contribute to this risk
- Children with ADHD are 12 times more likely to experience loss-of-control eating. Individuals with both autism and ADHD (AuDHD) show some of the highest rates of restrictive eating behaviours
This isn’t about food – it’s about how the neurodivergent brain interacts with the world:
- Sensory sensitivities can make certain foods intolerable
- Cognitive rigidity or a preference for routines can influence eating habits
- Interoceptive confusion (difficulty recognising hunger or fullness)
- Alexithymia (difficulty identifying emotions) can affect self-regulation
- Some young people with neurodivergence report that starving stops the constant noises in their neurodivergent brain
Diagnosing and recognising neurodivergent traits versus eating disorders
Autism and ADHD are under-recognised in people who are born female, Aboriginal & Torres Strait Islander people, and in other culturally and linguistically diverse minority groups. This lack of diagnosis can have a variety of negative effects on mental and physical health, including recognising they are at greater risk of, or are in the early stages of, an eating disorder.
Conversely, malnutrition from a restrictive eating disorder can mimic traits of autism, or the young person is simply too malnourished to assess their brain, behaviours and mental health, thus complicating diagnosis. Distinguishing between neurodivergent eating patterns and eating disorder behaviours is vital for proper care.
Neurodivergent people are more likely to have the risk factors for developing an eating disorder, including GI issues, immune-related disorders, and co-occurring mental health issues like depression, anxiety and suicidality.
Neurodivergent people are also more likely to be LGBTQIA+, adding complexity to care needs and increasing eating disorder and mental health risks.
Recognising neurodivergent traits versus eating disorder symptoms
It’s vital to differentiate between eating disorder behaviours and neurodivergent traits. Vital but often very difficult, particularly if your child is yet to be diagnosed:
- preferring bland or specific foods → could be sensory-safe eating
- eating alone or avoiding eye contact → could be social communication difference
- using devices or headphones during meals → could be sensory regulation
Avoid targeting behaviours unless they are clearly part of an eating disorder. Misinterpreting them can damage trust and lead to ineffective or harmful treatment.
Traditional treatment barriers
Unfortunately, current eating disorder treatment has not been designed with neurodivergent individuals in mind. Research shows that autistic and ADHD individuals often have poorer treatment outcomes, and there’s a risk that the treatment itself causes distress and harm.
Approaches like CBT (Cognitive Behavioural Therapy) and FBT (Family-Based Therapy) may not suit all neurodivergent individuals without thoughtful adaptation.
Rigid expectations around meal structure, exposure therapy, or social eating may inadvertently target adaptive neurodivergent behaviours rather than eating disorder symptoms.
For example, eating the same food daily or using headphones during meals may be sensory coping strategies, not pathological habits. Whereas exposure therapy (to certain foods) may cause extreme distress due to sensory issues, rather than the calories in the food.
Using the SAFETY model
The SAFETY model offers a helpful framework for parents supporting neurodivergent young people with eating disorders.
Here’s how it is implemented:
S – Sensory Environment
Create a sensory-friendly space around food. Dim lighting, reduce background noise, and don’t insist on social norms like eye contact or sitting at the table. Let them use headphones or eat in a quiet room if needed. Prioritise comfort over conformity.
A – Autonomy
Offer choices rather than directives. Let your child help plan meals, set boundaries, and define goals. Autonomy builds trust and engagement. Frame eating goals collaboratively and invite input on what feels manageable.
F – Flexibility
Adapt routines and expectations. If certain therapies or tasks feel overwhelming, it’s okay to pivot. For some neurodivergent individuals, tools like journaling or exposure tasks aren’t helpful. Embrace neurodiversity-affirming modifications, not rigid compliance.
E – Emotional Validation
Neurodivergent people may express emotion differently or have difficulty recognising what they feel. Use nonverbal tools like emojis, mood charts, or visual cards. Validate distress and avoid interpreting avoidance as defiance – it may be demand-avoidance, sensory overload, or burnout.
T – Trust Their Experience
What looks like resistance may be a neurological response. For example, executive dysfunction can make even small tasks overwhelming. Honour their lived experience and work with, not against, their brain.
Y – Your Advocacy Matters
If current treatment doesn’t feel like a good fit, advocate. Ask providers if they have experience with neurodivergent clients. Seek neurodiversity-affirming care, and don’t hesitate to request modifications. Trust your gut – you know your child best.
What about Family-Based Therapy (FBT)?
FBT remains a first-line treatment for adolescents with anorexia under the NICE (UK’s National Institute for Health and Care Excellence) guidelines. However, it’s essential to understand that FBT wasn’t designed with neurodivergent individuals in mind. Some neurodivergent young people may find aspects of FBT – such as rigid structures or loss of autonomy – particularly distressing.
That doesn’t mean FBT is inherently harmful. Many families have found success with FBT when:
- Adapted by a clinician who understands neurodivergence
- Paired with individual therapy that supports emotion regulation, trauma, or relational difficulties
- Or complemented by alternatives like CBT-E or AFT (Adolescent-Focused Therapy), which can also be adapted for neurodivergent needs
What matters most is ensuring person-centred, affirming care – with strong parental advocacy – no matter the model.
Why neurodiversity-affirming care matters
A neurodiversity-affirming approach avoids making unhealthy assumptions about neurodivergent traits. Instead, it:
- Focuses on strengths and unique processing styles
- Supports autonomy, communication, and consent
- Creates safe, inclusive environments
- Promotes a positive neurodivergent identity, which may protect against eating disorders and support lasting recovery
This framework is relational, not medical. It asks: “How can we change the environment to suit the person?”, not the other way around.
Practical tips for parents and carers
Reframe resistance. Demand avoidance, sensory overwhelm, or executive function difficulties may look like stubbornness but are real.
Incorporate special interests. Use them as motivators, rewards, or calming strategies.
Celebrate small wins. Eating a new food? Asking for help? That’s progress—no matter how small.
Respect communication preferences. Visual tools, texting, or body language can be more effective than verbal conversations.
Be flexible. Let go of conventional ideas around meals and social norms. This may be the case for your neurodivergent loved ones in many other situations anyway.
You are not alone
Parenting a neurodivergent child with an eating disorder can be confusing, exhausting, and isolating. But there is support, and more importantly, there is hope. With the right understanding, adaptations, and care, recovery is possible, and sustainable.
Remember: your voice matters. Your child’s voice matters. You are your child’s biggest advocate. By embracing neurodiversity and pushing for affirming care, you’re helping build a safer, more inclusive future for them, and for others with neurodivergence.
Additional resources:
- Eating Disorders Neurodiversity Australia (EDNA) has multiple guides and information that every parent should have bookmarked.
- Neurodiversity-affirming Therapy Model
- FBT for autistic individuals: AnorexiaFamily.com and LivLabelFree
Eating Disorders Families Australia (EDFA) provides support and services for carers supporting loved ones with neurodivergence and an eating disorder.
EDFA’s FREE Online Support Groups offer a safe space for you to connect with other carers of a loved one with an eating disorder Australia-wide.
EDFA’s Fill The Gap counselling service offer free, one-on-one online counselling to support carers in navigating the challenges of caring for a loved one with an eating disorder or disordered eating concerns.
Please contact Administrative Assistant Bailey Wightman on 03 9125 5670 or email bailey.wightman@edfa.org.au if you need support accessing the service.
About Eating Disorders Families Australia
Eating Disorders Families Australia (EDFA) is the only national organisation solely for carers and families of those with an eating disorder. EDFA provides support, EDucation, advocacy, and FREE online counselling services and annual membership. EDFA has a private Facebook forum, providing a safe place for eating disorder carers and family members to share experiences, seek advice and assistance, and find hope.