Eating habits and eating disorders in neurodiverse people

Michael McCreary, a comedian on the spectrum wrote in his 2019 book Funny, You Don’t Look Autistic that as a kid he used to explain to other people that autism means you can’t drink milk. He made fun of himself, as obviously there is no connection between autism and lactose intolerance, as everyone knows. Or was he wrong about joking?

Considering how many comorbidities are common in neurodiverse people I have come to the conclusion that neurodiverse (despite all it’s good intentions) is a misnomer. If eating disorders and unusual eating habits are an integral part of neurodiversity it becomes kind of hard to see “neurodiversity” as a neurological only condition. We are in need of a term that includes body and mind. I have been arguing that most neurodiverse people are evolutionary forager types as opposed to farmer-herder types and that not only cognitive and social differences are to be expected, but also physiological differences. To begin with it is recommended for neurodiverse people to cut down on gluten and dairy — farmer/herder nutrition.

Children with neurodiverse conditions (ASD, ADHD, gifted) tend to be very picky eaters and are five times more likely to throw tantrums when it comes to mealtimes. For severe cases of picking eating researchers concluded that selective eating that results in impairment of function should now be diagnosed as avoidant/restrictive food intake disorder (ARFID) — a new diagnosis that has been included in the latest Diagnostic and Statistical Manual of Mental Disorders.

ARFID is another label in the alphabet soup of diagnoses that neurodiverse children are given. We may think that these are the tantrums signs of a spoiled child or of an underlying psychological problem, but it doesn’t seem unreasonable that many of the foods or at least some ingredients really do hurt the neurodiverse child. It’s not a psychological phenomenon, it’s a physiological one. A coping strategy to avoid harmful foods that may easily backfire and worsen health like in the case of Greta Thunberg whose refusal to eat anything except tiny amounts of rice, avocado and gnocchi almost got her hospitalized.

The trouble with food may start much earlier: many mothers of neurodiverse children report that their child had been a colicky baby. Even though by far not all colicky babies are neurodiverse (in the strict sense) the condition may be an indication of struggling with certain nutrients in baby formula or the mother’s breast milk.

Colicky as babies, picky as toddlers, that isn’t the end of struggles with food intake for neurodiverse people. Come puberty come eating disorders. In recent years it has more and more crystallized that neurodiverse people are at much higher risk for eating disorders than neurotypicals. This is true for both (especially anorexia nervosa) and ADHD (especially bulimia). The typical onset for anorexia and bulimia is around 17 years and therefore most likely tied to sexual reproduction and psychological in origin. These eating disorders are also often accompanied by self-harm (40%).

Even if neurodiverse people have been spared all these troubles by the time they are grown-ups there is still a high chance of developing gastrointestinal problems.

  • Crohn’s Disease
  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Cyclical vomiting
  • Gastritis
  • Lactose intolerance

Food intolerance may be a lifelong problem for many neurodiverse people. It is what we would expect to happen if their (relatively) recent ancestors were foragers rather than farmers or herders. If this is really the case, it is time to think of neurodiverse people differently.

For more information on the “forager” view of neurodiverse people check out my book Beautiful minds — a new view of neurodiversity

Originally published at on June 18, 2021.