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Eating Disorders

Dietary Difficulties

Pica

Food Allergies
Fatty Acids

Eating Disorders

Professor Gillberg of the National Centre for Autism Studies at the University of Strathclyde believes that a small but significant number of cases of anorexia in females could be complicated by autism, and possibly the majority of cases of anorexia in males.

It is suggested that some girls may go undiagnosed with autism because they are simply believed to be quiet, serious, or shy. The first obvious sign that they are struggling is when they develop a calorie fixation. When this is the case traditionally successful means of therapy, such as family therapy, may be ineffective because they do not take account of their autistic perspective on things.

Autistic people could be particularly vulnerable to eating disorders for a variety of reasons. Autistic people often like rules and systems, which are a characteristic of many diets, however, there is also a tendency toward perfectionism in some, and this could result in taking dieting to an extreme. Furthermore, you can be very driven to fit in and be accepted, but not know how to be. The usual advice people give not only makes no sense to you it also doesn't work for you, so you can get quite confused.

There may also be a different perception of self image and identity. A characteristic of autism is difficulty in imagining what others are thinking and feeling, and I think this can also be true of understanding and appreciating how others see you. I think for most people their self image comes from how they imagine others see them. I think for autistic people our self image comes from somewhere inside. Trying to boost the self esteem of an autistic person is an exhausting task because, quite frankly, your opinion counts for almost nothing. It is what we think of ourselves that matters and that will be based on facts as we perceive them and on our interpretation of our experiences. Unless you can come up with a logical and more probable re-interpretation of whatever experiences a negative self image is based on you are wasting your time... simple reassurance is not enough.

Eating Disorders Association

BBC NEWS | Health | Girls' autism 'under-diagnosed'

Dietary Difficulties

Around 5% of children under the age of 5 have feeding problems in general, but amongst children on the autistic spectrum it could be nearer one third, and go on way past the age of 5.

The phrase 'fussy eater' isn't really adequate to describe what can honestly be a nightmare for parents and a source of considerable stress for children, for whom what should be one of life's pleasures can be a daily challenge.

It's quite simple really, and comes down to three things...

Firstly, there is the sensory aspect. Autistic people can be more sensitive than most to things like smell, taste, and texture.

Secondly, there is fear of change. Some autistic people like things to be kept the same and stick to a routine. Particularly for some children this might involve insisting on a ritual for meal times, always eating from the same special plate / dish, or always wanting to eat the same thing.

Thirdly, there is perfectionism. This could be an obsession with avoiding 'bits' in food (small blemishes or areas of discolouration) or a desire to keep foods on a plate totally separate and uncontaminated by each other.

For some children this combination of things can lead to them refusing to eat almost everything. For others it means they are just fussy and don't eat a very balanced diet.

To someone who hasn't experienced it for themselves it is hard to explain how this is not naughtiness or attention seeking. It cannot be controlled with discipline. It is not caused by bad parenting. A child who is like this acts like you are trying to poison them if you force the issue. They would rather be sent to bed with no food than be forced to eat something they object to... they would literally rather starve. It is in many ways irrational behaviour, but it is based on a rational fear... Whether it is psychological or sensory, an unpleasant experience is something to fear.

Sometimes you have no choice but to indulge children like this just so they at least eat something. Other times you might be able to trick or manipulate them in to eating what you want them to. Overall though the challenge is to introduce food to them in a context in which they don't fear it.

I was one such child, and I must admit I am still a bit like this as an adult. However as I got older I learnt how to enjoy food and be more relaxed about it and even be more experimental. The most important factor in this has been control. Being involved in the preparation of food made me far less fussy about the finished product and has encouraged me to try new things. Take for example my irrational hatred of dried fruit. For the first 25 years of my life I would not have put a raisin in my mouth if you had paid me... I would gag at the thought of it. If you gave me a cake or a bun with raisins in I would pick them out before eating it. Then I started to enjoy baking cakes as an occasional hobby, mostly for other people to eat, and I would want to experiment with my ingredients. Naturally I had to test what I had baked, so if that included raisins I would eat them too... I just did it. Somehow the context helped me overcome whatever psychological block I had in place. I don't dislike the taste. I wouldn't choose them, but I can tolerate them now and I don't pick them out of things anymore.

Another factor has been planning meals in advance. For most of my life I have struggled not to just eat the same thing every day... I would get stuck in a taste loop and find myself only ever feeling like I wanted to eat the same thing over and over. A couple pf years ago I created a menu at home that plans out the next 12 weeks meals in advance on a rota. I know what to expect and I can look forward to what I know I am going to have. I suppose in a way this is another aspect of control. It allowed me for the first time in my life to have a varied and balanced diet.

Teasing children about what they eat, forcing them to eat, and having stressful and/or unpredictable mealtimes on the other hand are things which increase fear and could well make a problem like this worse.

Pica

It is quite normal for many young children (under the age of 2) to explore their surroundings by putting non food items in their mouths. However, if after that age someone has a persistent craving to eat a non-food items for a month or more this is known as Pica, and it is more common amongst children on the autistic spectrum. Other reasons for Pica include pregnancy, mental health, and malnutrition.

Although consumption of some items may be harmless, others can be dangerous, for example soils contaminated with lead or arsenic or cleaning products.

Furthermore, eating non-nutritive substances can be harmful to a person's health because it may cause iron deficiency, serious bowel problems, abdominal pain and parasitic infection. Consuming non-food items leaves less opportunity to eat nutritious foods, which may lead to overall malnutrition.

It is usually temporary, but if you are at all concerned it is something about which you should see your doctor.

Some typical things which are eaten include:

  • dirt

  • clay

  • paint chips

  • plaster

  • chalk

  • cornstarch

  • laundry starch

  • baking soda

  • coffee grounds

  • cigarette ashes

  • burnt match heads

  • cigarette butts

  • faeces

  • ice

  • glue

  • hair

  • buttons

  • paper

  • sand

  • toothpaste

  • soap

When I was 5 I went through a stage of wanting to eat paper, and especially silver paper, all the time.

Food Allergies

While supporters of the gluten free diet vary from those who see it as a way to address specific health problems to those who see it as both the cause and a cure for autism, if you have a food allergy, autistic or not, eliminating that food from your diet is bound to improve your health and therefore you day to day functioning in life. Physical problems caused by food allergies could be things like digestive problems, sweating, hyperactivity, and sleeping difficulties. Some people believe that  the treatment of food allergies combined with the removal of the offending foods can in turn reduce what are believed to have been behavioural symptoms of autism. It is however by no means the case that special diets help everybody on the autistic spectrum, so I would strongly recommend actually getting medically tested for food allergies before making any dietary changes.

Fatty Acids

There has been research that has shown autistic people have a deficiency in crucial fatty acids such as those contained in fish oils. Increasing intake of fatty acids is reported to help with concentration, mood and sleep. You can increase your intake of fatty acids either naturally through your diet or by taking a supplement such as Eye Q.

Further reading available from Amazon.com or Amazon.co.uk

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