Autism and Binge Eating (Part 1)

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Autism and binge eating – is there a connection? While the relationship between autism and eating disorders is well-acknowledged, most of the conversation revolves around the restrictive side of the eating disorder spectrum, specifically anorexia and ARFID. Overeating and binge eating are much less discussed forms of disordered eating in the context of autism, ADHD, and other forms of neurodivergence. This is very problematic, considering many autistic people struggle with overeating.

Because every individual is deserving of validation and support, I’ve written this Autism and Binge Eating Series to shed light on the relationship between autism and overeating. Whether you are a neurodivergent individual struggling with binge eating or are seeking to better support someone you care for, I hope this series helps you understand the connection and ultimately, gain insights so you can have the healthy relationship with food you so deserve.

What is Autism?

Autism, short for Autism Spectrum Disorder (ASD), is recognized by the DSM-5 as a neurodevelopmental disorder typified by persistent differences in social communication and behavior. While autism is a spectrum, I, as an autistic individual, wholeheartedly disagree with the DSM-5’s definition of the condition. First of all, autism is not a disorder. By nature, the pathological phrasing implies that an autistic individual is “out of order”... but does being autistic equate to a lack of order, or is it that the neuronormative society we live in creates the illusion that anything different must be disordered?

Autism is a different way of being. Identifying as autistic doesn’t merely have to do with a unique thinking style, it encompasses a totally divergent way of experiencing the world. Which brings up the inaccuracy of autism being a so-called “neurodevelopmental” disorder. While there is no disputing that autism affects someone’s brain and the way it develops, the rest of the body is often ignored. The common autistic experience of feeling unsafe is largely rooted in nervous system activation, which can be an important factor of overeating and binge eating.

What is Binge Eating?

Binge eating is characterized by consuming an abnormally large amount of food in a short period, often accompanied by a sense of loss of control over eating. Unlike overeating, binge eating episodes are marked by intense feelings of shame, guilt, and distress. This form of disordered eating is much more than just having an extra helping at dinner; it involves eating rapidly, often in secret, and continuing to eat even when uncomfortably full.

While binge eating disorder is often associated with “emotional eating” and is often viewed as a way to “cope with emotional stress,” binge eating behaviors go much deeper than that. The rest of this post and series elaborates on the underlying reasons autistic people may binge eat.

Interoception, Hunger, and Fullness

Interoception, also known as the eighth sense, refers to the internal sensory system that helps you perceive and understand your body’s physiological needs. It encompasses the ability to sense internal cues such as hunger, thirst, heart rate, and fullness. Autistic individuals often experience reduced interoceptive awareness, which can make it challenging to accurately interpret these bodily signals. This diminished awareness can lead to difficulties in recognizing hunger and fullness, which can contribute to disordered eating patterns such as undereating and overeating.

As a young child, I distinctly remember never feeling hungry. At the same time, I wouldn’t recognize fullness until I was so overly full that I felt nauseous. Despite this confusion around internal cues, I had a big appetite. I would down bowls of cereal and eat entire boxes of macaroni and cheese as after school “snacks,” and once even stole money from my dad’s wallet to buy five slices of Starbucks banana bread, only to eat all of them in secret one afternoon. Because I have always had a naturally high metabolism, I “got away” with eating a lot of food. No one ever commented on my weight or eating behaviors, and I never thought twice about it...until I started learning about health and nutrition at the age of eleven.

As I write in my memoir Rainbow Girl, fifth grade health class was like the spark that set off the raging fire of an eating disorder, an illness that I would struggle with for years to come. My literal mind took the concept of there being “good” and “bad” foods so close to heart that my black-and-white thinking prompted me to create all kinds of rules around food. I also started engaging in strict exercise regimens, as I believed eating “clean” and exercising for a certain amount of time each day was my golden ticket to becoming the “perfect healthy eater.”

While I was diagnosed with anorexia nervosa (AN) shortly after the start of my journey to becoming “healthy,” this diagnosis has always felt wrong. I did not resonate with the fear of gaining weight and becoming fat, nor did I struggle with body dysmorphia. What I did despise was the “sensory ick” that came with a changing body, as well as the increased demands and responsibilities that I knew would accompany adulthood. By (literally) making myself small and adhering to the rules of a restrictive eating disorder, I believed I would be protected from the big, bad, unpredictable world.

The next 7 years of my life were dictated by hospital stays, eating disorder programs, therapists, dietitians, FBT (Maudsley), and being written off as “manipulative,” “too complex,” and “a hopeless case.” It goes without saying that all this time, I was racking up major energy debt – energy debt that would eventually need to be paid back. Of course, I didn't know this at the time. I thought I would just gain the weight I needed to be deemed “weight restored,” I would get my period back – or in my case – for the first time (which I talk about in my post on Autism, PMDD, and Extreme Hunger), and I would have fully reclaimed my health back. 

Unfortunately for me (or from a biological perspective, fortunately for my body), that wasn’t how the cookie crumbled. It wasn't until after I had gained weight (mind you, I was at the highest weight I had ever been in my life, gotten my period back, started working out again, and doing all the other things “healthy people” do) that a new beast was unleashed: extreme hunger.

Just like that, any possibility of me feeling like I had a merely a sliver of control left, was thrown out the window as I gorged myself in multiple pints of ice cream, entire cakes and pastry boxes, jars upon jars of peanut butter and nutella, family-sized bags of granola, and pretty much anything you can think of that society has labeled as “junk food.” Going through extreme hunger was absolutely terrifying for me because I believed I was now “swinging to the other side” and developing binge eating disorder.

You may or may not resonate with having a history of restriction. If you don’t, not to worry! I will be explaining reasons for binge eating in autistic people without a past of a restrictive eating disorder as this series continues, but before we dive into that: it is critical that you understand what extreme hunger is and why it’s different from binge eating disorder. Why? Because if your body is restricted in any way, your survival brain will prioritize food-seeking behavior and any strategies to combat binge eating will not work.

Extreme Hunger vs. Binge Eating Disorder

So, what exactly is extreme hunger? Exactly what is sounds like! Okay but for real this time. Simply put, extreme hunger is the completely normal biological phenomenon of a heightened need for food after a period of restriction. It’s often described as feeling like you’re a “bottomless-pit,” which I definitely related to. During my extreme hunger episodes, I would eat massive amounts of calorie-dense food, only to somehow never feel satisfied and literally would keep eating until I was so full and so nauseous that all I could do was lay on my bed in agony.

As I explained above, I feared that I was developing binge eating disorder. I mean, all of my behaviors matched the diagnosis: eating large amounts of food, eating rapidly, and feeling guilty after eating. According to Dr. Google, I was a binge eater! The thing is, when you’ve been restricting for a prolonged period of time, what’s happening internally is that you’re building up a negative energy balance. Just like if you rack up credit card debt by spending money that you don’t actually have, going on with your day-to-day life and failing to properly support your energy expenditure is going to cause you to build up an energy debt. Just like credit card debt needs to be paid off, so does energy debt. 

Extreme hunger is the solution to restoring energetic balance. Eating incredible amounts of food – specifically calorie dense, highly palatable, delicious food – is your body’s innate way of getting you to restore weight, heal the internal damage caused by restriction, and provide your nervous system with a sense of safety and trust. We will be talking about this nervous system component later on in this series (because nervous system dysregulation can be a huge factor in why autistic people may binge eat, whether they have a history of restriction or not) but for now, let’s come back to distinguishing extreme hunger from binge eating disorder.

Although extreme hunger behaviors are practically identical to the behaviors exhibited over the course of binge eating disorder, there’s one extremely important factor that separates the two, and that is this concept of restriction we’ve been talking about. If your body is still in energy deficit, or you still have energy debt that needs to be paid off, your body physically needs all the calories it can get and thus, we cannot speak of binge eating disorder.

If you’re in this camp – whether you’re dealing with extreme hunger, or are now dealing with what you think is binge eating after a period of dieting or another form of (unconscious) restriction, I highly recommended you read my book How to Beat Extreme Hunger: Find Food Freedom Without Losing Control. This book dives deep into what extreme hunger is, why it happens, when it happens, who it happens to, and how to deal with everything that accompanies the extreme hunger experience including digestive issues, hormonal changes, and key mindset shifts you need to make if you want to fully recover from an eating disorder.

If you’re a more visual learner, and prefer videos, presentations, and want tangible action steps to guide you through the extreme hunger process, I also have a course! Extremely Hungry to Completely Satisfied pairs beautifully with the book, and you can learn more about it here.

Now that you understand the role of interoception and you understand how extreme hunger is distinctly different from binge eating disorder, we can move onto all of the reasons why autistic people may overeat or binge eat. In Part 2, we’ll be diving into the sensory component of food and how this ties into nervous system regulation.