How to Recognize + Overcome Extreme Hunger as an Autistic Person in ED Recovery

Extreme hunger is SUCH a terrifying part of the recovery process and can be especially confusing if you are also autistic. There’s honestly not enough information out there about extreme hunger, let alone the overlap between autism and eating disorders! In this post, I bring together the topics of extreme hunger and recognizing hunger cues as an autistic individual. You deserve to finally stop obsessing over food and exercise so you can live your life instead!

Why do autistic people struggle with recognizing hunger?

Autism and Extreme Hunger…man, we have a lot to unpack today! First of all, let’s start with the basics and that is autism and hunger - we’ll get to the extreme part in a bit! As an autistic person myself, I know that physical hunger is not something that always comes naturally to us neurodivergent individuals. This is because the majority of Autistic people struggle with interoception. If you are unfamiliar with this term, I recommend reading my post Interoception in Autism and Anorexia, in which I explain how interoception plays a scientific role in Autism and Anorexia.

In short, interoception is the sense through which we monitor the inner state of our bodies. It tells you to use the bathroom when your bladder is full, and to get a snack when you’re hungry. But what happens when you lack interoceptive awareness, a very common trait among people with Autism and Anorexia? You are unable to recognize these inner cues, physical hunger being one of them. 

I believe this lack of interoceptive awareness is what triggered my own eating disorder at the young age of 11, because I remember simply not being hungry. This is also an age of becoming more independent and getting to make more of your own food choices, which I believe helps explain why so many people who do develop an eating disorder develop it around the start of puberty.

Not to mention, it was also during this time that I started to learn about nutrition in school. My autistic brain took health recommendation statements very literally, and food & exercise became my newest obsession. This is of course a whole separate topic which I will save for another post, but what I’m basically saying here is that people who lack interoceptive awareness are more likely to feel confused about hunger cues.

What happens when autistic people don’t eat enough?

So, when you are confused about your body’s cues and don’t eat enough because you’re simply not hungry, your body starts believing resources are scarce and will go into energy deficit. It’s this energy deficit that can spark Anorexia genetics in people who are predisposed to the illness, which again, I believe is a huge contributing factor to the common co-occurrence of Autism and Anorexia.

When you are in energy deficit, your body starts to economize. Because there is not enough energy coming in, your body will slow down and even stop certain processes that are non-essential to life. Your heartrate slows, your digestion gets messed up, you are more sensitive to the cold, and your hair and nails get brittle. If you’re a female, your menstrual cycle will cease, because why the heck would your body waste energy on a period if it could use that precious energy to keep your heart beating? All of these adjustments are made by the body in an effort to maximize your chances of survival.

Of course, there’s only so much energy conservation your body can do before it must turn to internal sources for fuel. In order to support your daily activities - not to mention the excessive exercise most people with co-morbid autism and anorexia engage in - your body will literally start eating itself up. Your organs shrink, your bone density decreases, and blood flow to the brain is reduced, which contributes to further deterioration of interoceptive awareness!

I do want to clarify here, that a lack of interoceptive awareness alone does not automatically equate to a lack of physical hunger cues. You may still have tummy rumbles or feel fatigued or dizzy if you need to eat, but someone who struggles with interoception may struggle in connecting these physical cues with the action of actually eating.

Why is extreme hunger so common among autistic individuals?

Autistic people can often go for hours without food because they are simply unaware of needing to eat, which is why extreme hunger at night may be a common occurrence among autistic individuals. When you’ve almost gone a whole day without food (or very little food) and then finally allow yourself to eat something later in the day, your body realizes “oh damn, I actually am really hungry!” and you may binge. This doesn’t make you an emotional eater or a binge eater, you simply have so many calories to make up for!

That example about bingeing at night due to restriction during the day is an excellent illustration of how restricted food intake can lead to extreme hunger in the short-term. So then what happens when you do develop a full-blown eating disorder as an autistic individual and restrict calories for weeks, months, years, maybe even decades? Your energy deficit turns into energy debt. Energy debt is a lot like financial debt, in the sense that you need to eventually pay it back.

Say, you take out a loan from the bank to buy a house. You buy the house and you’re very happy, but you’re also now stuck with a mortgage. You have an agreement with the bank to fully pay back whatever they lent you to buy the house, but you also have to pay the bank a little extra each month for lending you the money in the first place. That’s of course how banks make money!

The same goes for full recovery from an eating disorder. Because your body has been taking energy from precious organs and has had to make trade-offs between proper bodily functioning and fueling your day-to-day activities, your body is in energy debt. In order to “pay” your organs back and replenish your body to function optimally again, you need to eat a LOT of food! Not only do you have to eat a sufficient amount of food to support your daily life, but you have to eat extra food to pay back all the energy you took from places where energy should have never been taken from in the first place!

Another way your body conserves energy while it is in energy deficit is by shutting off physical hunger cues. When your body believes you are in a famine environment and does not trust that food is abundant, it’s not going to waste precious energy on sending out stomach rumbles like it would in a person who is in energy balance. Every single action in the body costs energy, and your body will only send out physical hunger cues if it trusts that doing so will result in a return on investment. In people who have difficulty recognizing internal cues in the first place, a complete absence of physical hunger cues can make it seem even more impossible to eat intuitively!

How does an autistic person recognize extreme hunger?

Now you may be thinking, so if you’re telling me I am unable to recognize – let alone experience – hunger cues in the first place, how can any of this be related to extreme hunger? Well, here is where things get interesting, because extreme hunger will often manifest in a way that is drastically different than you may think!

A huge misconception about extreme hunger is that it is simply this bottomless-pit hunger that so many YouTubers and Instagram recovery accounts describe. The apparent inability to feel physically satiated CAN be a way in which one experiences extreme hunger, but as we just learned, people with autism and anorexia aren’t always as aware of what it means to feel physically hungry or full!

So how DOES an Autistic person in recovery recognize extreme hunger, or hunger at all? You recognize your need for food by observing your MENTAL HUNGER. A huge part of the work I do with my autistic clients during 1:1 Coaching is discovering ways in which you can use your autistic traits as strengths to recover from your eating disorder. I constantly get asked whether or not it’s harder - or even possible at all - for an autistic person to recover from an eating disorder, because so many of the autistic traits are the root cause of the disordered eating behaviors. This may be true, but the way you allow it to impact your life as a whole depends on how you choose to use those traits.

Using your autistic traits to overcome extreme hunger!

Your obsession for following a certain food or exercise routine can be used as an excuse to stay stuck in your eating disorder, but this same obsessive trait can be used in recovery to commit to eating more food and following a rigid rest routine! It’s this obsessive thinking around food and exercise that is the tell-tale sign you have extreme hunger. Our bodies are SO incredibly smart and are constantly navigating and adjusting to find ways to maximize your chances of survival. If your body is trying to conserve energy by shutting off physical hunger cues, it will prompt you to seek out food in other ways.

And what is the most cost-effective way to signal interest in food besides a physical urging? Thinking about food! All of the planning, dreaming, and creating of potential meals and how they will “fit” into your day, that’s all mental hunger. All of the obsessive exercise you’re engaging in, also mental hunger. Your rigid exercise routine is a way in which you’re trying to remain in control of your body’s energetic balance, and thus acts as a justification for the precisely planned food.

So, if you’re reading this and you’re simultaneously speculating what your next meal or workout is going to be, this is your sign to go into the kitchen and EAT! Use your autistic trait of a need for routine to create a consistent eating plan. Use your autistic trait of a preference for predictability to plan your fear foods. Use your autistic trait of being detail oriented to visualize every detail of your fully recovered life. Because a fully recovered life is possible for you, my fellow autistic friend…but only if you’re willing to work for it.