Autism and Fear of Weight Gain: A Nuanced Perspective

In Part 1 of this fear of weight gain series, we explored how eating disorders in autistic people often aren’t about weight or shape, but rather about finding safety in an overwhelming world. I shared my personal journey and explained why viewing eating disorders through the lens of control misses the point entirely. Now, let's dive into eight specific reasons why autistic people might fear weight gain, offering a more nuanced perspective than the typical "fear of fatness" narrative.

1. Sensory Sensitivities

Weight gain is an incredibly sensory-rich process. Different parts of your body expand, your shape changes, clothes fit differently, and parts of your body may touch or rub against each other in new ways. For an autistic person, this is like sensory overload on steroids.

When I gained weight in ED recovery, I felt SO trapped in a body that I experienced as "wrong." It felt like my soul was being propped into a costume that didn't fit. By shrinking myself during anorexia, I didn't have to fit – and thus feel – the costume. Similar to plasmolysis in plant cells (when plant cells shrink away from their cell walls due to water loss), restriction of food causes your body to retreat into itself so you no longer feel like an exposed nerve ending, which is pretty much the default autistic experience.

2. No More Numbing

Eating disorder recovery isn't just about physical changes. It's about confronting ALL the feelings, thoughts, and emotions that the eating disorder numbed you from. Because my anorexia started at age eleven (before I had shown any signs of puberty) I didn't start puberty until I was in recovery at age eighteen!

Can you imagine? Not only was I gaining fat tissue in places I'd never had it before, but my hormones were going absolutely wild. And don't even get me started on getting my period for the first time (and honestly, every month it's still awful as someone who has PMDD). But beyond these intense physical changes, nutritional rehabilitation also means restoration of cognitive function – which for the neurodivergent brain means more thoughts going balls to the walls.

3. Autism and Existential Angst

Let's talk about existential angst for a minute. When you're autistic, you already spend so much time worrying that you’re doing life "wrong" – like everyone else got some secret manual that you missed. Add to that the fear of doing weight gain "wrong," and the entire process becomes too overwhelming. Not only are you trying to navigate a world that wasn't built for your brain, but now you're doing it while your body changes in ways you can't control.

It's all connected to feeling trapped in a human body. As autistic people, we already experience our bodies differently. Sensations are more intense, anxiety is heightened, and, if you’re like me, you may feel like you’re walking around in a cardboard cutout of a world. Weight gain elevates this trapped sensation, makes you want to crawl out of your skin. The eating disorder provided concrete answers in a world that often felt too abstract, and recovery meant facing the terrifying reality that maybe there are no "right" answers.

4. Identity Crisis in Eating Disorder Recovery

For as long as I could remember, my identity was the athlete. The little skinny girl. The "perfect healthy eater" who showed no remorse when I was the only one who could "resist" all the food at holiday parties. For seven years, anorexia was a core piece of who I thought I was. My eating disorder gave me a role to play, and I played it perfectly – even though it was slowly killing me.

To gain weight meant to release this identity, and that was terrifying. I talk about this identity crisis in my book Rainbow Girl because it's such a crucial part of recovery that nobody prepares you for. When your entire sense of self is built around being small, disciplined, and "in control," recovery isn't just about changing your body – it's about discovering who you are without labels. For neurodivergent people specifically, it’s about unmasking, embracing your authentic self, becoming curious as to who you are before you judged everything about yourself.

5. Change: It's Complicated 

Here's something most people get wrong about autism: it's not that we hate ALL change. We only struggle with changes we don't initiate or want. I can spontaneously start writing a new book after receiving a burst of inspiration at the gym because I want to, while a last-minute change of plans can cause me to spiral into anxiety. Weight gain falls into that second category, as it's change we can't control.

With weight gain, we can't decide where the fat will go, how it will distribute, or how much weight we'll ultimately gain. We can't predict what clothes size we'll wear or how people might treat us differently when we look "healthy." This lack of control over our changing bodies can feel overwhelming, especially when we're already dealing with the daily challenges of being autistic in a neurotypical world.

6. The Terrifying Prospect of Being "Healthy"

One of the most significant ways in which my eating disorder protected me was through shielding me from confronting the fear of being healthy. When you're already struggling to handle the world – the sensory overload, the social demands, the constant masking – the eating disorder ensures you don't have to deal with the expectations that accompany being healthy. Gaining weight and becoming "healthy" means losing that buffer between you and the world. You're suddenly responsible for your actions and are expected to handle (adult) life in a world that already wasn’t built for you. 

7. Desire For Predictability

Another terrifying aspect of recovery was facing all the unknowns about how my body would change. How much weight would I gain? What would a bigger body feel like? What if that body was too uncomfortable? Where would I buy new clothes? All of these uncertainties can be so overwhelming that staying in the eating disorder just seems to be the “safer” option.

A need for predictability is tightly intertwined with the identity crisis mentioned previously. Even though I was miserable in my eating disorder, it was predictable. I had my food and exercise routines down to a science. Being larger, that is to say, being another identity, was threatening because it was unknown. And humans, especially autistic humans who thrive on predictability, tend to stick with what we know – even if we also know it’s hurting us.

8. Gender Dysphoria in Eating Disorders

While this isn't part of my personal story, many of my clients have shared how their fear of weight gain connects deeply to gender dysphoria. Gender dysphoria happens when there's a disconnect between the sex you were assigned at birth and the gender you identify with. For many people, this creates an intense desire to change their body shape, with restriction often becoming a way to suppress or modify gender-specific features.

This adds another layer to the fear of weight gain because body changes during recovery might intensify gender dysphoria. Weight restoration can mean developing or regaining features that don't align with someone's gender identity, making recovery even more complex for autistic individuals who are also navigating gender identity.

Beyond "I Don't Want to Be Fat"

Now, you might be reading all of this and thinking "This makes sense, AND what if I or someone I care for still says over and over again that they don't want to be fat?" I'm genuinely curious what lies beneath that fear. Is it really about the weight, or is it about not being accepted? About being exposed? About being different? About having to face all these deeper challenges we've talked about?

The irony, of course, is that engaging with anorexia already makes you different. I always felt the eyes staring at me when I left the house. I knew that having a different plate at dinner wasn't considered "normal." Yet at the same time, anorexia had become my version of normal – it was my identity, my safety net, my way of existing in the world. So addressing the fear of weight gain isn't really about the weight at all; it's about the willingness to create a new identity, one that allows us to exist fully in the world, even when that world feels overwhelming. It's about finding ways to feel safe without compromising our ability to live.

How do you cope with anorexia weight gain? In Part 3, I share how I made peace with weight gain as an autistic person – from both a physical and metaphysical angle!