Neurodivergent People Struggle with Food –And Why We Shouldn’t Worry So Much About It
A couple months ago, I updated and greatly expanded my client handout on Diet and Nutrition for Neurodivergent People. In the three years since I created the original version, I’ve learned a great deal – through my work as a therapist specializing in neurodivergence and trauma, through my research, and also (not least) through my own lived experience as a neurodivergent person who often struggles with the whole process of eating.
Like so many other ND people, I have pretty significant interoception problems. My brain doesn’t receive the signal that I’m hungry until far too late, when I’m nauseated and my blood sugar is completely off. Although I’m not as choosy about food as many autistic people normally (I’ll eat almost anything on a good day), the more stressed I get the harder it is to find any food that doesn’t make me queasy just thinking about putting it in my mouth. It’s a hard cycle to break, once it gets started.
So I keep “safe foods” around. For me, that’s bananas, saltine crackers, a few specific types of protein bars, and maybe on a slightly-better-than-horrible day, some avocado toast. When things are at their worst, I subsist on meal replacement shakes.
This whole dynamic is very hard on my body, as you can imagine – especially when it’s compounded by the fellow travelers that tend to come along with eating problems when I’m extremely stressed. Sleep disruption. Collapsed motivation. High anxiety about all the things I’m not getting done because I feel so “off.” Shame. Self-blame. And so on.
This has been such a difficult cycle for me, and has happened so often over so many years, that I’ve been working with an integrative medicine naturopath who specializes in stress medicine and cellular biology to try to find fixes. Much of what I shared in the Diet and Nutrition handout delves into what I learned from her and from the research I’ve done around the interventions we’ve been trying, to learn the science behind it. It’s been eye-opening.
So… I packaged all that into one of my usual 40+ page handouts full of what I hoped would be useful information that might set people like me on a more hopeful, more actionable path.
Then, because I’m not a nutritionist, or a dietician, or a doctor (just a therapist who nerds out on neuroscience), I asked a colleague who is a licensed nutritionist, specializes in working with neurodivergence, and is neurodivergent herself, to review it and give me feedback.
She did, which I greatly appreciate. I’m sure it took her a while – I write long. When she met with me next, the look on her face wasn’t what I expected. And the first words out of her mouth, after a moment’s hesitation, were an even greater surprise.
Basically, she told me to throw it out and start over.
Not because the information was wrong or misleading – she said the actual content was sound. But because for neurodivergent people who are already overwhelmed with the whole concept of food, and eating, and everything that comes with it, being handed a 40-page list of all the things they “should” be doing to improve their health (however well-intentioned) is likely to make them collapse into a shame spiral.
I hear this. Hoo boy, do I hear this.
Then she gave me some insight into her work and what she does with clients. She said that often she’s not trying to get people onto a “well-balanced diet” (whatever that is) or a supplement regime. She’s trying to get them to eat. Period.
OCD-type contamination fears. Strong sensory reactions to textures, temperatures, smells, flavors. Refusing to eat leftovers or anything that’s been in the fridge for more than a few days. Difficulties getting food in the first place, because supermarkets are so overwhelming. Decision fatigue trying to plan a meal, much less cook it. Body dysmorphia. Digestive systems that are chronically out of whack in one way or another. A lifetime of being shamed and pressured about food. Fear of judgment.
The list of issues that neurodivergent people have around eating and nourishing our bodies is long.
I see this in my practice, and in my own life. Many ND people, especially (but not uniquely) those assigned female at birth, have major struggles that tend to get (mis)labeled as eating disorders. If they do seek help, often they’re shunted into programs for anorexia or bulimia that are not helpful, and sometimes harmful. Or they’re sent to a dietician or nutritionist who gives them the usual spiel about a well-balanced diet and then labels them “non-compliant” when they don’t adopt it.
I’m grateful that I’ve found a couple of good ND-affirming nutritionists and integrative medicine doctors to whom I can refer people with these struggles – because all I can really do, as a therapist, is normalize the experience and validate how hard it is, and maybe offer a few suggestions about what I’ve learned and experienced that might help. Which isn’t enough.
The other thing my colleague told me, which is essential, is that we obsess far too much about what we eat and trying to make it “balanced.” Our body can assemble the basic materials it needs out of almost anything, as long as there’s some food in our food (as opposed to chemicals and additives).
Eat what you can, when you can, and maybe take a multivitamin. Relax.
So what did I do with that nutritionist’s feedback, you ask?
I haven’t scrapped the handout – not yet. It’s still up on my website. I do think the information is potentially useful, for those who have the bandwidth to process it.
But I am rethinking how I’ve been approaching the idea of sharing information. I’m slowing down the process of writing my usual 40- to 60-page mini-books on various topics related to living with neurodivergence and/or trauma, and instead I’m going back to take a careful look at what I’ve already created. Checking for blind spots. Making sure I’m not inadvertently making things harder, if nothing else just by overwhelming my audience.
I happen to like in-depth information that tells me not just what’s happening, but why, and what I can do about it. I’m autistic, after all, and therapy, neuroscience, family systems, and related topics are some of my strongest special interests. But not everyone can handle that amount of text. And not everyone will respond the way I would.
So instead, I’m focusing on reviewing my existing material for quality, tone, accuracy, and any blind spots that I might have missed (like the overwhelm and potential shame spiral around that diet and nutrition handout). And then creating shorter, more visual “TL;DR” versions that someone can absorb in 3 minutes, instead of having to struggle to stay awake reading my long-form versions. (I recommend those as insomnia cures. Just saying.) As well as a one-pager that summarizes the main points up front, like an executive summary but in graphic form.
In my day-to-day therapy practice, when a client is struggling with overwhelm and shutdown, I just sit with that. It makes sense. It’s normal and natural to feel that way. This world is a hard place, and I for one am still waiting for my people to arrive in their flying saucers and take me home. These “humans” are weird.
And then, when my client is ready (which might very well not be that day, or that month), I suggest they identify one small thing that they can do, where they feel just a little bit of agency. Some 1% increment that might shift things in the direction they want. And if they can’t manage that, that’s okay. Shutdown and collapse are real. They don’t operate on a timeline.
So, if you’re neurodivergent and this topic resonates with you, here’s what I would say.
Throw out all the “shoulds” that you hear from the world around you about food, diet, nutrition, eating, and everything associated with it. (Don’t “should on yourself,” as we say.) Including from me and my well-intentioned handouts.
Eat your safe foods. Do what you can, when you can.
When you have the capacity to make your safe little “hobbit hole” in the world a bit bigger, the information about how to take small steps in that direction is out there. Including on my website, as well as other even better resources, such as Dr. Megan Anna Neff’s Neurodivergent Insights. But wait until you’re truly ready and have the spoons.
With that, I offer a toast with my banana to tap up against your safe food, and I wish you a peaceful weekend.
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