People with ARFID are all too often severely harmed when we do not apply the neurodiversity paradigm to this condition and instead pathologize it. As an eating disorder therapist, I have worked with quite a few individuals who have been forced to eat foods that cause intense sensory distress by their parents and caregivers, medical providers, and therapists.

I believe neurodiversity affirming care is about accepting those we work with as complete and whole, and as having the capacity to move toward the future they want, in the present moment, as they are now. This ironically means accepting that parts of the people we work with may always be living in or fused with the past, and that maybe this isn’t something to be fixed or changed.

Labels are tricky business. Our desire, and at times need, for labels (or lack thereof), is highly individual. I think for me, the most important thing to remember and process, are both the benefits and limitations of labels around identity and diagnosis. There is no perfect system here, so understanding how exactly they may help a person, and where they may fail them, and figuring out a way to balance it all out so that the least amount of harm is done, is a great conversation to have between patient and provider when regarding medical diagnosis.

Being a “picky eater” is a woefully inadequate description of ARFID (which stands for “Avoidant Restrictive Food Intake Disorder”). Most of the time, it didn't even have to do with disliking certain foods. A food could look good, smell good, even taste good to me, but my body physically wouldn't let me swallow it. It was as if foods were inappropriately setting off alarm bells in my body, reacting as if I were trying to poison it.

Over time I have developed not only the skills to create food, but the skills to accommodate my disabilities in the kitchen. It has been a work in progress, and always will be, as my condition progresses and I go through new struggles in the future. But, for now, I would like to share the things I do that make kitchen work a bit easier for me.

“I think eating disorder treatment can become much kinder and sensitive to how the body interacts with society and its various structures. In this way, I think we can infuse the social within the medical – or, we can reveal how so much of the medical, so much of the body, is deeply social.”

Behaviours that others see as “impulsive” may in actuality be resulting from our body and brain’s valid need for rest from the constant struggle of controlling and regulating ourselves.

The concept of disability has emerged from the interaction between ableism and perceived differences in body and mind. Ableism breeds inequity, and as such, it is a systemic, structural, and societal issue.

Because of the highly complex nature of eating disorders, I feel that it often does not make sense to only utilize one model of disability to conceptualize these conditions. Drawing from both the medical model and the social model can strengthen our approach to addressing the multifaceted biological, psychological, social, and cultural aspects of disordered eating and recovery.

Nothing can become more inclusive until treatment and society does. Providers, my statement to you is this: the system you’re working under excludes most of the people who most need your help. If you’re not working to change that, you’re effectively accepting it. You can advocate for these systems to change, or you can continue leaving us to die. Inaction does not excuse you from impact.

Many neurodivergent people may find some aspects of Intuitive Eating to be inaccessible for a variety of reasons, and accommodations may need to be put in place to support neurodivergent people in recovery.

Many specific needs of neurodivergent folks struggling with eating disorders set them apart from their neurotypical peers. These needs are so individualized that making a comprehensive list is simply impossible, but consider these categories: sensory processing, executive functioning (including emotion regulation), and social engagement.  

“Eating disorders are sneaky.” This is my orientation to the field from the other side of the couch, years into my own solid recovery but still unaware of my neurodivergence.

I have always had a really difficult relationship with food because I am autistic, meaning my body processes incoming sensory information differently, and because of this I need to have access to a very narrow list of safe foods to ensure that I am able to eat.