Adapting Intuitive Eating for Neurodivergent People
Intuitive Eating is a common area of focus in eating disorder treatment and recovery spaces. It is often seen as a way of eating that individuals in recovery should strive for and work toward, and highlighted as the end goal of the recovery process. There is a great deal of value in the concepts and principles of Intuitive Eating, as they offer an alternative to making food choices as a way to control one’s body size and instead emphasize listening to one’s body. However, 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. The following are several ways that Intuitive Eating may be inaccessible for neurodivergent people and accommodations that can be made to address this.
1. Neurodivergent people may struggle with interoception.
In shifting away from eating to control one’s body size or according to a set of rules prescribed by diet culture, Intuitive Eating often focuses on eating according to one’s bodily sensations, in particular one’s hunger and fullness cues. Two principles of Intuitive Eating are “Honor Your Hunger” and “Feel Your Fullness.” Although these are only two out of the ten principles of Intuitive Eating, these principles are sometimes the ones that are most commonly focused on in eating disorder treatment and recovery spaces, as well as in our healthcare systems and culture more generally. In fact, many people mistake Intuitive Eating for the “hunger and fullness” diet - i.e. the idea that one should only eat when hungry and always stop eating when full.
This can be very harmful for neurodivergent people, as many neurodivergent people struggle to feel internal cues and bodily sensations, including hunger and fullness. An emphasis on “only eating when hungry” can result in neurodivergent people delaying eating until they are so hungry that they are shaky, highly irritable, or even on the verge of passing out. A focus on “stopping when full” may cause neurodivergent people to overthink every bite they take and scrutinize whether they are truly hungry or truly full.
To modify Intuitive Eating for neurodivergent people, it may be important to focus on eating enough and eating consistently throughout the day, rather than eating according to one’s hunger and fullness cues. Neurodivergent people may need more of a structured meal and snack schedule than neurotypical folks in recovery, as well as some guidelines around a minimum amount of food. This does not make their eating less intuitive or their recovery less real - it is an important way of honouring their body’s needs and unique ways of functioning.
2. For neurodivergent people, “emotional eating” may be life-saving.
Intuitive Eating places emphasis on not using food to cope with one’s emotions, and on eating in response to physical hunger, not emotional hunger. For neurodivergent people, this emphasis can lead to restriction and disordered eating, and needs to be modified. Because neurodivergent people may struggle with feeling internal physical sensations including hunger, they may not realize that their body is in need of food until they feel irritable, anxious, restless, are having a lot of thoughts of food or a particular kind of food, having urges to use food to stim, or experiencing other phenomena that we may categorize as “mental” or “emotional” hunger. Responding to these experiences by eating can be incredibly important, especially if someone is not experiencing (and therefore not responding to) other types of hunger cues that manifest more physically. For some neurodivergent people, if they did not respond to these kinds of “mental” or “emotional” cues, they would rarely eat, and their bodies would be depleted.
Additionally, many neurodivergent people are more susceptible to mood swings, irritability, difficulty concentrating, and other mental health symptoms if they do not eat enough. Taking in energy can be an important way to regulate one’s mood and emotional state. There is absolutely nothing wrong with recognizing this and responding to it by eating. This includes eating more calorie dense foods including sugary/starchy foods.
For neurodivergent people, we need to emphasize eating in response to any kind of hunger - not only physical hunger, but also mental and emotional hunger.
3. Neurodivergent people may find “mindful eating” to be inaccessible.
Intuitive Eating sometimes focuses on eating mindfully, i.e. paying close attention to one’s bodily and emotional state throughout meals. This often includes an emphasis on eating without distractions to allow for the optimal ability to check in with oneself and tune in with one’s internal experiences.
For neurodivergent people, this can be inaccessible for a variety of reasons. As mentioned above, many neurodivergent people find it challenging to feel internal physical sensations at all. In addition, many neurodivergent people need external stimulation to help themselves feel regulated. Eating without distractions could be quite uncomfortable and even painful for this reason. Purposely subjecting the body and mind to discomfort or pain is the opposite of intuitive!
For many neurodivergent people, what feels more intuitive - and therefore truly aligned with Intuitive Eating - may very well be eating with distractions/eating in the presence of external stimuli. Eating while stimming with a fidget toy, eating while watching TV or using other electronics, or eating while walking or moving around in some other way (if it is medically safe for an individual to engage in movement) may make the eating experience far more comfortable and enjoyable for neurodivergent individuals.
4. Some foods and forms of food preparation may be inaccessible to neurodivergent people.
Intuitive Eating’s focus on making peace with all foods is an extremely valuable goal, as carrying guilt, shame, anxiety, and fear around particular foods or food groups can have detrimental effects on our mental and physical health. However, this goal sometimes leads to a high degree of emphasis on partaking a large variety of foods and eating as many types of foods and preparing foods in as many different ways as possible.
For neurodivergent people, this may not be accessible. Many neurodivergent people have sensory aversions to particular types of foods. There may also be barriers to cooking and other steps involved with food preparation due to difficulties with executive functioning, attention, and the sensory aspects of these processes. For neurodivergent people, the principle of making peace with all foods may need to be adapted to focus more on making peace with those foods that are accessible and convenient to eat (which may include processed and pre-packaged foods such as frozen dinners, instant meals, etc.), and supporting folks in eating enough food on a consistent basis in a way that accommodates their sensory and executive function needs.
5. Neurodivergent people may experience barriers to many forms of movement.
One of the principles of Intuitive Eating focuses on engaging in movement in order to help one’s body feel stronger and more energized. This principle is very valuable in that it shifts the goal of movement away from diet culture’s messaging around exercise for weight loss to a more recovery-oriented focus on movement for well-being and how one feels internally.
However, it is important to acknowledge that neurodivergent people may experience barriers to many forms of movement. Executive function and attentional challenges may make it difficult for neurodivergent people to build any form of movement that requires sustained attention over a period of time into their routine; sensory issues may make some of the bodily sensations involved with movement uncomfortable or painful. Some neurodivergent people struggle with coordination and other skills needed for some forms of movement. For neurodivergent people experiencing burnout or other mental health struggles that result from the exhaustion of having to navigate a world that was not designed with them in mind, movement may be perceived as another chore or responsibility that they have to engage in.
Many neurodivergent people may need unconditional permission not to exercise, or to engage in forms of movement that are accessible to them (which may include slower forms of movement or movement that is not considered exercise). For neurodivergent people, it is important to recognize some of the additional barriers around movement and focus on challenging the idea that movement is an obligation.
A Final Note
Intuitive Eating is a valuable paradigm for unlearning ideas from diet culture and moving toward freedom with food and body liberation. However, I feel that Intuitive Eating can easily turn into a diet if its 10 principles and the guidelines it offers are seen as unchangeable. To me, part of developing an intuitive, flexible, relaxed relationship with food is being able to modify the principles and guidelines of this paradigm according to one’s own unique needs, challenges, and preferences.
The above modifications are not just applicable to neurodivergent people. One shouldn’t need a specific diagnosis or neurotype in order to be able to adapt Intuitive Eating to their needs. I believe that quality eating disorder care involves exploring each individual’s unique cognitive style, challenges, and needs, and navigating what recovery means to each person on that basis, rather than imposing a one-size-fits all definition of what recovery, eating, or movement should look like. It is my hope that the above modifications will help providers support people in recovery to explore what works for them and use their intuition to make recovery-oriented choices, rather than feeling compelled to recover according to neurotypical or ableist standards.
Author: Shira Collings, MS, NCC (she/they)
Shira is a pre-licensed counselor in the Philadelphia area. She primarily works with people with eating disorders, disordered eating, body image distress, and those breaking free from diet culture. As a neurodivergent diet culture dropout themself, they are especially passionate about supporting neurodivergent folx in finding freedom with food. Click here to learn more about their services.