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Original poster

Is this an eating disorder, or a very healthy lifestyle?

33 replies

gentlydoesntit · 04/04/2022 17:02

Please be gentle with me if possible - I know this is an emotive subject and I don't mean to upset or annoy anyone. I just need some outside opinions if possible as I'm unable to be objective anymore.

Would you characterise the following as symptoms of a worrying eating disorder, or could it be just someone who's super healthy?

For context, person in question is diagnosed autistic and gets obsessive v easily. They would say they’re just health-conscious but for at least the last year they have:

  • Stayed with a BMI around 18.5, at the borderline of underweight.
  • Exercised daily, gets very upset if they cannot do so, wants to be healthy and is terrified of illness.
  • Been very controlled about everything they eat, only eat certain foods, prefers healthy low calorie veg and whole foods and hates anything "processed". Agonises if breaks the rules.
  • Stressed if eating more than a certain number of calories or unhealthy foods, logs every calorie
  • Worried about putting on any weight at all, says they think they’re overweight and still need to lose body fat.

I keep swaying between two minds - is this an unhealthy eating disorder or is this “just” (for want of a better word) an obsessive and controlling lifestyle? (Is there a difference?)

OP posts:
AmbushedByCake · 04/04/2022 17:04

What they eat and how much they exercise may be healthy for their body, but the extremely rigid and obsessive mindset is mentally very unhealthy.

BlingLoving · 04/04/2022 17:07

I couldn't say specifically that this is an eating disorder, but I would consider this a sign of fragile mental health.

One thing that does shout "ED" is this: Worried about putting on any weight at all, says they think they’re overweight and still need to lose body fat. when they are, apparently, on the edge of being underweight.

Lubeyboobyalt · 04/04/2022 17:09

there seems to be disordered thinking/eating and possibly some kind of dysmorphia or possibly the beginnings of Anorexia Nervosa

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TwilightSkies · 04/04/2022 17:13

Eating disorders aren’t just about food. It sounds like an eating disorder to me.

karalime · 04/04/2022 17:14

Orthorexia is a term that I have heard for this. Not sure if it is an official diagnosis yet though.

fairylightsandwaxmelts · 04/04/2022 17:14

Sounds like my dad - he is also autistic and has diagnosed orthorexia, which is an unhealthy obsession with healthy eating.

RandomThought96 · 04/04/2022 17:18

Sounds like an eating disorder to me. The person should seek professional help.

chisanunian · 04/04/2022 17:20

I keep swaying between two minds - is this an unhealthy eating disorder or is this "just" (for want of a better word) an obsessive and controlling lifestyle? (Is there a difference?)

From what you have said, it could possibly be both.

marjayy · 04/04/2022 17:24

Yes this sounds DS like an eating disorder.

Waxonwaxoff0 · 04/04/2022 17:37

It's an eating disorder. Having rules around food and panicking if the rules are broken is an eating disorder.

Poppyliveshere · 04/04/2022 17:39

@gentlydoesntit

Please be gentle with me if possible - I know this is an emotive subject and I don't mean to upset or annoy anyone. I just need some outside opinions if possible as I'm unable to be objective anymore.

Would you characterise the following as symptoms of a worrying eating disorder, or could it be just someone who's super healthy?

For context, person in question is diagnosed autistic and gets obsessive v easily. They would say they’re just health-conscious but for at least the last year they have:

  • Stayed with a BMI around 18.5, at the borderline of underweight.
  • Exercised daily, gets very upset if they cannot do so, wants to be healthy and is terrified of illness.
  • Been very controlled about everything they eat, only eat certain foods, prefers healthy low calorie veg and whole foods and hates anything "processed". Agonises if breaks the rules.
  • Stressed if eating more than a certain number of calories or unhealthy foods, logs every calorie
  • Worried about putting on any weight at all, says they think they’re overweight and still need to lose body fat.

I keep swaying between two minds - is this an unhealthy eating disorder or is this “just” (for want of a better word) an obsessive and controlling lifestyle? (Is there a difference?)

I’m a MH professional working with autistic females. Yes it sounds unhealthy but the drive to restrict and control food intake is very different to that of a neurotypical with an ED, and therefore won’t respond with a conventional approach.
DogsAndGin · 04/04/2022 17:42

The difference is whether or not it is causing harm (coming from my psychologist pal!)

This sounds like ‘orthodox’ eating to me. It is not necessarily problematic - but can become problematic if they are putting themselves in calorie deficit/inadequate calorie intake with all the exercise and low calorie meals.

Do you know how many calories they are consuming? You can work out an estimated calorie consumption if you know their exercise routine too.

It also sounds like some CBT may help them deal with their phobia of illness.

Good luck OP, you are doing an amazing job of looking out for this person 😊

Borgonzola · 04/04/2022 18:00

I would say orthorexia in the first instance.

Sounds a bit like a friend of mine, who would get stressed if she couldn't exercise, and developed into standing all day at work/on the train/when visiting friends' houses. Would spend all Saturday and Sunday mornings at the gym. That was when it became exercise addiction.

She had safe foods and basically consisted on rice cakes, Diet Coke and apples. She stopped eating in front of people altogether or going to events where she might have to eat.

Then she ended up in hospital. She's fine now but she recently broke her hip (she broke the other one in her late teens) due to early onset osteopaenia.

Not trying to scaremonger. I watched her go downhill for about 2 years. It was awful Sad

beattieedny · 04/04/2022 18:07

Definitely on the cusp of one. Not fully there but could easily go downhill. It is certainly unhealthy.

patternsg · 04/04/2022 18:10

but the extremely rigid and obsessive mindset is mentally very unhealthy.

agree

ofwarren · 04/04/2022 18:11

It's not uncommon for autistic people to have restrictive eating and get stressed about eating the wrong food. It's also common for autistic people to have a special interest which dominates their life, in this case "healthy eating and lifestyle".

There is nothing wrong with this per se, as long as the woman in question is able to maintain a normal weight.

Knittingchamp · 04/04/2022 18:14

We'd need to know exactly what they're eating ans how much they're exercising, really, those details make a big difference.

Grammarmum · 04/04/2022 18:23

Google orthorexia ….someone very close to me had this and had counselling with an ED disorder therapist and took citalopram.
This person is now well and happy but admits that food will never be a friend !

Dingdong99 · 04/04/2022 18:28

Definitely - I say this as someone who had bulimia and anorexic tendencies for years. I was like that

Original poster
gentlydoesntit · 04/04/2022 18:28

Thank you all so much, I'm so grateful to you.

I hadn't heard of orthorexia and will do some research.

In answer to one of the questions, they eat a maintenance diet of at least 2k calories a day with extra protein shakes and haven't lost weight for a long time. They exercise every day with walking, boxing and weightlifting.

@Poppyliveshere, if you don't mind sharing, could you say what approach does work with young autistic people?

@ofwarren yes this is what I usually end up thinking - and there are worse obsessions to have for sure. But one chocolate bar over the weekend has caused a long day of agonising and worries.

OP posts:
Poppyliveshere · 04/04/2022 18:47

@gentlydoesntit

Thank you all so much, I'm so grateful to you.

I hadn't heard of orthorexia and will do some research.

In answer to one of the questions, they eat a maintenance diet of at least 2k calories a day with extra protein shakes and haven't lost weight for a long time. They exercise every day with walking, boxing and weightlifting.

@Poppyliveshere, if you don't mind sharing, could you say what approach does work with young autistic people?

@ofwarren yes this is what I usually end up thinking - and there are worse obsessions to have for sure. But one chocolate bar over the weekend has caused a long day of agonising and worries.

It’s so very difficult without an in-depth understanding of the real cause, and with autism, particularly in females, there is likely to be a degree of pathological demand avoidance (PDA) which needs a very skilled approach. So no single approach; possibly non directive and non talking, ie creative?
pointythings · 04/04/2022 18:48

The intersection between eating disorders and autism is only just beginning to be explored in research and in clinical practice. The consensus at the moment is that people in this situation will not benefit from conventional treatment for ED and that inpatient treatment would be harmful (not that this is likely to be needed at BMI 18.5). The added complication is that community ED teams are under immense strain - but that is not to say this person would not benefit from specialist support.

I hope they find a way to live happily with food at some point.

CoralDaffodil · 04/04/2022 19:01

The mentality sounds like that of someone with an eating disorder I agree with other posters.

Rewritethestars1 · 04/04/2022 19:23

This us me except my bmi is higher. I'm autistic and yes I have an eating disorder. I have body dysmorphia. Its a horrible way to live. I do eat bad food so I'm not totally like your friend but when I have I beat myself up for days over it.

Rewritethestars1 · 04/04/2022 19:31

Also to add many autistic people have dysregulated introception. So they don't always feel the hunger urge and will forget to eat or will be constantly ravenous despite eating loads. We have both types in our family. I'm someone who had to learn hunger cues and as a teen I was so so thin as I'd forget to eat or just simply never be hungry. That's not a brag at all either as I was bullied and called skeleton or told I looked ill, which I did.

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