Adult DS with special needs becoming overweight.

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DS is 21 and is piling on weight. 😔

He has autism and ADHD, very sensory, anxious etc. He also has arfid so eats a very small range of foods. He has low muscle tone (always has done) and doesn't like much activity wise.

If he was younger it would be easier - well I guess it was easier which is why he was a healthy weight as a child! But now he's older he helps himself to snacks, goes to a day place with a tuck shop, goes out with carers and chooses his food and portions etc.

He has his own bodily autonomy and access to money and rightly so.

I don't know how to approach it with him as he's so sensitive and very negative and all or nothing. I don't want him to start secret eating (although I think he does do a little of this).

I've tried to explain to him about calories, portion sizes, food as fuel, etc. it doesn't seem to be going in. I've also explained about being thoughtful of others in the house around food eg he will eat all the cereal or biscuits before me or my youngest get a look in. He says sorry then continues.

He's very verbal and not quite classed as learning disability but does need a lot of support. I just don't know what to do or try.

He also will turn down stuff like going for a walk or going swimming and he's old enough and big enough that I can't force him! So exercise levels aren't great either!

This sounds incredibly challenging, and autism alongside ADHD and ARFID makes it so much more complex than simply managing weight. You're clearly doing your best to support his health while respecting his independence, which isn't easy. It may be worth speaking to a specialist with experience in autism and ADHD, such as ADHD Certify, for tailored guidance.

I've not heard of them thank you I will check them out.

It is very tricky!

I'm also mindful that with his all or nothing view of things and him having an aunt and cousins who've struggled with eating disorders in the past that he could very easily go from over eating to undereating. 😔

I never thought I'd say this but some things were easier when he was little.

Such a difficult balance when he's an adult. I think professional support would be your best bet rather than trying to manage it alone.

My daughter is also adhd plus asd/pda and very overweight. She is obsessed with eating carbs and sugar and cannot regulate herself with portions or make better choices independently. I too found it easier when she was younger as I guess we had more control so I identify with your post.
for us seeing a specialist dietitian really helped. Someone who understands about autism/adhd and the effects on gut health. She gave her good advice which was more acceptable to her as it wasn’t coming from me.

I also found that simply not having the high calorie snacks available in the house made a difference (appreciate that might be more tricky for your son with Arfid as well) but having other things readily available (for my child hummus and crackers worked as an alternative to biscuits (she needs crunchy foods) and happily she will also drink protein shakes sometimes which also made her less hungry for snacks. I’ve worked hard at increasing her activity levels which sometimes she will agree to and sometimes not.

She likes swimming which is good exercise (although it means I have to go as well which I really don’t enjoy as she gets very overexcited and splashes and dunks me. But I just have to suck it up really.)

Honestly I don’t think there is a good solution here but any small thing you can change will help, even if it’s only in a very small way it’s still something. Ultimately although obviously we want them to he healthy as young adults we do have to pick our battles and I know with my daughter that I have to proceed with caution and ultimately protect my relationship with her over anything else. she has such high anxiety I’m always mindful of not making that any worse.

Runforcarbs gosh yes that sounds very similar.

I think asking for a dietitian appointment might be a good shout actually. Like you say sometimes they will listen more to someone else.

We both like swimming but he is usually reluctant to go. I think suggesting a routine around it may help.

Mine loves eating too.

I'm very cautious how to raise it as he has such a fixed, and negative mindset that it could easily go the other way to secret binge eating, making himself sick or not eating at all etc.

Just a thought - do you need to directly raise it with him? Or could you simply encourage more exercise (under the guise of fun activities) while also having healthier food options for him. It depends how rigid he is with what he will eat - does he eat anything healthier or is it really that he only eats a small range?

Generally for us, if I tried to discuss something like this with her she would get very cross and defensive, and like you say you’re worried about him then taking things too far in another direction. So - maybe don’t tackle it head on by speaking to him about it but take action quietly around him without him really noticing what you’re doing.

only you know really what he can cope with and as you are only too aware it is really tricky. Any activity where he is moving his body will be helpful. What does he like? Can you take him bowling? Mini golf?

food wise - any reduction in calories will help even if it’s only a very small change. My daughter eats a lot when she’s at home all day looking at screens, but some days she just needs to do that so I just try and offer alternatives to the high sugar and high fat things she likes. Sometimes she will accept. Other days she will be very keen to go swimming or ice skating or whatever which is great. But it’s a balance and I have to work around how she is on that day, as I suspect you’d need to do too.

I just wonder whether you do actually need to directly raise it with him, if he’s likely to find this difficult. If it’s unlikely to be a successful way of getting to what you want for him, can you achieve what you need to another way, without the direct approach?

Just to add - when we saw the dietician, we didn’t talk about weight (I had a phone call with her ahead of the appointment where I shared the information with her without my daughter hearing). So my daughter thought the appointment was just to help her digestive issues (she has chronic constipation because she withholds) and then the dietitian lead with this. But the end result was some positive changes to her diet anyway. Her weight was never directly discussed. We were very lucky with our dietician - she was very knowledgeable about autism and food issues and this was massively helpful.