In recognition of World Autism Awareness Month, we sat down with Holly Whitehead, All Ages Services Director at First Steps ED, to explore how autism can shape a person's relationship with food, and what truly supportive care looks like. 

How common is the overlap between autism and eating disorders? 

It's more common than many people realise. Research estimates that between 4% and 23% of people with eating disorders also have autism — a significant range that reflects just how varied presentations can be. At First Steps ED, over a third (35.9%) of our service users are neurodivergent, which underlines how central this is to the work we do every day. 

Why does this overlap exist? 

The reasons are complex and interconnected. A few of the key ones we see in practice include: 

• Need for routine and control – Many autistic people rely on routine as a way of managing a world that can feel unpredictable. When that need for control becomes focused on food or the body, it can escalate into an eating disorder. 

• Sensory sensitivities – Processing sensory information differently can make the taste, texture, smell or appearance of food overwhelming. This can lead to selective or restrictive eating patterns that are not simply "fussy eating" but a genuine sensory response. 

• Interoception differences – Autistic people may identify internal body cues differently, including hunger cues and fullness signals. This can make it harder to develop a consistent or intuitive relationship with eating. 

• Stimming and sensory-seeking behaviours – For some people, bingeing can function as a sensory-seeking or stimming behaviour, providing regulation or comfort. 

• Executive functioning challenges – Difficulties with planning and organisation can make consistent meal preparation and eating routines genuinely hard to maintain. 

There is also a well-established link with ARFID (Avoidant/Restrictive Food Intake Disorder), which is characterised by limited food intake not driven by body image concerns. ARFID is significantly more prevalent among autistic people and is increasingly recognised as distinct from other eating disorders in both cause and treatment. 

What role does anxiety play? 

Anxiety is often a significant thread running through both autism and eating disorders. Uncertainty, change and social situations can all be particularly challenging for autistic people, and mealtimes frequently sit at the intersection of all three. Eating with others, trying new foods, or navigating unpredictable environments can provoke real distress and restrictive behaviours can become a way of managing that anxiety, even as they cause harm. 

How does First Steps ED adapt its approach for autistic service users? 

The most important thing is that care is never one-size-fits-all. More traditional therapeutic approaches, such as standard CBT, may not be the right fit for autistic people, who often process and communicate differently. At First Steps ED, we tailor our support to each individual, getting to know that person and their needs, going at their pace and making sure the therapy we provide affirms and validates their experience.  

This might mean adapting how we communicate, being explicit and concrete rather than relying on implicit understanding, having a more creative approach, offering more structured sessions, or ensuring sensory needs are considered in how and where support is delivered. What matters is that the person feels understood – not just focusing on their eating disorder, but who they are. 

What would you say to someone who recognises these experiences in themselves or a loved one? 

Please reach out. There is no threshold you need to meet, and you do not need a formal diagnosis to access support. If food, eating or your relationship with your body is causing distress and especially if you recognise some of the patterns described here, we want to hear from you. Support that understands neurodivergence can make a real difference.