Unpacking the Why: What Causes Eating Disorders?

Body Image and Eating Disorders Awareness Week (BIEDAW) runs from 1–7 September 2025, with the theme “Unpacking the Why: What Causes Eating Disorders.” This theme asks us to explore the underlying causes of eating disorders and we would like to highlight how factors such as neurodivergence (e.g. ADHD & Autism) and Avoidant/Restrictive Food Intake Disorder (ARFID) are often overlooked.

Eating disorders are complex mental health conditions that affect people of all ages, genders, and cultures. By understanding the why, we can create more inclusive, compassionate, and effective support.

What Causes Eating Disorders?

There is no single cause of an eating disorder. Instead, they develop through an interaction of biological, psychological, and social influences. Some common contributing factors include:

• Genetics and family history
• Anxiety, depression, or other mental health conditions
• Perfectionism and high self-expectations
• Trauma and difficult life experiences
• Cultural and social pressures around body image
• Sensory sensitivities or challenges with appetite regulation

While body dissatisfaction is often discussed in the media, it is important to recognise that not all eating disorders are about appearance. For some people, food avoidance or restriction has very different roots.

Understanding ARFID

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder where individuals severely limit what or how much they eat, but not because of body image concerns. Instead, ARFID may be driven by:

• Strong sensory sensitivities to texture, taste, or smell
• A lack of interest in food or eating
• A fear of choking, vomiting, or experiencing illness from food

ARFID can appear at any age and often leads to nutritional deficiencies, low energy, and significant impacts on daily life. Unlike anorexia or bulimia, ARFID is not motivated by weight or shape, which can make it harder to identify and diagnose.

The Link Between Neurodivergence and ARFID

Research shows a strong connection between neurodivergence and ARFID. Many individuals with ARFID are also autistic, have ADHD, or experience other forms of neurodivergence. Eating can feel overwhelming due to heightened sensory sensitivities or difficulties with interoception (the ability to sense hunger and fullness).

For example:

• Autistic people may avoid foods with certain textures or smells.
• Individuals with ADHD may struggle with meal planning and forget to eat – hello 2pm hangry mode!
• A past negative experience with food, such as choking, can lead to long-term food avoidance.

Studies has found that there is a correlation with adults and children experiencing ARFID also meet criteria for autism, showing the need of adequate assessment and support through psychological therapy and dietetics. 

Why Neurodivergence Matters in Eating Disorder Care

Neurodivergent people often face unique challenges when accessing eating disorder treatment. Standard approaches may not always work if they do not take sensory needs, executive functioning differences, or communication styles into account.

Without neurodiversity-affirming care, individuals may feel misunderstood or pressured into unsafe eating practices. This highlights the importance of creating therapies and support systems that recognise and respect neurodivergent needs.

Creating Neurodiversity-Affirming Support

To better support individuals with ARFID and other eating disorders, services need to:

• Use person centred approaches: Recognise that strategies must be adapted to each person’s sensory profile and cognitive style – no same size fits all approach here!
• Avoid forcing food: Gentle, supported exposure to new foods works better than pressure or punishment.
• Include family and carers where appropriate: Provide practical tools for parents and support networks.
• Promote empathy and understanding: Listening to lived experience ensures that treatment is inclusive and supportive.
• Flexible therapy models: Adapt standard treatments to suit neurodivergent thinking styles and processing.
• Clear communication: Offer written, visual, or step-by-step instructions to reduce overwhelm.
• Executive functioning support: Help with planning, shopping lists, meal prepping, and reminders around eating.
• Environment adaptations: Reduce overwhelming settings (bright lights, strong smells, noisy rooms) when introducing meals.
• Choice and autonomy: Involve the person in deciding which foods to trial, and when, to increase trust and ownership.
• Training for professionals: Ensure therapists, dietitians, and GPSs are trained in both eating disorders and neurodiversity-affirming practice.
• Non-judgmental language: Avoid framing food habits as “wrong” or “bad”  instead, emphasise safety, nourishment, and self-compassion.
• Creative tools: Use visual food diaries, sensory play, or gradual cooking exposure to make food exploration engaging and less intimidating.

Why “Unpacking the Why” Matters

By unpacking the why behind eating disorders, we:

• Challenge the stereotype that eating disorders are always about body image
• Highlight the connection between neurodivergence and ARFID
• Promote earlier recognition and better treatment pathways
• Encourage a shift towards inclusive, compassionate, and incorporating both lived experience and evidence-based care

BIEDAW 2025 is an opportunity to learn, share, and advocate for those whose voices are too often left out of the conversation.

Eating disorders are never simple, and neither are their causes. For neurodivergent people and those with ARFID, food can be about safety, sensory needs, and lived experiences rather than weight or appearance. By broadening our understanding, we can ensure that every individual receives the support they deserve.

This BIEDAW, let’s commit to listening more deeply, learning from lived experience, and ensuring that eating disorder care is inclusive of neurodivergence.