It Is Literally Saving Me Spoons: Autistic People’s Experiences of Eating and Feeding Disorders—A Photovoice Study

Abstract

Despite the high prevalence of eating disorders (EDs) in Autistic people, few qualitative studies explore this overlap beyond Autistic women with anorexia nervosa (AN). We used Photovoice to explore the experiences of Autistic people with EDs across diverse genders and ED typologies. Our final sample included 14 Autistic individuals (male n = 3, female n = 8, gender-queer n = 3; m = 31.07 years). Participants completed five workshops across four groups ( n = 20 group sessions), capturing images that best represented their ED experiences and discussing them with their group. We conducted content analysis on the images and inductive-reflexive thematic analysis on the workshop transcripts, Microsoft Teams messages, and image narratives. Our analysis produced five key themes: (1) Autistic identity: how autism diagnoses shape ED experiences and perceptions of normality; (2) the “overwhelm bucket”: how cognitive and sensory overload trigger ED behaviors; (3) diagnostic intersectionality: how traits interact across Autism, EDs, and co-occurring diagnoses, complicating clinical separation; (4) “go without me” (social consequences): how ED-driven social withdrawal conflicts with a desire for reconnection; and (5) services and support: key barriers to accessing care, the necessity of autism-informed treatment, and the value of creative methods. Our findings align with existing Autistic-ED models while broadening representation to men, gender-diverse individuals, and people experiencing bulimia nervosa and binge eating disorder. Our findings challenge deficit-based views of Autistic sociality, underscore how identity, overwhelm, and intersectionality shape ED experiences, and demonstrate the urgent need for autism-informed, community-led care that rejects neuronormative assumptions.