Behind the Mask: Identifying Autism in Your Female Patients with Eating Disorders

For EDAW 2025, Dr Moreen Rubin spoke about Autism and ED’s in Female Clients- the recognizing of it and the correcting of common myths.

This super comprehensive presentation was made more special by Moreen’s own self disclosure and various case examples.

ASD is prevalent in individuals with eating disorders- especially prominent in anorexia nervosa, where traits such as rigidity and perfectionism align with restrictive eating behaviors. Here we learned what Autism really is vs. what we’ve been told. We saw a visual of neuronal pruning varying from neurotypical and we learned about the basics of sensory seeking or sensory avoiding. Dr Rubin expanded on hyper-empathy and emotional overwhelm, internalized routines and sensory management, adaptive communication styles for different processing, and the mimicking of behaviors or adjusting of personality.

There was a brief lesson on brain regions involved in hunger, fullness, temperature, and thirst differences in autism.   We learned that autistic masking is different from being Introverted, and it was emphasized that the masking for sensory or social needs is unrelated to an intellectual deficit. And that stress during recovery & food exposure work can lead to an “I Don’t Care Anymore” stress response.

Most importantly, we learned what to adjust when the usual approaches are not working. Treatment must include sensory-friendly food strategies, structured & predictable meal plans, emotional regulation skills, and an understanding of autism-specific triggers. Moreen closed with 6 excellent suggestions, a 5-Step approach to treating food rigidity in an autistic client, and things to stop saying regarding this population-alternative language was suggested.

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You can access the full video here.   

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