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

Abstract

Background: Despite the high prevalence of eating disorders (EDs) in Autistic people, few qualitative studies explore this overlap beyond Autistic women with anorexia nervosa (AN). Methods: 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. Results: 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. Conclusion: 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.