Eating disorders and neurodivergence: A stepped care approach

Drawing on fundamental constructs pertaining to human rights, bioethics, humanistic psychology, phenomenology, and social justice, this report challenges the hegemonic discourse of pathology that characterises traditional understandings of neurodivergent body awareness and image, feeding, and eating experiences. It is a call to action for all eating disorder stakeholders to engage in a radical rethink of how neuronormative feeding and eating practices, which influence research and clinical practice across all levels of eating disorder care, may prove counterproductive or even harmful for neurodivergent people (see Blair, 2023; Elwyn, 2023; Babb et al., 2022; Longhurst & Clark, 2022; Brede et al., 2020).

Creative and collaborative problem-solving is critical to improve the outcomes of all people with feeding difficulties and eating disorders, especially those who are neurodivergent. To this end, we invite readers to join us in practicing epistemic and cultural humility to facilitate progress towards dignity-based practice (Abimbola, 2023). Such humility requires an awareness that our knowledge of the neurodivergent experience of eating disorders, body image, and health more broadly, is currently incomplete, biased, and insufficient. When we combine our humility with epistemic empathy, that is, understanding how others make meaning and accepting different perspectives as valid and valuable, we have in place the necessary foundations to come together to solve complex problems.

This report is not a definitive end-point, rather is it an initial step which aims to encourage reflection, discussion, and collaboration amongst stakeholders to inspire future co-production and co-design of appropriate, effective, and culturally valid neurodiversity-affirming feeding and eating disorder supports across all levels of care.