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. 2025 Jun 23;13(1):120.
doi: 10.1186/s40337-025-01271-5.

Re-imagining connection: the role of late autism diagnosis in eating disorder recovery and social support

James Downs  1 , Marissa Adams  2
Affiliations

Re-imagining connection: the role of late autism diagnosis in eating disorder recovery and social support

James Downs et al. J Eat Disord. .

Abstract
in English, German

This paper explores the complex relationship between autism, social connection, and eating disorder recovery, drawing on the lived experiences of two late-diagnosed autistic adults with histories of longstanding and severe eating disorders. Using narrative and autoethnographic methods, we examine how delayed autism diagnosis intersects with the social dimensions of illness, and the process of treatment and recovery. We identify unique barriers autistic individuals with eating disorders face in building meaningful social connections, navigating support systems, and accessing appropriate care. By integrating personal insights with existing research, we advocate for earlier autism screening and neurodiversity-affirming treatment approaches that embrace and value autistic differences, including the strengths inherent in neurodivergence. This requires a shift in how social support is conceptualised within eating disorder care, prioritising the creation of meaningful connections that address the unique social and emotional needs of autistic individuals. We argue for clinical practices that not only recognise the challenges faced by neurodivergent individuals but also embrace the strengths they bring, fostering environments where autistic individuals can engage authentically in their recovery process. This approach ultimately benefits patients and treatment providers alike, promoting more inclusive, empathetic, and effective care for all.

This article is written by two individuals who have lived with longstanding and severe eating disorders and were diagnosed as autistic in adulthood. Using stories from their lives, the authors explore how delayed or missed autism diagnoses affected their mental health, social lives, and experiences of treatment. They describe how feeling misunderstood and unsupported made their eating disorders worse, especially before being diagnosed. Receiving an autism diagnosis later in life helped them reframe their struggles, reduce shame, and begin building more meaningful and supportive connections. The authors show the value of recognising and supporting autistic differences, rather than seeing them as problems to fix, and how this can support recovery in ways that feel more respectful and authentic. They also highlight that social support can look very different for autistic people, and caution against one-size-fits-all approaches in treatment. Drawing on both lived experience and research, the paper makes recommendations for how eating disorder services can become more inclusive and responsive to autistic people’s needs. This includes earlier autism screening, flexible support options, and working alongside people with lived experience to design better, more compassionate care.

Keywords: Autism; Co-production; Eating disorders; Lived experience; Neurodiversity; Qualitative research; Recovery; Social support.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Foundations of socially-inclusive care for late-diagnosed autistic adults with EDs
See this image and copyright information in PMC

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