Weight Management for People on the Autism Spectrum?

An image of the author (Sophia Shapira) holding a lightsaber during her 2018 visit to Disneyland.
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People with autism are at higher risk of being overweight, and even of being obese. Perhaps the solution might be a weight management system that is designed for people with autism the way that many of the better systems out there are designed for neuronormative people.
Throughout my adult life, weight management has been a struggle – most of it, a losing one. No matter what I did, I almost constantly remained significantly overweight. True, I do indeed have large bones (and in my case, I very legitimately and verifiably do – it is not just the cliché euphemism that you might be thinking of) and this causes my ideal weight to be above what the standard body-mass index chart would suggest – but for nearly all of my adult life, I have even remained very significantly overweight even after adjustments are made for that.

Of course, I do not define my self-worth by my weight – so I have no desire to lose any weight for that reason. However, if my weight affects my health, that is a problem I care about. Nonetheless, very few efforts of mine to lose weight have been effective – and the few efforts that were by any means effective proved to be, at least for me, completely unsustainable.

Then, a few months ago, I was diagnosed with autism. Make no mistake, the autism itself is nothing new to me. It is only the diagnosis that is new – the label that I can use to name a set of factors that have affected me profoundly my entire life.

And then the other day I realized – many of these factors that I have been dealing with my entire life that the diagnosis of autism gives a name for – those are the same factors that I have always have found to render all weight-management regimens, systems that worked very well for other people, to be either undoable or unsustainable where I was concerned.

Now, I am not suggesting that as someone with autism I have a different set of nutritional needs than a neuronormative person does. Granted, as the causes of autism are biological, there is a chance that to some extent, my personal metabolism may be a factor in my weight management woes – but, my admittedly amateur guess is that if that is a factor at all, it is probably a very small one. What more likely accounts for the bulk of my weight management woes is that autism makes it difficult for me to follow through with weight-management lifestyle strategies that otherwise would have been very successful for me. In the case of some of these strategies, they were so difficult that I was completely unable to follow them at all – while in the case of others, I was able to follow through a while but couldn’t keep it up indefinitely.

I did some searching about this issue. I was able to find very little about the causes of this phenomenon, and even less about possible solutions. I was, however, able to find confirmation that this phenomenon is indeed a general tendency for people with autism – even if not a universal absolute (there are people with autism who are skinny). So, without any definite answer or solution from the medical community or any professional community that would be properly qualified to give the most reliable answers possible – and lacking the option to just sit around and wait till they come up with those answers (which could take years, in which time my weight management problems could very likely be lethal) I am forced to take the less-than-ideal, yet nonetheless necessary approach of figuring things out as best I can as an amateur.

This brings us to the two ways that people view autism – the disease model and the neurodiversity model. I will say upfront that I look at it through the neurodiversity model – yet nonetheless, even if just for the sake of contrast, I must mention both approaches toward autism here.

People who see autism through the disease model see it as a malady, a defect so-to-speak. Even if they accept the reality that no “cure” is believed to exist for autism, the approach that they would consider to helping someone with autism would be managing it as any other incurable disease. Any weight-management plan that I could imagine being cooked up by those who approach it in that manner would require a lot of careful supervision by professionals – possibly to a degree that would be unrealistic without institutionalisation, something that most people with autism (myself included) prefer to avoid.

However, people like myself who approach autism through the neurodiversity model tend to see things differently. We acknowledge that living with autism can be very difficult indeed – however, we attribute many of these difficulties not to any inherent weakness on our part, but rather, to the fact that we are in a position of having to navigate a world that is of, by, and for neuronormative people. I strongly suspect that the lack of effectiveness and viability of weight management systems where we are concerned is one more instance of this well established pattern.

While many of the weight-loss plans are fad diets, there are a lot of plans out there that are based on solid science in the relevant fields, plans that differ from one another only in the strategies that they offer people for assuring that they follow through with the healthy lifestyles that they need. However, these management strategies have one thing in common – they all play to the strength of neuronormative people, not to the strengths of people with autism.

Maybe what we in the autism community need is a weight management system that plays to our strengths rather than to the strengths of others – a system that does for us what other systems, such as Weight Watchers, do for neuronormative people. Of course, this isn’t really a solution that I offer here, but at least it is an idea what approach we could take in efforts to come up with one.

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