My autism diagnosis helped me beat bulimia - Francesca's story

I was 17 when my relationship with food started to become problematic. Anxiety and depression had slowly taken over my life, taking away my appetite and any enjoyment I found in food. As a result, I lost weight. It was unintentional. I didn’t even notice at first – but other people did. “You’re looking slim!”, always said with a look of admiration.

Slim = good. Smaller = better. And so, weight loss became a goal. It was something I thought I could control but, in reality, the more I tried to control food, the more it controlled me. Cutting out certain foods and skipping meals led to secret binges that filled me with shame.

The binge/restrict cycle followed me to university but remained mostly manageable until I started my second year. A lot of things were going on in my personal life and with uni, and I couldn’t cope. My eating spiralled out of my control and the restricting that came after each binge wasn’t enough to stop me gaining weight. Along came what seemed to be the perfect solution: making myself sick.

Within weeks, I was in the grips of bulimia. I couldn’t concentrate on uni work, stopped going to lectures and isolated myself from my friends. I had a constant sore throat, stomach pain and headaches. What was left of my student loan after I paid rent was wasted on food to binge and purge on. But I couldn’t stop.

After months of struggling, I finally opened up to a friend who persuaded me to go to my GP. I was referred to the specialist eating disorder service (SEDS), but the referral was rejected due to my healthy BMI. I had taken a huge step in reaching out for help and the rejection confirmed my worries: I wasn’t thin enough, I was just making it up, I wasn’t really ill.

It wasn’t long after that the first lockdown hit. My anxiety levels prevented me from going to the shops to buy binge food and being at home with my family meant having meals together every day. Although I wasn’t able to fully stop bingeing and purging, I got significantly better.

Upon returning to university for my final year, things deteriorated again. Knocked by my previous rejection from services, I was reluctant to reach out for help. Thankfully my second referral was accepted. I was given an assessment via the phone within three weeks, diagnosed with bulimia nervosa and started online group treatment less than a month later through the FREED model. Although I struggled with it being via Zoom, I found the group really helpful. We had sessions ranging from body image to emotional regulation to dietetics. The skills I learned are ones I still use today.

After completing the group, I had some individual sessions with my care coordinator. She agreed to see me in person as I wasn’t coping with all of the phone and video calls, and it was during this first face-to-face meeting that she brought up the possibility of me being autistic.

I was discharged when I finished my degree in summer 2021 and moved home. There was a lot of change going on and the anxiety I had around this led me to restrict my intake and relapse with bingeing and purging. I lost a lot of weight quite quickly and was referred to the local eating disorder service. However, as I was still a healthy weight and the rate of my weight loss had slowed, I wasn’t considered a priority and was put on a 10-month-long wait list.

Initially I was not motivated to get better. I felt like I was being told once again that I wasn’t sick enough, that I had to prove that I was ill, to show that I was struggling. Thankfully, I had some incredible people around me. I cannot express how crucial the support of my friends and colleagues was to me in starting my real recovery. They helped me realise that I am never going to be “sick enough” for my eating disorder, that I am enough as I am, that I deserve to take up space in the world.

By the time I started treatment again in October 2022, I had got myself to a good place. Therapy and psychoeducation have helped my recovery, but they didn’t “fix” me. I did the hard work myself. It was also around this time that I was going through the autism diagnostic process after a year and a half of waiting. In December 2022, I received my official diagnosis. Understanding how my brain works has helped me massively in terms of my mental health. There are so many ways autism can impact eating – from sensory issues to interoception difficulties to rigid behaviours. Accepting and understanding my autism and how it affects me was a huge step towards overcoming my eating disorder.

I never thought I would be able to live a life free from bulimia. I didn’t think I was “bad enough” to recover. I’ve never been in hospital; I’ve never been underweight.

But eating disorders aren’t weight disorders and BMI does not determine the severity of someone’s suffering.

I still struggle sometimes with feeling invalid, but I know that it’s just the eating disorder trying to pull me back in – and if you give it an inch, it’ll take a mile. It’s been months since I last binged and purged and I am learning that there is so much more to life than the misery of an eating disorder. Food doesn’t have to be a punishment or a source of anxiety, it can just be part of a happier, healthier life.

Contributed by Francesca

If you've been affected by any of the issues raised in this story, or are concerned for yourself or a loved one, you can find support and guidance on the help pages of our website.