TL;DR: The overlap between neurodivergence and eating disorders is well documented, but masking may be the critical variable. Research shows that camouflaging neurodivergent traits predicts eating disorder severity more than neurodivergence alone. Four mechanisms connect masking to disordered eating: performance eating, sensory overwhelm at meals, the dual-task problem, and the burnout-relapse cycle.
The Meal That Requires a Performance
A woman sits at a work lunch, a group of eight at a restaurant she did not choose. The menu has seventeen options, all unfamiliar. The lighting is fluorescent. Three conversations are happening simultaneously, and she is expected to participate in at least one while also selecting food, placing an order, eating at a pace that matches the group, and maintaining facial expressions that communicate enjoyment. She is autistic. Nobody at the table knows this.
She orders a salad because salads are predictable. She eats slowly because matching the group’s pace while processing the sensory environment requires more cognitive bandwidth than she has available. She smiles when someone makes a joke she did not fully hear because the background noise collapsed three conversations into a single undifferentiated wall of sound. When a colleague says “you barely touched your food,” she says she had a late breakfast.
She has been doing this for fifteen years. The eating disorder started around year three.
The Research Finding That Changes the Clinical Picture
The connection between neurodivergence and eating disorders is well established. Studies show elevated rates of autism and ADHD in eating disorder populations, and elevated rates of disordered eating in neurodivergent populations. Sensory processing differences affect food tolerance, executive function challenges complicate meal planning, and the rigid thinking patterns associated with both autism and anorexia nervosa share neurological substrates.
But the research finding that reshapes how clinicians should think about this overlap comes from camouflaging studies. When researchers measure neurodivergent traits and eating disorder severity, they find a correlation. When they add camouflaging, the measure of how much effort a person expends to appear neurotypical, into the model, camouflaging predicts eating disorder severity more strongly than the neurodivergence itself.
The implication is significant: it is not being neurodivergent that drives the eating disorder. It is the sustained effort to hide it.
Four Mechanisms
Performance Eating
Every shared meal is, for a neurodivergent person who is masking, a performance with multiple simultaneous demands. The performance includes eating foods that may cause sensory distress (wrong textures, overwhelming flavors, unpredictable temperatures), matching the group’s pace (too fast or too slow relative to the person’s natural rhythm), and maintaining the facial expressions and body language that communicate “I am enjoying this” regardless of the actual sensory experience.
Performance eating teaches the nervous system that meals are high-stakes social events. Over time, the association between eating and performance becomes automatic. The person does not just feel anxious at group meals. They feel anxious about food itself, because the neural pathways that encode “eating” have been conditioned to include “social surveillance” as an inseparable feature.
Sensory Overwhelm
A group meal is a multi-sensory event at a scale that most neurotypical people do not register. The restaurant’s ambient noise, the overlapping conversations, the visual complexity of a crowded table, the smell of multiple dishes arriving simultaneously, the texture and temperature of the food itself: all of this constitutes sensory input that the neurodivergent brain processes with greater intensity and less automatic filtering than the neurotypical brain.
Sensory overwhelm at meals creates a direct competition for cognitive resources. The resources the person needs to manage sensory input are the same resources they need to maintain their mask, and both draw from the same resources required to attend to hunger cues, satiety signals, and the mechanical demands of eating. When the system is overwhelmed, something gets dropped. Frequently, it is the eating.
The Dual-Task Problem
Eating while socializing is, from a cognitive standpoint, a dual-task challenge. It requires simultaneous processing of social cues (who is talking, what are they saying, what response is expected), conversational contribution (generating appropriate content, timing delivery, monitoring reception), body-state monitoring (am I hungry, am I full, does this food feel safe, is my posture right), and food mechanics (cutting, chewing, swallowing, pacing).
For a neurotypical person, much of this processing is automatic. For a neurodivergent person who is masking, almost none of it is. The social processing that neurotypical brains handle implicitly requires explicit, effortful computation for many neurodivergent people. When eating and socializing compete for the same explicit processing resources, the person must choose which task to prioritize. Masking usually wins, because the social consequences of a failed mask feel more immediately threatening than the consequences of a missed meal.
This is how skipped meals become a pattern. Not through restriction motivated by body image, but through a resource allocation problem that the person may not even consciously recognize.
The Burnout-Relapse Connection
The fourth mechanism operates on a longer timescale and explains why neurodivergent people in eating disorder recovery relapse at higher rates than neurotypical peers. Eating disorder recovery is energy-intensive work. It requires consistent meal planning, tolerance of discomfort, cognitive flexibility around food rules, and sustained engagement with therapeutic interventions. All of this draws on executive function.
Masking also draws on executive function. Constantly. The neurodivergent person in recovery is attempting to rebuild their relationship with food while simultaneously maintaining the neurotypical performance that their social and professional life requires. The two demands compete for the same finite cognitive budget.
When the masking depletes the budget, which it will, because masking always eventually depletes the budget, the person faces recovery with an empty tank. And the eating disorder, whatever form it takes, offers something that recovery cannot: a low-effort, familiar, highly automated coping strategy. Restriction requires no planning. Bingeing requires no social computation. Purging provides a predictable sensory reset. The eating disorder asks almost nothing of the executive system at exactly the moment when the executive system has nothing left to give.
This is why recovery programs that do not address masking produce incomplete results. The person learns skills for managing the eating disorder, returns to an environment that demands constant masking, depletes the resources those skills require, and relapses. The treatment addressed the symptom without addressing the drain.
What This Means for Treatment
Clinicians treating eating disorders in neurodivergent clients need to assess camouflaging as a clinical variable, not an incidental feature. The degree to which a person masks predicts the energy available for recovery, the environments that will trigger relapse, and the accommodations that treatment must include.
Practical changes include reducing masking demands during meals in treatment settings (allowing sensory accommodations, not requiring group dining at standard pace, permitting stimming behaviors that support self-regulation), building “unmasking” skills alongside eating skills, and recognizing that a relapse following a period of high social demand is not a failure of the eating disorder treatment. It is a predictable consequence of the energy equation.
The woman at the work lunch does not need a better meal plan. She needs permission to eat in ways that her nervous system can actually sustain, which means meals where the performance requirement is low enough that there are cognitive resources left over for the actual act of eating.
That permission, in a world organized around neurotypical social defaults, is harder to grant than any clinician’s treatment protocol accounts for.
Frequently Asked Questions
Is there a connection between neurodivergence and eating disorders?
Yes. Research shows significant overlap between autism, ADHD, and eating disorders. Sensory processing differences affect food relationships, executive function challenges complicate meal planning and preparation, and the effort of masking neurodivergent traits depletes the cognitive resources needed for recovery.
Does masking cause eating disorders?
Masking does not cause eating disorders directly, but research shows that camouflaging neurodivergence predicts eating disorder severity more than neurodivergence itself. The effort to appear neurotypical drains executive functioning resources needed for recovery, and when the masking energy is depleted, the eating disorder offers a familiar, low-effort coping strategy.