In this episode, Catherine Boyle talks about the link between anorexia and autism, and 2 ways that you, as a ministry leader, can help.
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Quick Links:
The Invisible Link Between Autism and Anorexia Article
Anorexia Nervosa Mortality Rate
"There’s This Kid" Free Downloadables
Transcript:
I don’t remember what the sermon was about that fall day, more than 40 years ago, but I felt compelled to speak privately with the pastor during the time of the altar call. Tears were streaming down my face while he prayed with me. At the end of the prayer, he said, “I want to talk to you.”
I dutifully made an appointment to talk with him within a few days’ time. He asked me some questions; I remember my answers sounding hollow. Everything I said was the truth, but I never revealed anything of significance that was happening in my inner world. Really, I didn’t know how.
Anorexia was an enormous monster that seemingly arose out of nowhere in my life.
At that time, I was approaching what would be my lowest weight, when the scale barely tipped 100 pounds.
The pastor had been on staff at my church for a couple of years. By then, my involvement was limited to Sunday mornings, but he certainly had observed my dramatic weight loss within the previous few months. And he certainly knew from my tearful time of prayer that something traumatic was beneath the surface of my life.
If you follow the work of Key Ministry, one of the things you’ll hear us frequently say is that ‘behavior is communication.’ To help ministry leaders understand children who too often are considered problems to be solved instead of people to be loved, we’re creating a series of free downloadables called ‘There’s This Kid.’ We’ve already created one about ADHD, with examples of behaviors and strategies for ministry leaders. We’re about to launch our next downloadable on anxiety.
But a behavior that you might see in your work with children and teens may not seem like a behavioral concern at all, and that’s eating disorder.
Typically, a teen with an eating disorder is not going to disrupt your Sunday School class because of it. Rather, eating disorders manifest in how a person uses, abuses or avoids food, and thus can be easy to keep from view. But if you look closely, even the behaviors around eating disorder are telling a story. Kids and teens are expressing what’s inside of them, by both their actions - or their lack of actions.
Today, I want to focus your attention more specifically on the link between anorexia and the high end of the autism spectrum.
This is a relatively recent scientific understanding. In fact, because girls with autism are frequently under-diagnosed compared to boys, an eating disorder is often the first issue that brings them to a doctor’s attention. Thus, anorexia has come to be known in some circles as ‘Female Asperger’s’, or high functioning/Level 1 autism. If girls are on the autism spectrum, a different treatment approach is typically recommended for their eating disorder, compared to the treatment for girls not on the spectrum. Just to be clear, I am not on the spectrum, but according to online tests, I am close.
If you think you don’t have any children or teens dealing with an eating disorder in your ministry, respectfully - you’re wrong! Just like the statistics from the National Alliance on Mental Illness (NAMI) reveal that 1 in 4 or 5 people everywhere have a mental health challenge, the statistics on eating disorder indicate that it is a similarly pervasive issue. And sadly, anorexia has the highest mortality rate of any mental health challenge, and is the leading cause of death for women ages 15 - 24.
Statistics from the National Association of Anorexia Nervosa and Associated Disorders (ANAD) reveal that about 9% of the population worldwide are impacted by eating disorders. But less than 6% of people with eating disorders are medically diagnosed as “underweight.” So you can easily have children or teens in your church who have disordered eating struggles and not appear emaciated.
Current statistics also indicate that 20 - 30% of adults with eating disorder also have autism. Up to 10% of children and teens with eating disorders also have autism, and about 20% of women with anorexia have high levels of autistic traits, even without a formal diagnosis. Yes, they are talking about me! And as stated above, the ‘normal’ eating disorder treatment approaches are not nearly as beneficial for girls and teens on the spectrum, or with strong autistic traits. We’ll include links to these statistics and helpful articles in our show notes.
So what do you do with this information, as a ministry leader? What can you do today that my former pastor was not equipped to do?
Here are two things that you can do whenever you observe or suspect anorexia in a child or teen within your church family:
1. Help shorten the time from onset of symptoms to proper treatment by getting to know mental health professionals in your church and community.
One of the things that we consider important is that ministry leaders make connections with psychiatrists, psychologists, therapists and others whose professions are dedicated to healing and helping mental health challenges. You can start with what God has put right in front of you, that is, the members of your faith community who work in the mental health field. From those connections will come connections to other individuals and supports that can benefit the families in your church.
Just like a child or adults with autism have special support needs that allow them to flourish, children or young adults with anorexia also need specialized care. And when autism and anorexia are combined, even more specific approaches may be needed. Ministry leaders can serve as important conduits of information for parents and young adults, helping to shorten the time between onset of symptoms and proper diagnosis and treatment. And in the case of anorexia, which has the highest mortality rate for any mental illness, you may literally save a life.
2. View mental health issues as opportunities for deepened discipleship.
Whether or not your church has an official mental health ministry, mental health issues are impacting your church. And it’s likely that at some point your ministry will include a girl or young woman who has autism or autistic traits and develops anorexia.
We have many resources on the Key Ministry website to help inform ministry leaders about different approaches helpful for people on the high end of the autism spectrum. Whether autism is a factor or not in a young woman’s struggle with anorexia, I encourage you to think about your ministry to and with children and teens with any mental health issue as opportunities for deepened discipleship. Mental health issues, especially something as potentially deadly as anorexia, always involve struggles with identity and purpose, which are inherently spiritual issues.
Whatever the details of a diagnosis, your role as a ministry leader is to help the young woman and her family learn that God has not abandoned them in the midst of anorexia. It is critical to provide a solid foundation of truth about the character of God, and who He says we are as His children, especially in the midst of a mental health crisis. In my opinion and experience, crises of identity and purpose can only be fully resolved by combining helpful treatments with a biblical understanding of who God made me to be. But after the crisis is over, a richer relationship with Christ can be the result.
All those years ago, my former pastor had nothing to offer me, other than prayer, a listening ear and caring heart. Those were incredibly important; I’m telling you this story today because his response mattered to me then and it matters to me now.
But now you have much more information than my former pastor did, and you benefit from our culture having a common basic understanding of autism, autistic traits and anorexia. So if a scenario like the one I presented to my former pastor unfolds in your ministry, encourage the teen and her family to consider not only treatment for the anorexia, but to explore specialized care associated with autism. It may just be that your recommendations can help hasten her recovery from anorexia, and help her find what God would have her do with these experience once she overcomes.
