The Autistic Anorexic: An Unexpected Divergence on Recovery Road

Ryan Althaus (1)

Rev. Ryan Althaus; MDiv MBC

“I must say, Ryan, you present one of the more interesting cases of Autism I’ve ever studied.” “Autism?!” I parroted the passive diagnosis back to my evaluator. Did he just call me autistic? I thought, as I looked towards, though not into, his wrinkle-lined eyes. Rarely did I look into anyone’s eyes, the emotions that filled them are too intense for that. Instead, I’ve learned to look at the bridge of my conversational partner’s nose—their metaphysical third eye—a fitting response for someone who feels as though they are trapped in a different dimension than the other earth-bound beings whom they are interacting with. I also tend to tack on a trademark pair of turquoise-tinted sunglasses. Whereas a fashion accessory to most, these magical lenses dim the bright sights, loud sounds and overbearing personalities of a world that I seem especially sensitive too.

“Yes, autistic,” he continued. “And the professional and personal life that you’ve created to accommodate your ritualistic behaviors—coupled with your ability to mask your anxieties, forgo your feelings, and play the part of a charismatic public figure through exercise and eating is pretty extraordinary.” He paused. “Unfortunately, your extraordinary is also isolating,  exhaustive and, as is the case with eating disorders, deadly.”

From as early as I can remember, I’ve always had a peculiar relationship with food and  movement. Early in life, I figured out that physical exhaustion provided a quick fix for emotional  uncertainty and anxiety, far before ever understanding the terms emotion or anxiety. Thus, while most kids were playing video games and watching cartoons, I could be found running laps around the yard, perfectly content with the company of my own shadow, because the forced-fatigue freed me from my feelings. This quirkiness was considered cute as a kid, but as my eating and exercise idiosyncrasies evolved, that quirky cuteness transitioned into a dangerous eating disorder.

As for the food side of things?
To this day I still struggle to dine in accordance with the social norm; however, with the help of a nutritionist, I figured out how to properly fuel my body via my unique consumption habits.

So why am I blogging about my neuro-diverse brain?
Because the road that I have traveled in regard to my eating disorder and recent ASD/ADHD diagnosis didn’t have to be nearly so rocky, and the prospect of paving a smoother path for others puts purpose to the pain!

Autism and Eating Disorder diagnoses have experienced an exponential rise as of late, but the overlap between the two is often overlooked. My eating disorder has always been less about numbers and looks, than the physical sensation of starvation and satiation, the comfort found in ritualistic eating and my difficulty in identifying hunger/fullness cues. What’s more, with education, awareness and intentionality, being different does not have to mean disordered. For most of my life, my behavioral patterns were evidence of an ED and OCD, and treated with exposure therapy and forced re-feeding. However, whereas an anorexic compulsion  exacerbates anxiety, an autistic ritual alleviates it…and you cannot expose away Autism! In  fact, exposure therapy and forced feeding in terms of autistic-anorexia can cause long term  trauma and further inhibit one’s ability to fuel a healthy and happy life.

Finally, am I glad I pursued this diagnosis?
Incredibly! The treatment protocol from medication, to mediation, to meal formation is very different for Autism as opposed to traditional Anorexia; however, I finally feel as though I am on the right track to reclaiming my health, life and laugh!

Rev. Ryan ‘Mango’ Althaus is a 39 year old addiction recovery counselor, certified Chaplain, radio host, and minister of the Presbyterian and Unitarian Church in charge of LGBTQ, disability and mental illness inclusion for the SF Bay region. Following a decade of professional marathoning and triathloning, Ryan has since given up endurance athletics to focus on recovery, and now strives to be a surf-bum in training alongside his dog, Rafiki, in Santa Cruz, CA. You can learn more about Ryan and his journey in his new book, From Emaciated to Emancipated: The Story of a Skinny Mango, tune into his Podcast: The Kooky Side of Crazy, and/or connect with him through his website,