Sensory Processing and Eating Disorders

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Eating disorders are complicated mental illnesses characterized by a disruption in a person’s eating patterns, leading to mental and physical complications. Sensory processing disorder (SPD) is a neurological condition characterized by altered sensory signals, commonly resulting in ineffective behavioral responses; it is widely debated and not included in the DSM-5. Research has found a link between some eating disorders and sensory processing concerns.

Avoidance-restrictive food intake disorder (ARFID), pica, and anorexia nervosa (AN) are three eating disorders that demonstrate etiology partially related to sensory processing struggles. Individuals with SPD either experience hyper- or hyporeactivity to one or more of their five sensory channels. Altered responses to touch, taste, sight, sound, and smell each have the potential to lead to eating-related concerns.

Sensory Processing Disorder

SPD is not a disorder recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or the International Classification of Diseases (ICD). Currently, it is only recognized by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood. Sensory processing concerns are typically thought of in connection with diagnoses such as autism or attention-deficit/hyperactivity disorder. However, recent research suggests there may be enough evidence to prove SPD as a standalone diagnosis.

Every human has different sensory experiences. Some people may hate the feeling of wool against their skin. Other people may avoid oatmeal, pudding, or any foods with a soft, mushy texture. This doesn’t mean that everyone has SPD.

SPD is a condition in which the brain accepts and responds to sensory stimuli in an ineffective way. SPD happens when the threshold for what an individual can sensorily tolerate begins to interfere with their everyday lives. Essentially, SPD happens when an individual’s emotional, physical, social, and/or psychological well-being is impacted.

SPD can manifest in one of two ways—sensory seeking and sensory avoiding. Sensory seeking happens with individuals who are hyporeactive to sensory input. Sensory avoiding happens with individuals who are hyperreactive to sensory input.

Here is an example of how this may manifest for someone: A seeking child, or a child who is underresponsive to sensory input, may develop a taste for spicy and sour food at an early age. An avoiding child, or a child who is overresponsive to sensory input, may limit their intake to a few foods they can tolerate.

Link Between Eating and Sensory Processing Disorder

Eating is a multisensory activity. In cases of SPD, either one or multiple sensory channels are impaired causing disturbances to the perception of textures, smells, colors, tastes, sounds, etc. When applied to eating behavior, the disturbances in sensory input can manifest in either a hyper- or hyporeactivity to foods.

An example of hyporeactivity to food may be forgetting to eat or failing to feel hungry even though hours have passed between mealtimes. An example of hyperreactivity to food may be avoidance of crunchy foods due to an intolerable texture. Both manifestations of sensory concerns can lead to unhealthy eating patterns that can impact a person’s mental and physical well-being.

About Sensory Eating Disorders

Sensory concerns are commonly seen in the diagnostic profile of individuals with ARFID, pica, and more recent research even suggests anorexia nervosa. The interaction between these individuals’ SPD profile and eating disturbances could qualify these eating disorders for a newly proposed subcategory called “sensory eating disorders.”

The subtype of “sensory eating disorders” would involve an eating disorder whose problematic eating patterns was largely influenced by struggles with sensory processing. Some traits seen in ARFID, pica, and anorexia have diagnostic features that align with atypical reactivity (hypo- or hyper-) to food.

Sensory Processing Disorder Essential Reads

It’s Not Autism, It’s Sensory Processing Disorder

Sensations: Too Much, Too Confusing, or Not Enough?

Below are three examples of how SPD could correlate with the above-mentioned eating disorders:

• Sensory concerns in ARFID may cause a person to avoid eating based on the sensory characteristics of food.
• Sensory concerns in pica are commonly due to an underresponse or hyporeaction to chewing or taste. This can lead individuals to be drawn to ingest materials or objects not meant for consumption.
• Sensory concerns in anorexia commonly look like a hyperreactivity to sensory channels leading to a heightened awareness of the body’s reaction to food. This awareness can lead to unhealthy restrictive patterns to try and blunt the sensory stimuli and, in turn, control the body’s appearance.

Tip for mental health professionals: If a client’s eating disturbance is a result of sensory processing concerns, professionals may consider conceptualizing the disorder as a sensory eating disorder. This can help inform treatment goals by assisting clients with sensory exposure and integration.

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Signs of Disordered Eating Among Individuals with Sensory Processing Disorder

• Sticking to one type of texture (e.g., soft foods, crunchy foods)
• Avoiding cold foods
• Avoiding hot foods
• Only eating foods of a certain color palette (e.g., only tan foods, only red foods)
• Avoiding foods of a certain smell
• Refusing foods if small changes are made (e.g., new packaging, new brand, new presentation)
• Taking a long time to finish a meal
• Ingesting dirt, lotions, stones, or other objects
• Going long periods of time without remembering to eat or feeling hungry
• Eating alone or only in a certain location

When to Seek Help

• Are your eating struggles impacting your day-to-day functioning?

• Are your sensory concerns inhibiting your mental or physical well-being?

• Are you simply curious about exploring your relationship to food and/or sensory processing?

There can be a multitude of reasons why individuals seek a mental health professional. None of the reasons are wrong. You don’t have to reach a particular threshold before seeking help or support. If disordered eating or sensory processing concerns are coming up in your life, consider speaking with a mental health professional.