Young autistic type 2 diagnosis- help needed with diet ideas

[Mehatabel]

My son is 21 and has Aspergers. He has recently been diagnosed with type 2 diabetes and needs to lose quite a bit of weight. He has quite restricted patterns of eating due to his autism and the majority of what he prefers to eat is carbohydrate based, so this is going to be a very big challenge! Does anyone have any advice or experience of trying to help someone with autism slowly adapt their diet in the face of this sort of diagnosis? He is particularly annoyed that he has been diagnosed in the run up to Xmas when he was looking forward to enjoying nice Christmas food. Any help or advice would be much appreciated as we have tried many things over the years to help him eat more healthily.

 

[Inka]

Welcome @Mehatabel 🙂 Sorry to hear about your son’s diagnosis. As you’ve correctly identified, eating lots of carbs isn’t a good idea. Would you be happy to write down an average day’s food for him? That way we could suggest tweaks and substitutions, and identify ‘problem areas’.

You could try cutting carb portions gradually and replacing the missing carbs with veg or protein to fill him up, and/or you could look for low carb options eg low carb bread, granola, etc. I think keeping his meals fairly close to what he likes to eat, but carefully adjusting them would be a good way forward initially.

There’s no reason why he can’t have nice food at Christmas but it will need a few adjustments. I’d refrain from purchasing too much of his favourite foods because that might tempt him. Or you could buy mini versions or make your own treats.

 

[Lucyr]

Hi and welcome. Diabetes isn’t only about diet, and non autistic people often don’t seem to comprehend how difficult it can be for autistic people to change their diet or expand their range of safe foods. People here will most likely give impossible advice about cutting out carbohydrates, I’d reccomend bearing in mind that most here don’t understand autism.

Diabetes can be managed with medication and exercise as well as diet changes, so I’d suggest focusing on developing a routine for exercise and any medication. Once it’s a routine it will become easy to stick to. For food, I wouldn’t try and push any fast or radical changes. Instead, work on reducing the portion size of some elements of the meal and increasing the portion size of the protein and vegetables. Help him work on trying new foods by supporting with opportunities, but the types of food he is willing to try needs to come from him.

 

[Mehatabel]

Hi Inka,
Thanks for your reply. He loves things like rice crispies, sausage rolls, chicken nuggets, sandwiches, filled pasta, pizza. He will eat quite a few different types of veg, fruit and meat but is not keen on anything he has to prepare, even though he is perfectly capable of cooking...in the past, we have tried cooking healthier things in advance for him to eat for lunch, but he is unwilling to reheat most things as he says they taste weird when they've been in the fridge and reheated. He won't eat eggs unless they are in cakes. My husband and I work full time and at the moment he is at home a lot of the time and the temptation to eat unhealthily is huge.
The biggest issue is that he is an emotional eater and when he feels anxious, which he does much of the time, he wants to eat unhealthy food and he won't stop until he has eaten the entire pack of whatever it is. He does enjoy swimming so we are trying to do that more, but he is not motivated to go out for walks. He has got an exercise bike but not sure how much he uses it.

 

[Mehatabel]

Hi and welcome. Diabetes isn’t only about diet, and non autistic people often don’t seem to comprehend how difficult it can be for autistic people to change their diet or expand their range of safe foods. People here will most likely give impossible advice about cutting out carbohydrates, I’d reccomend bearing in mind that most here don’t understand autism.

Diabetes can be managed with medication and exercise as well as diet changes, so I’d suggest focusing on developing a routine for exercise and any medication. Once it’s a routine it will become easy to stick to. For food, I wouldn’t try and push any fast or radical changes. Instead, work on reducing the portion size of some elements of the meal and increasing the portion size of the protein and vegetables. Help him work on trying new foods by supporting with opportunities, but the types of food he is willing to try needs to come from him.

Hi Lucyr,
Thanks for your help. He has just started metformin which the doctor says should help reduce his appetite a bit, which may help. He has also started propranolol which I hope will help with the anxiety. We have found some lower carb bread which he is enjoying with marmite and I'm trying to encourage him to eat more veg with his meals and have a glass of water before he eats to help him feel fuller. We are going to try to go swimming at least twice a week and his occupational therapist has given him an exercise routine so I'll encourage him to do that regularly as he seems to have lost motivation to do it recently. Although as parents we could see this coming a long time ago, he was still very shocked by the diagnosis and is still processing it emotionally so I am just trying to help him make incremental changes.

 

[Inka]

Hi Inka,
Thanks for your reply. He loves things like rice crispies, sausage rolls, chicken nuggets, sandwiches, filled pasta, pizza. He will eat quite a few different types of veg, fruit and meat but is not keen on anything he has to prepare, even though he is perfectly capable of cooking...in the past, we have tried cooking healthier things in advance for him to eat for lunch, but he is unwilling to reheat most things as he says they taste weird when they've been in the fridge and reheated. He won't eat eggs unless they are in cakes. My husband and I work full time and at the moment he is at home a lot of the time and the temptation to eat unhealthily is huge.
The biggest issue is that he is an emotional eater and when he feels anxious, which he does much of the time, he wants to eat unhealthy food and he won't stop until he has eaten the entire pack of whatever it is. He does enjoy swimming so we are trying to do that more, but he is not motivated to go out for walks. He has got an exercise bike but not sure how much he uses it.

Would he eat and enjoy something like cold meats, salami and cheese? That would be a low carb breakfast, lunch or snack, depending on what would work for him. Something like biltong is low carb and good to chew. Would he be happy with a smaller portion of Rice Krispies and a non-carb treat such as above? Would an exciting open sandwich (one slice of bread) that he could make himself by quickly tipping out some chicken and salad or whatever be an option?

I would look to find new less carby favourites that he might stick to. So he has food he can enjoy, but has reduced the carbs.

For the emotional eating, which is really common, is he going out to get this food or is it in the house? Is this something he’d be ok talking to someone about?

For exercise, what about something electronic/techy? Some challenge?

 

[Leadinglights]

When I worked at the Uni I talked to a few students who had Asperger's and what came across was they very much liked routine. I assume your son is at home during the day but is there some activity that he likes which could act as a distraction from snacking or having some tasks to keep him busy. A friends son was very sensitive to the smell and taste of different foods so making big changes might be challenging. But small steps and giving him some choice in what he has. Could it be a bit of a project for him to decide what would be a better food choice.

 

[Mehatabel]

When I worked at the Uni I talked to a few students who had Asperger's and what came across was they very much liked routine. I assume your son is at home during the day but is there some activity that he likes which could act as a distraction from snacking or having some tasks to keep him busy. A friends son was very sensitive to the smell and taste of different foods so making big changes might be challenging. But small steps and giving him some choice in what he has. Could it be a bit of a project for him to decide what would be a better food choice.

Thanks. Like many young people with Aspergers he is very keen on video gaming so I thought I might look to see if there were some apps that might be game based which might encourage him to exercise. He is trying very hard to do the right things but it is very hard for him. Luckily, as I'm a teacher, I will have a bit more time over Xmas to help him try to develop a better routine around food and exercise so am hoping that will help a bit. I just worry that he'll revert to his previous eating habits once we're both back at work....

 

[Mehatabel]

Would he eat and enjoy something like cold meats, salami and cheese? That would be a low carb breakfast, lunch or snack, depending on what would work for him. Something like biltong is low carb and good to chew. Would he be happy with a smaller portion of Rice Krispies and a non-carb treat such as above? Would an exciting open sandwich (one slice of bread) that he could make himself by quickly tipping out some chicken and salad or whatever be an option?

I would look to find new less carby favourites that he might stick to. So he has food he can enjoy, but has reduced the carbs.

For the emotional eating, which is really common, is he going out to get this food or is it in the house? Is this something he’d be ok talking to someone about?

For exercise, what about something electronic/techy? Some challenge?

Those sound like good ideas re breakfast and lunch. I will definitely suggest it to him. He really likes pepperoni but I do worry about the amount of salt he is consuming because he can't stop at 1 but will eat at least 5...
He has been referred to a dietician so I'm hoping they will be able to help and he is currently speaking to a psychologist who has experience in autism and anxiety eating (although that is costing us a fortune and isn't sustainable long term!)

 

[Inka]

Yes, the salt content isn’t ideal, but perhaps it could be a kind of stepping stone rather than a longterm daily item? Start with that and then see if you can gradually expand it to less salty items.

Would he be interested in a written plan to follow? Would that appeal in its routine, and also remove the ‘too many choices’ aspect? That, and identifying genuine hunger would help. There are some good resources about interoception and eating.

 

[Mehatabel]

Yes, I think that definitely helps. He has been studying for an access to higher education course from home, although he has been having a break recently as he has not been very well. I usually leave him a daily list of jobs to do around the house (hoover the lounge, etc..) and in the last week I have been giving him some suggestions of suitable breakfasts and lunches he could have to reduce the decision making for him.

 

[Leadinglights]

Are there any volunteering opportunities nearby, my nephew who has Down's Syndrome used to work a few hours in a charity shop.
It seems there is support when people are children but is all drops away once they become adult.