QC: When Neurodivergent Brains Forget To Eat- Dr. Jennifer Gaudiani

Quick Format And Safety Note

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Life moves fast, and so should the answers to your biggest questions. Welcome to Endo Batteries Quick Connect, your direct line to expert insights. Short, powerful, and right to the point. You send in the questions, I bring in the experts, and in just five minutes, you get the knowledge you need. No long episodes, no extra time needed. And just remember, expert opinions shared here are for general information and not for personalized medical advice. Always consult your provider for your case-specific guidance. Got a question? Send it in, and let's quickly get you the answers. I'm your host, Alana, and it's time to connect.

Meet Eating Disorder Expert Dr. G

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Today I am honored to welcome Dr. Jennifer Gattiani. Dr. G is an international medicine physician and one of the world's leading experts on eating disorders. She's the founder of the Gattiani Clinic in Denver, where she and her team provide compassionate, comprehensive care to people struggling with eating disorders and their medical complications. She's a certified eating disorder specialist, a fellow of the Academy for Eating Disorders, and the author of Sic and Death, a Guide to Medical Complications of Eating Disorders, a groundbreaking book that changed how patients, families, and even other doctors understand this illness. What makes Dr. G's work especially powerful is her focus on populations often overlooked, people living with chronic illness, neurodivergence, and complex medical needs. Please help me in welcoming Dr. Jennifer Gattiani.

Neurodivergence And Skipped Meals

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I want to talk about because a lot of us with endometriosis, mast cell, EDS, all of these other things also are neurodivergent, which plays a huge role. And the way that we eat, the way that we process what we should eat, the way that we listen to our hunger cues. I mean, I'm speaking from experience here when I tell you my husband has had to make me lunch because I will not eat. Not because I I'm like being thoughtful, like I don't want to eat. It's because I literally get in a zone and I don't eat. I don't even think about it. I don't hear my body. And sometimes when I eat, it's like a bite or two and I'm good. But that's also not great, right? So we have we have to figure out. I'm a lazy eater, is what I always say. I'm a lazy eater. I do it out of necessity a lot of times. I'd rather not take the time to do it because I have other things I'd like to focus on. So I think a lot of us find ourselves in this position. When you have patients that come in with that as well, how do you walk them through this? And what are some signs that doctors and family members and ourselves can pay attention to as this being some sort of disordered eating, or maybe we should seek help

Sensory Overload And Feeling Too Full

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for that?

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I love this question so much. I think the last couple of years have really humbled me as I have learned the importance of neurodiversity and relationship with food. It's a topic I just adore because a lot of the time it has been ignored or it has been underaddressed. And as a result, folks feel like they're failures of the system when in fact the system has been failing them. The system is normed around neurotypicality. And the truth is, so many people who have struggles with food do have some form of neurodiversity. It could be at the formal ADHD or autism level, and it could also be at a sort of subclinical, but still very much important relationship with food textures, tastes, scents, colors, the feeling of fullness in one's body. The people, you know, for me, when I in my health privilege, when I'm satisfiedly full after a meal, I feel good. Other people who have absolutely no, you know, overwhelming pathologic drive for body change feel terrible when they're full. Not because they have sort of an eating disorder necessarily, but because their sensory input is you've just some done something yucky and dangerous. And you know, guess what? That can certainly end up leading to a formal eating disorder. So there's a bunch of things that I love to do now when it comes to patients who either arrive to us with a diagnosis in the neurodiversity realm or who have been undiagnosed their whole life. And I really love to ask questions about all of the stuff you just talked about. How, how do you feel it is to arrange meal planning? How do you do planning a grocery list? What is it like for you to come to a meal time and you're focused on a task? How do you do when you're multitasking? There's so many questions one can ask. I've learned that there's this fascinating sort of general narrative that affects or applies to a lot of my patients with neurodiversity. In this case, as I speak it, I'm gonna use ADHD, but you could just as easily sub autism or other subclinical neurodiversity here.

How Shame Can Fuel Restriction

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So I'm gonna also use it, use um a girl model because I think that they are the ones who are the most missed in this. So let's say that there's a little girl and she knows that she's pretty bright. She might be unusual bright, not necessarily school bright, but she knows she's bright. And yet what she finds in school in academic settings is that something keeps her from being able to be her whole self. Maybe it's restlessness, maybe it's distraction, maybe it's her mind going all sorts of sparkling places at once. And in that gap between knowing she's bright and yet not being able to do the things asked of her in a neurotypical system, shame starts to form. And as this shame forms and influences her sense of self-esteem, yeah, she might turn to other things where she's particularly good. Maybe that's athletics. Because maybe on the PE field, she's just as good, if not better, than her peers. And she's like, okay, okay, this is a place that I feel like I'm doing things that that feel good. But at some point, she may accidentally learn that if she eats less, her brain is more focused. The truth is that restriction does make people less creative, joyful, and energetic. And as such, the brain noise can quiet down. And when that brain noise quiet down, they might find they're better at school. And when they eat more, when everyone's like, oh, you'll feel so much better when you eat more, they feel worse because their thoughts and emotions feel so big. And of course, feeling big in your thoughts and emotions can easily translate into feeling big in your body in our society. And so they're sort of the more the seeds of the more classic eating disorder can be sown. But what you find is that this person can end up getting labeled as having an eating disorder when sure, there are behaviors and there's malnutrition that that looks like that, but we're failing to address the actual underlying situation.

ADHD Treatment As Food Support

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So when you just have a young person like that, a young person could be, of course, any age here, but usually the first relationship with some kind of treatment is in adolescents or one's 20s, and you immediately feel like a failure in recovery because everyone says you're going to feel better and you feel worse. So then you have that shame piece, that self-esteem piece where you're like, apparently the only thing I'm good at is like restricting. I don't know. This is not really working that well for me. And when we finally say, now hold on a second, let's talk about how you feel worse. You just told me you feel worse at the end of each day. You might be able to kind of hang in there, but at the end of the day, you are doing behaviors that you know are incongruent with what you want for yourself, but you feel totally out of control to manage them. And you feel so distanced from yourself, but you feel profoundly exhausted and overwhelmed, but everyone's asking you to just do things on a certain schedule. And you say, you know, this might be autism, this might be ADHD. What if we treated these? For ADHD, I use medications, if the person, of course, consents and wishes to. And some are like, wait a minute, in someone with a restrictive eating disorder, you would use stimulants that affect the appetite? You say, yeah. In whose world is anorexia or atypical anorexia an appetite problem?

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Right.

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It isn't. This is a complex biopsychosocial disorder. And when you do find the right medicine combo when it comes to ADHD, for instance, oh my gosh, people are like, wait a minute, I can meal plan, I can focus on things in a way that feels gentle and authentic. I can interact with people more comfortably, and I don't need to use food restriction or caffeine to self-medicate here.

Wrap And How To Send Questions

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That's a wrap for this quick connect. I hope today's insights helped you move forward with more clarity and confidence. Do you have more questions? Keep them coming. Send them in, and I'll bring you the expert answers. You can send them in by using the link in the top of the description of this podcast episode or by emailing contact at indobattery.com or visiting the Indobattery.com contact page. Until next time, keep feeling empowered through knowledge.