Neurodiversity, Food, and Weight Inclusivity
A conversation about neurodivergent feeding relationshipswith Dr. Molly Moffat
In Episode 12, Season 5 of the Fat Doctor Podcast, I had the pleasure of speaking with Dr. Molly Moffat, a fellow GP who specializes in community pediatrics and neurodivergent feeding relationships, particularly. Our conversation explored the intersection of neurodivergence, weight inclusivity, and food, with profound insights into how societal expectations affect both neurodivergent children and adults.
Finding Weight-Inclusive, Neurodiversity-Affirming Healthcare
Dr. Moffat describes herself as “a perpetually exhausted and overwhelmed human being, an autistic ADHD, a mum of 3, 2 of whom are neurodivergent.” Beyond her work in community pediatrics, she runs her own practice supporting families and carers of children with feeding differences, approaching her work through a weight-inclusive, neurodiversity-affirming lens focused on health and social justice.
What makes our connection particularly special is how aligned we are in our perspectives. As Dr. Moffat noted, she’s always felt somewhat like “a pariah” in medical circles, uncomfortable with the culture of invalidating patients’ experiences. She shared a telling memory from her junior doctor days when she prescribed pain medication for a patient with viral meningitis, only to have a nurse scoff, “Oh, Molly, one day you’ll learn!” – implying compassion was somehow naive.
This disillusionment with conventional medical approaches led Dr. Moffat initially to lifestyle medicine, but her journey took a different turn as she recognized her own neurodivergence and that of her children. Simultaneously, she was learning about eating disorders while deep in lifestyle medicine spaces where discussions centered on diet minutiae rather than fundamental questions about relationships with food.
“I remember sitting with my children who were eating white pasta and feeling really stressed about it,” she recalled. “Luckily, I had the insight to realize that’s not right – I don’t want my kids to pick up on that stress.”
Understanding Autism Beyond Stereotypes
Our conversation delved into common misconceptions about autism, particularly the harmful idea that “everyone’s a little bit autistic.” As Dr. Moffat explained:
“People get confused when people say, ‘We’re all a little bit autistic.’ What they’re referring to is individual autistic traits that most people might relate to in isolation. But when we look at somebody who’s autistic, they have many of those traits together.”
This distinction is crucial. Dr. Moffat illustrated with her own sensory sensitivity to smells: “I can give you a story of when I was so distressed by a particular smell that I was consumed by it for hours, couldn’t think about anything else. That’s different to just not liking something.”
We discussed how functioning labels in autism are “extremely unhelpful and actually very harmful,” rooted in ableism and external judgment. “We assume somebody who is wheelchair-bound or non-speaking is not functioning as well as somebody who has a job,” she noted. “But we don’t see the fallout at the end of the day or the impact on their mental health. We don’t see how utterly exhausted they feel.”
One of the most illuminating parts of our conversation was about the double empathy phenomenon, a theory developed by autistic academic Damien Milton that challenges the notion that autistic people lack empathy. Instead, as Dr. Moffat explained, “It wasn’t a lack of empathy. It was a mismatch in empathy between neurotypicals and autistic people… that was causing neurotypical people to see autistic people as lacking empathy.”
The Intersection of Neurodivergence and Feeding Relationships
Dr. Moffat’s work with neurodivergent children and their feeding differences addresses a critical gap in healthcare. She helps children “be their authentic selves and understand their feeding behaviors,” supporting parents to understand feeding differences and implement appropriate accommodations.
What makes this work so important is its rejection of conventional goals around children’s eating. “The goal is never for a child to eat more pieces of carrots or eat a piece of broccoli,” Dr. Moffat emphasized. “The goal is for the child to be as safe as they can around food and for their needs to be met.”
Her approach challenges deeply ingrained societal norms about “proper” eating. We discussed how many parents, including ourselves, had internalized the idea that families must eat together at a dining table, with everyone consuming the same foods.
“I used to be very much like, it’s not about what the child eats, it’s about how they eat, that connection, being with their family at mealtimes,” Dr. Moffat admitted. “But I think that can be just as harmful as focusing on how many carrots they’re eating. That can feel unsafe and very unpleasant to many children.”
She described how letting go of these expectations paradoxically improved outcomes: “What we’ve noticed is, since reducing that pressure and allowing my daughter to not eat with us and eat separately, there’s more chance that she actually will eat with us, because she has that reassurance and feeling of safety.”
Challenging Diet Culture and Food Rules
Our discussion revealed how deeply diet culture has infiltrated family eating practices, even for those trying to be conscious of weight stigma. The pressure for “mindful eating” without distractions, for instance, can be particularly harmful for neurodivergent individuals who might need headphones or screen time to manage sensory overwhelm during meals.
Dr. Moffat offered a refreshing perspective on food’s purpose beyond nutrition:
“I think we totally overstate the importance of food and nutrition. We’ve stopped enjoying food and see it purely for its nutritional value. But food has so much more to offer. When I think about licorice sweets, I think about my grandma. When I think about fish and chips, I think about the time I went to Cornwall with a friend. Food can evoke memories.”
We noted the double standard that exists around comfort behaviors: having a glass of wine after a hard day is socially acceptable, but comfort eating is stigmatized, particularly for fat people.
Supporting Parents of Neurodivergent Children
For parents worried about their children’s limited food preferences – a common concern with neurodivergent children who might only eat “white” or “beige” food – Dr. Moffat offers practical guidance:
“Multivitamins are great things,” she noted pragmatically. But more importantly, she encourages parents to consider: “You’ve got two options. One is you continue forcing fruit and vegetables and creating distress. Or the second option is, you think about the environment and what other things you can be doing – not commenting on food and creating positive relationships and behaviors around food.”
She urges parents to consider their long-term goals: “When we’re looking at a child, let’s zoom out a little bit. Think about this child in 20 years time. Most parents can recognize that in 20 years, they don’t just want their kid to be eating broccoli. They want their kid to be happy, confident with their body, confident around food.”
The Value of Self-Diagnosis and Finding Community
Our conversation highlighted the importance of self-diagnosis in the neurodivergent community. “Self-diagnosis is entirely valid,” Dr. Moffat asserted. “The diagnostic criteria has some updating to do – it’s based on boys from a long time ago.”
She acknowledged that some people seek formal diagnosis for external validation, as she did herself, while emphasizing that the most dangerous misinformation comes not from TikTok or social media but “from people in power” who should know better.
For those wondering if they might be neurodivergent, Dr. Moffat offered reassurance: “Usually, if you’re thinking it and wondering about it, you probably are.” She noted how neurodivergent people tend to find each other naturally due to shared communication styles and experiences.
Meeting a Critical Need in Healthcare
Dr. Moffat’s unique approach addresses a significant gap in healthcare services. As I noted during our conversation, “There is no support around this area, and all of the support that’s available out there is laced with diet culture.” Her weight-inclusive, neurodiversity-affirming approach to feeding differences offers families an alternative to the shame-based, restriction-focused advice that dominates conventional healthcare.
For parents of neurodivergent children struggling with mealtimes – which, as we joked, is virtually all of them – Dr. Moffat provides not just practical strategies but permission to let go of harmful expectations. Her work represents a critical step toward a healthcare system that honors the needs and experiences of neurodivergent individuals rather than trying to force them into neurotypical molds.
Are you neurodivergent or do you know someone who is? How has that impacted your (their) relationship with food and with healthcare? Share your thoughts in the comments below.
Dr. Molly Moffat works with families of neurodivergent children with feeding differences. You can email her or visit her website for more information on her work. If you’re looking to consult with a weight-inclusive doctor, you can also check out the services I offer. This blog post is based on a conversation Asher and Molly in Episode 12, Season 5 of the Fat Doctor Podcast. You can listen to the podcast or watch the video on YouTube.