Autism Without Fear: “Do I Look Fat in This Diagnosis?”

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by Michael John Carley

After an over-abundance of holiday food/under-abundance of exercise, January is a time we tend to see added skin in the mirror, or feel ill. For a few, the food hangover even feels like a spiritual hole; a void where our workout regimens or dietary discipline once lived.

I myself didn’t exercise for two weeks, ate terribly, and as a result, felt awful after the holiday.

Fat consciousness is also a worthy topic because individuals with autism suffer higher rates of obesity than the neurotypical population. Over the past two and a half years, Disability Scoop has written about obesity’s effect on spectrum children, as has Spectrum News, and WebMD. The journal, Pediatrics, covered the topic in a 2015 study (that found 33% of spectrum kids to be overweight, and 18% to be obese); and a year earlier, the National Institute of Health (NIH) had looked into multiple, international studies that found roughly the same findings as the Pediatrics study. Additionally, NIH cited that all children’s obesity rates have tripled over the last 20 years.

Now, the absence of adults in these studies is somewhat infuriating. But the data wouldn’t differ much if they studied our grownups because the social origins of obesity are primarily the same: Lack of exercise, side effects of medications, sensory issues with food texture (we tend to love soft, mushy, processed food; and can be picky about not eating the good stuff), sleep issues, depression, and an all-around pragmatic questioning of “Why should I care if I’m fat? Isn’t it what’s inside that counts?

Well, yes and yes (it is what’s inside that counts). Yes in the literal sense because if you eat crap, and the crap goes inside you, then you will feel like crap.

But yes also on a figurative level because privileged societies are notoriously bigoted when it comes to body types. We still watch Bravo shows, and read fashion magazines that demonize the “unskinny.” We are fooled into thinking that “plus-sized” (hate that term) models are accepted in the fashion world when they are not—they are tolerated (hate that word). My 28 years in New York, a very body-conscious town, certainly showed me how cruel folks can be to those whose forms deviate from whatever the “shape du jour” is for that afternoon. And yet oddly enough, in progressive NY, L.A.,…etc., and in direct contrast to other forms of bigotry, body-shaming is more prevalent in more educated and wealthier communities. Usually, these are the incubators for social progress; but in this one issue of body pluralism, big cities are surprisingly backwards.

We still, as a culture, haven’t separated “health” from appearance. Ok, the super models aren’t as anorexic as they once were, but we are still idealizing an image that is not usually healthy, and we are still labeling overweight (as opposed to obese) people unfairly as “unhealthy.” Though no data exists, I would wager that the average “overweight” person has more energy, capacity for focus, and sex drive than the average skinny person—as many are malnourished.

Even obese people (as defined by the CDC here) shouldn’t be pigeon-holed, pitied, or judged into a negative light because they could be, yes, lazy as all get-out, and so depressed that they don’t care whether they live or die. But they could also be working their tails off to rectify things, and adopt healthier habits. And we will not be able to decipher whether or not they are trying hard simply by their appearance.

Obesity will never be healthy. And the national epidemic that we now have—spectrum or not—is scary, and says nothing good about Americans as a people. But we too often assume character deficits are the cause of the obesity. Again, there could be medications that cause the problems, an inability to exercise caused by another disability…etc.

Needless to say, there is also a major role here played by income. Lower-income folks do not have the money to afford the more-expensive, organic versions of their daily foods; nor do they have the money for gym memberships, or the wherewithal to not be so overwhelmed that they can’t find room in their day to exercise. And as our (already out of control) income discrepancy is expected to keep widening…

Furthermore … it’s no secret that I’m a big advocate for spectrum kids not being shut out of competitive sports. But in my school consulting I have spent years and years having the same conversation with parents:

He can’t play anything. Look at how obese he is!

The risks of concussions are more real than anyone tells you. But football is also the only arena where a body type like your son’s will be heralded, and celebrated—Not demonized. Wouldn’t it be nice for him to feel great about his body, just for once?

Readers of this column also know that too often I find my new hometown of Green Bay, Wisconsin to be corrupt and bigoted. But go figger: Green Bay has actually created an atmosphere wherein the negative stigma for larger body types … barely exists. Granted, they are proportionately “bigger” here in Wisconsin than in New York City, making for more of a majority viewpoint. And this phenomena also doesn’t negate the fact that the entire Midwest has a major health problem with obesity (and depression, and economic ineptitude, and racism, and poor education, and homophobia…). But the culture here celebrates the extra pounds, “owns” them—Few would dare to body shame someone in Green Bay, and it is a surprisingly cool element about this place. This aura of protection for those at risk of ridicule couldn’t really be characterized as a “movement,” given that it is so unconscious. But there’s still tremendous civil rights value to unconscious movements.

Also…what do we really know? In a span of 10 years, I’ve gone from drinking skim milk, to soy milk, to rice milk, to almond milk, and now coconut milk. We used to think pasta was the healthiest thing in the world, and that red meat was terrible. We used to think sugar only affected our teeth, and yet a recent New York Times front page book review of “The Case Against Sugar” paints the dangers of this additive (and they make a convincing case) as equal to cigarette smoke. Reality TV shows about people losing tremendous amounts of weight? Sorry … the producers snuck them pills, and contestants gained weight back once the show was over.

Due to our autism challenges, some of us are unaware of the stigma. We may not notice society’s condemnation of our extra pounds in similar fashion to how we often avoid the nonsense of gender expectation. But even if nonverbal, we still need to be coerced into healthier habits, as our bodies develop the same as others, even if our minds don’t. Unfortunately, parents often feel too overwhelmed to deal with the negative fallback (“meltdowns”) of such a transition. But these parents need to understand that in addition to their children being in better moods because they feel better, that their efforts could result in restoring many extra years of their child’s life. A failure to address this, dare I say it, might even be a sign that they believe their child’s life has less value, in addition to being a sign that the parents need help.

And on the other end of the spectrum, those of us who have the cognitive or functional ability to decipher what others think of us … these spectrum brothers and sisters would do well to separate health, from body appearance; and … to separate cultural pressure (which changes day by day) vs. true biology. By all means, provide constructive criticism to those who have no desire to exercise or eat well. Tell them to love their autism (and yes, their fat—for even the skinniest need it to survive). Yet also tell them to kick depression’s butt.

But to judge supposedly obese or overweight people by what they look like—in addition to the potential bigotry—invalidates not only their true health, but also the fact that they may be doing everything they can to get healthier. Furthermore, why would obese people continue to try and get healthy, if supposedly healthy people won’t give them a chance? If that’s how healthy people behave, then who wants to be like healthy people?

And when does the conversation about what’s “emotionally healthy” finally get a word in?

My penance for bad habits over the holiday break is to do “the Insanity workout” for the 3rd time. But I’m not doing such a difficult regimen because there’s a roll where two of my abs used to be. It’s because I’ve been healthy enough to know what being healthy feels like. It greatly affects my capacity for confidence and self-esteem. When it’s there, it’s awesome. And I want that back at its fullest. Knowing what this emotional health feels like also makes it easier for me to obtain it again.

But for many others (however categorized), absorbing that idea about loving yourself is like trying to visualize a color you’ve never seen. They’ve never been there. If they have never loved themselves, what frame of reference do we think they have … to understand what loving yourself even means?

In short, many people who are categorized as overweight are emotionally healthy about their bodies. Many supermodels are not. And Father Time is going to get us all to a physically hideous place someday anyway. The acceptance of fat, and the loving of fat (since it is a part of our body)…that’s a good start. After that can come the guts it takes to want to be happy.

And this is where those seemingly perfect folks at the gym are unfortunately right. We do have to strive to feel good. Because aside from consciously accepting a much shorter, or a much sadder life for ourselves, we really have no other option.


Michael John Carley is the Founder of GRASP, a School Consultant, and the author of “Asperger’s From the Inside-Out” (Penguin/Perigee 2008), “Unemployed on the Autism Spectrum,” (Jessica Kingsley Publishers 2016), and the upcoming “’The Book of Positive and Happy Sex for People on the Autism Spectrum (and Beyond?)” In 2000, he and one of his two sons were diagnosed with Asperger’s Syndrome. Re-evaluated in 2014 under DSM-5, Michael John was diagnosed with Autism Spectrum Disorder. For back columns of “Autism Without Fear,” or for more information on Michael John, you can go to

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