Compulsive overeating in adult Asperger's

[Jena_C]

Looking for an expert to advise.   We are in the UK, Our daughter 27 has been dx with Asperger's in 2007.   She
always turned to food during her exam stress and been overweight as a result.   Not being dx for such a long time
caused her more stress and has been stressful for the parents too.   She had a psychotic episode in 2005/2006
which finally helped her being assessed/diagnosed/treated.   With Abilify she's a lot improved and studying at
postgraduate  level in the University.  
Her problem is overeating both in portion and wrong food.   She has the knowledge of right diet since we the parents
are in med profession but she is least bothered.   She's been dx  Diabetes (result of Seroquel, which she was tried
on prior to Abilify).   She's on METFORMIN  and currently her GP prescribed ORLISTAT.   She knows Orlistat won't
work on carbohydrate, yet she is taking lots of carb rich food.   Fortunately being on Orlistat puts her off fatty food
for the fear of possible problem BUT she would never lose weight if she continues to eat big portion and carbohydrate.
She's 5' 6'' in Ht  and  nearly 91kg in weight, her body mass index is well above the normal.
Please advise,  how we can do something to help her reduce in weight.   She being Asperger's it's soooo difficult
to make her listen.    Her motivation in weight reduction is very short lasting, if she tried one day, the next day it's
as usual wrong food and big portion.    I know it's a silly question to ask when the person herself is aloof but still
as a mother I can not stop asking, please help.   She's on Thyroxine for hypothyroid and also has PCOS.
I would very very much appreciate for any suggestions/advice but we are in the UK.    Any UK organisation who
might deal with this kind of situation?    She is an academic girl and spends time being a student studying, yet
severely prone to STRESS when it comes to exam.    Please HELP!

[Jena_C]

Thank you very much for your kind reply.   Sorry,  I didn't explain it correctly in my
question.   The doctor (psychiatrist) is not treating her for "eating disorder".   We needed
psychiatric help for her in 2006 when she was very depressed and showed psychotic
symptoms.   With long time history (from the begining of primary school, age 5yrs) of
not being able to enjoy social/peer company, isolating herself etc the psychiatrist had
her assesed by the As Specialist and she was dx as Asperger's.   She has always been
very close with mum/dad and her only sibling but was uncomfortable with group or in
school and in social situation.    Academically was good and likes to continue with education
rather than looking for job.   In her own words " job would be stressful".    She tried once
with a job after achieving her Bachelor degree ( as a work experience) with a hope to
get admission to the medical school which she succeeded but didn't like her job.  She
was unable to continue with her Medical study ( found it too stressful ) and that's the time she started showing "psychotic symptoms".    I must confess that she always
tried to achieve educationally and always wanted to be a doctor.   Not being able to achieve her life long ambition made her feel real hopeless and her main delusion during
that psychotic episode made her feel that, she is not loved by us since she was not as capable as her sibling.   She was very withdrawn for a few months.   Finally she took a
voluntary admission for a couple of days in the psych. unit when the Pdoc was able to
start her with some anti psychotic plus an anti depressant.    She could not take the SSRI but her continuation with the Aripiprazole made a world of difference.   She got
her insight back and admitted to the Pdoc that mum/dad loves her.   It took time for her
to come out of her negative symptoms of lack of motivation but finally went back to a
different course to do a master degree in last October.    She is working too hard again
and has NO trace of psychosis BUT this overeating disorder did not go away.
She told me this morning that until she completes her assignments/exam she won't be
able to stick to a healthy diet regime since she is under stress with her study just now.
She stopped taking her Orlistat(for weight loss) until then for the fear of the effect of the drug while she's commuting to the University.  I understand that's sensible but my question is, How do you treat a patient who craves for wrong food with big portion when under exam stress?
It seems to us that our beautiful girl would be studying with stress probably all her life
and will be eating wrongly all her life unless there is some kind of treatment available.
She refused to go to the Psychologists,   she feels that they just do a routine job which
does not help her.    She has all the respect for the Psychiatrist though !    Incidentally,
my feeling for the Psychologists is not any different, they are just earning their living
and many of them are not capable to spend time and show patience to their patients.

Sorry for the long story but  a bit of her background might help.

Thank you.

[Roger Gould, M.D.]

I don't believe there is such a thing as a doctor who treats aperger and emotional eating...From what you describe, she is willfully continue to stay heavy despite how much she may want to change.  That means, she has a conflict with herself, and your trying to help only deals with the side of her that wants to succeed in weight control, not the part of her that needs to stay heavy. I hesitate to suggest my 12 session online shrinkyourself.com program only because you mentioned a psychotic episode. If you, and her doctors, think she is stable enough she can take my program which will help her deal with her emotional eating conflict, but it would help is she was also seeing a psychotherapist who could talk to her about what she is learning about herself in the course.