Why weight loss often comes with unmasking

Autistic people often learn to hide or suppress their natural behaviours in an effort to blend in with neurotypical people. This process is known as 'masking'. It's a survival strategy developed from a young age, often in response to social pressure or negative experiences. While masking can sometimes help a person navigate social situations, it comes at a significant cost to their mental and physical wellbeing.

Masking can involve a range of conscious or subconscious actions. For example, a person might force themselves to make eye contact even when it feels uncomfortable, or they might rehearse conversations in their head before speaking. One of the most common and physically demanding aspects of masking is suppressing 'stimming' or self-stimulatory behaviours.

Stimming includes a wide variety of repetitive movements and actions, such as:

• pacing

• rocking

• hand or arm flapping

• finger fidgeting

• fiddling with clothes or objects

• making repetitive noises

These movements are a natural part of being autistic. They serve several purposes, including helping to regulate emotions, manage sensory input, and express feelings. For many years, autistic people have been told to stop or hide these movements, but suppressing them requires a constant, often exhausting, effort.

What does it mean to stop masking?

Lately, more and more autistic people are choosing to 'unmask'. Unmasking means allowing themselves to be their authentic selves, to stop suppressing their natural behaviours, and to accept their autism as a core part of their identity. This is a brave and often liberating process, but it can also have unexpected side effects.

One of the most surprising side effects of unmasking is an increase in physical activity. This isn't the kind of activity you'd associate with a gym workout or a run; instead, it's a subtle, constant increase in movement throughout the day. This phenomenon is known as 'Non-Exercise Activity Thermogenesis', or NEAT.

What is NEAT?

Non-Exercise Activity Thermogenesis, or NEAT, is the energy expended for everything we do that isn't sleeping, eating, or sports-like exercise. It includes the energy used for walking to the car, typing at a keyboard, gardening, and even fidgeting. NEAT is a significant component of our daily energy expenditure.

When an autistic person chooses to unmask, they stop suppressing their stims and other repetitive movements. These movements, which were previously suppressed and hidden, are now allowed to happen naturally. The result is a significant increase in NEAT. A person might find themselves pacing more while on the phone, rocking while watching television, or fidgeting with their hands in a meeting. While each individual movement may seem small, the cumulative effect over a day or a week can be substantial.

The link between unmasking, NEAT, and weight loss

When a person moves more, they use more energy, which their body gets by burning calories. An increase in daily movement, even small movements, adds up over time. If a person's energy intake (from food and drink) stays the same while their energy expenditure (from NEAT) increases, they will create an energy deficit. This deficit can lead to weight loss.

For many autistic people, this weight loss can be a completely unexpected side effect of unmasking. They may not have been trying to lose weight at all. In some cases, the weight loss can be quite noticeable over a few weeks or months. While some might initially welcome this, it is crucial to understand that losing weight too quickly can be unhealthy.

Rapid weight loss can lead to:

• loss of muscle mass

• fatigue and low energy

• nutritional deficiencies

• hair loss

• gallstones

It's important to be aware of the potential for weight loss when starting to unmask. This is not about being scared of unmasking, but about being informed and prepared so that you can manage the changes happening in your body.

Adjusting your diet to stay healthy

If you are an autistic person who has decided to unmask and you are noticing changes in your weight, it's essential to take a proactive approach to your health. The key is to balance the increase in energy expenditure from your NEAT with a corresponding increase in your energy intake.

You should aim to increase your food and drink intake to match your new energy needs. This isn't an excuse to eat unhealthy foods. The goal is to nourish your body and provide it with the fuel it needs to function properly. Focus on increasing your intake of healthy, nutrient-rich foods.

These are the healthy food groups you'll need to consider increasing in your diet:

• Proteins

  Proteins are essential for building and repairing your body and for maintaining your muscles. Without protein, exercise wouldn't do you any good, which is why body builders eat extra protein before they work out. Protein also helps you feel full after a mean, which means you don't feel so much like reaching for less nutritious snacks (like chocolate, biscuits, and ice cream!). Good sources of protein include chicken, fish, eggs, beans, cheese, milk, lentils, nuts, seeds, soya, and tofu.

• Fibre

  Fibre is crucial for a healthy digestive system, and it helps stop you getting constipated because it keeps water in your digestive system for longer, which helps you use the toilet more easily. It also helps to regulate your blood sugar levels, preventing energy crashes, which is really important if you are diabetic as well! Good sources of dietary fibre include oats, brown rice, wholegrain bread, fruits (with the skin on), and vegetables.

• Complex carbohydrates

  Complex carbohydrates are what your body turns into energy, like it does with sugar, but their complexity makes the process slower. However, sugar is a simple carbohydrate that your body uses up immediately when you eat or drink something sweet, and that causes a 'blood sugar spike', which is followed by a 'blood sugar crash' (and you feel tired or unwell). Complex carbohydrates provide a slower, more steady release of energy, which is perfect for fuelling your body throughout the day. They don't cause the 'sugar rush' and they don't mess with your blood sugar levels as much, so they're perfect food for getting healthy, long-lasting energy. Great sources of complex carbohydrates include sweet potatoes, quinoa, wholegrain pasta, and wholemeal bread.

By increasing your intake of these foods, you can provide your body with the energy it needs to support your increased movement and maintain a healthy weight.

When to seek professional advice

It's important to remember that unmasking is not a magic answer for weight loss. The changes in energy expenditure are subtle and can vary greatly from person to person. While some may experience noticeable weight loss, others may not experience any at all. The key message here is to be mindful of your body's signals and to respond to them in the right way, and at the right time.

If you find yourself losing weight quickly or unintentionally after starting to unmask, it is really important to speak to your doctor. They will be able help you in two main ways:

1. They'll give you a health check

   Your doctor will want to perform a general health check to ensure that the weight loss isn't being caused by an underlying medical condition that you don't know about yet. While your weight loss might well be linked to unmasking, it's always wise to rule out other possible causes!

2. They can send you to a dietary specialist

   Your doctor can also refer you to a registered dietitian or a nutritional specialist. These professionals can provide personalised advice on how to increase your energy intake in a healthy way to maintain your weight. They can also help you create a meal plan that fits your lifestyle, personal preferences, and nutritional needs.

So should you unmask yourself, or not?

Unmasking is a beautiful and courageous journey towards authenticity for many autistic people. It allows them to embrace their true selves and live more freely. While the emotional and psychological benefits are well-known, it's important to be aware of the physical changes that can also occur, particularly the increase in physical activity through Non-Exercise Activity Thermogenesis (NEAT).

This increase in daily movement can lead to a healthy, natural, and unplanned increase in energy use, which in turn can lead to weight loss. By understanding this connection, autistic people who are unmasking can take steps to ensure they are properly fuelling their bodies. This might mean simply increasing your food and drink intake, focusing on healthy proteins, fibres, and complex carbohydrates.

In the end, unmasking is about self-care and self-acceptance. Part of that self-care is listening to your body and ensuring it has the nourishment it needs. By being aware of the NEAT phenomenon, you can ensure that your journey to authenticity is also a journey to greater physical wellbeing.