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Analyzing the Relationship Between Autism and Eating Disorders


With April being Autism Awareness Month, it brings upon a critical opportunity to deepen our understanding of the intersection between autism spectrum disorder (ASD) and eating disorders. 

 

Autism spectrum disorder is characterized by difficulties in socializing, sensory processing, executive functioning, and communication to name a few (APA, 2013). Autism is a spectrum disorder which means that each individual will vary in their severity and experiences of symptoms. Although more research on ASD has occurred within the past few years, research on the relationship between ASD and the development of eating disorders remains sparse.  

 

Autism and Eating Disorders

 

In 1983, Christopher Gillberg was the first to identify that ASD and anorexia co-occurred within families setting off an interest to look into this relationship further (Brede et al., 2020). It has been found that autistic women are at a higher risk of developing anorexia than women within the general population (Brede et al., 2020). Furthermore, Nickel and colleagues (2019) performed a systemic literature review and found that approximately 4.7% of individuals with anorexia, bulimia, or binge eating disorder had an autism diagnosis. Research on this area is new, but understanding why autism and eating disorders correlate is essential to properly inform intervention, treatment, and prevention strategies. 

 

What has been found so far…

 

Diagnostic Issues

Autism spectrum disorder has often been seen as a “boy’s disorder” and research on ASD has often used male samples. This influences the way that ASD is understood and leaves girls and women vulnerable to being undiagnosed or misdiagnosed (Lockwood Estrin et al., 2020; Young et al., 2018). What this means is that the rates of autism diagnoses in women may not be an accurate representation of how many women are autistic. When autism goes undiagnosed it can have severe mental health effects on the individual, including the development of eating disorders (Westwood & Tchanturia, 2017). As well, these individuals with missed or misdiagnoses may not be given adequate support and treatment for their eating disorders.

 

Repetitive and Restricted Behaviours

Repetitive and restricted behaviours (RRBs) are displayed by some autistic individuals and refer to when they have strict routines and hyper-focused interests. It is hypothesized that RRBs among autistic individuals may present as one being extremely interested in calories or food(Westwood & Tchanturia, 2017).  

 

Sensory Sensitivities

Many autistic individuals have sensory processing difficulties, including being hyper-sensitive to certain sounds, smells, tastes, and textures. Sensory sensitivities may impact how selective an autistic individual is with their food. This means that an autistic individuals’ reasoning for avoiding food may relate to its sensory properties (Brede et al., 2020). 

 

Social Communication 

Being autistic may make it more difficult for individuals to get help for their eating disorders because of the difficulties they face, such as with social interactions (Westwood & Tchanturia, 2017). This may greatly impact one’s quality of life as they may not be receiving the necessary support and interventions needed to get better. 

 

Alexithymia 

Alexithymia refers to when an individual has trouble understanding why they feel a certain way. They lack introspection and cannot recognize or describe the emotions they are feeling (Perina, 2023). When looking at how this can relate to eating disorders, Brede and colleagues (2020) found that autistic individuals who had introspective difficulties may participate in restricting food intake or binge eating. One individual from the study stated, “I don’t really fully understand my thirst and hunger responses, or my fullness responses, so that really influences my eating because I can binge or miss meals very, very, easily” (Brede et al., 2020). 

 

 

The relationship between autism and eating disorders is not well understood and there is a need for continued research in this area. Having a more comprehensive understanding about the diverse challenges faced by autistic individuals who have eating disorders is necessary to provide proper support. As well, this research can help to identify common risk factors and possible underlying mechanisms to provide more targeted strategies. Autism and eating disorders are both stigmatized within society and promoting greater awareness of them can help to challenge the misconceptions seen in the world today. 

 

Note: This article uses identity-first language as this is the preference of most autistic individuals. We acknowledge that some individuals prefer person-first language, i.e. “individuals with autism” instead of “autistic individuals.”

 

 

References


APA. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American 

Psychiatric Publishing; 2013.

Brede, J., Babb, C., Jones, C., Elliott, M., Zanker, C., Tchanturia, K., Serpell, L., Fox, J., & 

Mandy, W. (2020). “For Me, the Anorexia is Just a Symptom, and the Cause is the Autism”: Investigating Restrictive Eating Disorders in Autistic Women. Journal of Autism and Developmental Disorders, 50(12), 4280–4296. https://doi.org/10.1007/s10803-020-04479-3

Lockwood Estrin, G., Milner, V., Spain, D., Happé, F., & Colvert, E. (2020). Barriers to autism 

spectrum disorder diagnosis for young women and girls: A

systematic review. Review Journal of Autism and Developmental Disorders, 8(4), 454–470. https://doi.org/10.1007/s40489-020-00225-8

Nickel, K., Maier, S., Endres, D., Joos, A., Maier, V., Tebartz van Elst, L., & Zeeck, A. (2019). 

Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Frontiers in Psychiatry, 10, 708–708. https://doi.org/10.3389/fpsyt.2019.00708

Perina, K (2023, October 12). Autism and Alexithymia. Psychology Today. 

Westwood, H., & Tchanturia, K. (2017). Autism Spectrum Disorder in Anorexia Nervosa: An 

Updated Literature Review. Current Psychiatry Reports, 19(7), 41–41. https://doi.org/10.1007/s11920-017-0791-9

Young, H., Oreve, M.-J., & Speranza, M. (2018). Clinical characteristics and problems 

diagnosing autism spectrum disorder in girls. Archives de Pédiatrie,

 


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