Eating Disorders Among Children with Autism: Risk Factors

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Many mental health conditions share common traits with eating disorders (EDs). One of the most notable of these is Autism Spectrum Disorder (ASD).

To specify, ASD is defined as “a neurodevelopmental disorder characterized by impairments in social communication and the presence of restricted and repetitive patterns of behavior and interests [1].”  Additionally, the NIMH defines an eating disorder as a fatal illness that causes severe disturbance to a person’s eating behaviors [2].

Research has yet to determine any directional or causal relationship between these two disorders, meaning there is no clear answer as to which comes first or if one causes another.

Yet, numerous studies have shown that these disorders share common traits and are often found to be co-occurring.

Common Symptoms Raise Questions

With such similar traits and symptoms, and the later onset of EDs, researchers wonder if an ED can be a symptom one develops as a result of having a disorder that falls on the autism spectrum.

Various symptoms of ASD are apparent in adults with EDs; however, fewer symptoms have been seen in young people until now. One study found “elevated levels of ASD traits in EOED participants,” stating that “young people with early-onset eating disorders (EOED) had difficulties with resistance to change, compulsive behaviors, and self-injury of comparable severity to those of participants with ASD [3].” Specifically, this study found that the shared trait of compulsive, ritualistic behaviors occurred in over 50 percent of EOED participants [3].

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With ASD symptoms being found in those with EDs, it leads many to wonder whether those with ASD have an increased likelihood of developing an ED. It is known that children with ASD have a fivefold increase in selective eating when compared to the general population [1]. Selective eating refers to “accepting only a variety of foods and refusing many foods [1].”

It is important to emphasize that selective eating does not necessarily indicate an eating disorder; however, it does indicate using food and eating to cope with symptoms of discomfort and anxiety. Research is beginning to look into whether these behaviors create higher risk of those with ASD developing an ED.

Some studies have posited that the two disorders are often linked due to similar risk factors. One study found that patients with both ASD and anorexia nervosa (AN) have significantly lower levels of oxytocin, which impacts one’s ability to love as well as their sociability. This study also noted that ASD and AN are more prevalent in patients with perinatal distress or complications.

Understanding the Connection

Girl struggling with eating disorder recoveryResearch into both ASD and EDs in children is still new. As such, it is difficult to determine directionality and causality, and it is currently unclear whether those with ASD are at higher risk of developing an ED.

What is clear is that these two disorders can display similarly and may have a connection to one another. As researchers continue to increase our understanding, it is important to be aware of the relationship these disorders share and to be vigilant when working or interacting with a loved one with ASD. Knowing the related symptoms may be key to avoiding eating disorder development in those who fall on the autism spectrum.

Image of Margot Rittenhouse.About the Author: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering.

Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


[1] Tanner, K. et al. (2015). Behavioral and physiological factors associated with selective eating in children with autism spectrum disorder. American Journal of Occupational Therapy, 69.
[2] Eating disorders (2016). The National Institute of Mental Health, Retrieved from
[3] Pooni, J. et al. (2012). Investigating autism spectrum disorder and autistic traits in early onset eating disorder. International Journal of Eating Disorders, 45:4, 583-591.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published June 8, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on
June 8, 2017.
Published on