A recent study suggests that 20 to 30% of adults diagnosed with eating disorders are also diagnosed with Autism Spectrum Disorder (ASD), “a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication  .”
While this connection has been established for some time, as with many co-occurring disorders, researchers and mental health professionals found themselves in a “chicken-or-the-egg” situation. That is, does an ASD diagnosis precede disordered eating, or is it a result of disordered eating?
Much of the previous research has been done with individuals seeking eating disorder treatment, making it difficult to learn which symptoms appeared first. New research published in the Journal of Child Psychology and Psychiatry has attempted to learn just that.
The direction of the relationship between eating disorders and ASD can be difficult to determine, as each disorder has some shared symptoms. Individuals diagnosed with ASD are highly-sensitive to sensory experiences such as “smells, tastes, textures, noises, and body sensations .” If these sensory experiences are uncomfortable or harmful, these individuals will engage in avoidance behaviors.
As eating involves many of these sensory experiences, a common aversion found in those with ASD is an aversion to uncomfortable food smells, tastes, textures, color, etc. This can lead to malnutrition, arrested growth, weight loss, and many other health challenges.
The key here is that, while individuals with disordered eating behaviors may avoid foods for different reasons, the physical impact and potential for harm is the same.
Based on elements that were missing from previous research, the new study addressed a few of these missing components. For example, researchers followed participating individuals over multiple years, from birth until the ages of 16.
Additionally, researchers “investigated autistic traits reported by the mother, rather than a diagnosis of autism, meaning that the study findings would involve children who do not necessarily have autism, but also would include children with autism who might not have been diagnosed .” In all, 5,381 children/adolescents participated.
The study found that those with eating disorder symptoms showed autistic traits by the age of seven, indicating that these traits had pre-dated the disorder and may be a risk factor for disordered eating .
Additionally, those children that displayed higher autistic traits at the age of seven were 24% more likely to have weekly disordered eating behaviors by age 14 . Those experiencing eating disorder traits at age 14, however, did not experience increased autistic traits when surveyed at age 16, indicating that eating disordered behaviors did not then lead to increased ASD behaviors .
Essentially, those children with autistic traits were more likely to develop disordered eating behaviors.
This information provides increased insight into the directionality of the relationship between ASD and eating disorders. The researchers that conducted this study determined that, in the future, it will be beneficial to learn why those with ASD are at increased risk for eating disorders.
It will also be important to consider all of this information in the future to determine whether or not prevention and treatment approaches need to be adapted differently for individuals diagnosed with ASD.
Resources University College London (2020). Children with autism face higher risk of eating disorders, study finds. Science Daily. Retrieved from https://www.sciencedaily.com/releases/2020/05/200512205555.htm.  Unknown (2020). What is autism. Autism Speaks. Retrieved from https://www.autismspeaks.org/what-autism  Geraud, L. (2016). What you must know about eating disorders and the autism spectrum. Eating Recovery Center. https://www.eatingrecoverycenter.com/blog/2016/05/26/must-know-eating-disorders-autism-spectrum-lisa-geraud  Solmi, F. (2020). Trajectories of autistic social traits in childhood and adolescence and disordered eating behaviors at age 14 years: a UK general population cohort study. The Journal of Child Psychology and Psychiatry.
About the Author:
Margot Rittenhouse, MS, PLPC, NCC 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 Hope 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.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a 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 August 7, 2020, on EatingDisorderHope.com
Reviewed & Approved on August 7, 2020, by Jacquelyn Ekern MS, LPC