Understanding the link between disordered eating and Autism Spectrum Disorders

A number of studies have suggested a possible link between anorexia nervosa and autism. Whilst there aren’t enough reliable studies to tell us exactly how many people with anorexia will also have autism, it is recognised that there is a strong overlap in symptoms, and that higher rates of autistic traits are found in people with anorexia than in the general population. Often, especially if anorexia has been present from an early age, the presence of an autistic spectrum disorder may not have been picked up.

The following symptoms may be common to both anorexia and autism

• rigid behaviours around food

• high levels of anxiety

• difficulties sensing hunger

• social and emotional difficulties

• preference for rule based, rigid routines

• attention to detail rather than ability to see the bigger picture

The relationship between anorexia nervosa and autism is complex however, and not yet fully understood. There are a number of possible ways in which the two distinct disorders could be related:

• Symptoms common to both disorders may suggest an underlying neurodevelopmental disorder making people vulnerable to both difficulties.

• Starvation present in anorexia may result in symptoms similar to those found in individuals with autism.

• People with autism may struggle socially and emotionally and therefore be at higher risk of developing anorexia as response.

• People with autism often exhibit picky and rigid eating and may therefore be more susceptible to anorexia through resulting low weight.

There is some evidence that anorexia is harder to treat in individuals who have autism. The presence of autism is likely to mean that treatment needs to be adapted, and that more skills based approach, including dietetics and occupational therapy will be beneficial in helping people to recover from their anorexia.