Young people with autism or autistic traits are more likely than others to develop mental health disorders. According to Autistica, seven in ten people with autism have mental health challenges. These challenges can make it harder for autistic people to enjoy their lives and pursue the things they love the most.
Eating disorders are one type of mental health disorder that seem to affect autistic young people more than other people. Young autistic people may show different disordered eating behaviours, such as using food to cope with emotions or placing a lot of their self-value on body shape or weight.
These behaviours can seriously affect both the physical health and mental well-being of young people, preventing them from living the life they deserve.
The good news is that, with effective treatment, young autistic people can recover from eating disorders and other mental health conditions. Research can also help us to spot the early signs of disordered eating and identify those who are most at risk, preventing their development in the first place.
This blog looks into the relationship between autism and eating disorders, exploring possible explanations behind the link. It also outlines some of the treatment options available for young people with disordered eating behaviours.
Understanding Autism in Young People
Autism is a spectrum of developmental conditions that affect the way young people experience and interact with the surrounding world. Every autistic young person is unique. Some can live independently, while others may require specialist support with aspects of daily life.
Some symptoms of autism spectrum disorder include:
- delayed speech
- difficulties concentrating, listening, or understanding
- finding it hard to express emotions
- understanding things literally
- having restricted interests
- heightened or reduced sensitivity to smell, colour, sight, or touch
Autism is not a mental health problem, but a way of processing the world. It can bring young people challenges, but also great joy. Treating young autistic people with respect and understanding is fundamental to creating a world where young people with ASD can flourish.
How Common Are Eating Disorders Among Autistic People?
While research surrounding autism and eating disorders is still limited, recent studies suggest that autistic people are at a higher risk of developing eating disorders than people who are not autistic.
A 2016 study among adults with autistic spectrum disorder (ASD) and/or ADHD found that 10.8% of those with ASD had a feeding or eating disorder. Specifically, 6.7% had anorexia nervosa, 2.7% bulimia nervosa, and 1.4% binge eating disorder.
Their results suggest that eating disorders are more common among people with ASD (and ADHD) than the general population.
They also found that while among the general population, more females than males are diagnosed with eating disorders, among the people with ASD or ADHD there wasn’t a significant difference.
Another study among adolescent girls found that those with Asperger’s syndrome (a form of autism spectrum disorder) were at a higher risk of developing eating disorders than their peers. 26.8% of those with the disorder scored above the eating attitudes test cut-off point, compared to only 7.1% without.
In 2020, a study among 14-year-old children in the UK found that greater autistic traits in childhood could increase the risk for eating disorders during adolescence.
Adolescents with disordered eating behaviours showed more autistic traits than those without, at several points during childhood and adolescence.
Are People With Eating Disorders More Likely to Be Autistic?
Some research also shows that people with eating disorders, specifically anorexia nervosa, may show autistic traits. Studies have found that people with a current diagnosis of anorexia nervosa, as well as those who have recovered, are more likely to meet the DSM-5 criteria for autism spectrum disorder than other people. They suggest that the prevalence of autism in adults with eating disorders is between 20-30%.
The National Specialist Eating Disorders Service at Maudely Hospital in the UK also found high rates of eating disorders among the women that they see. They found that 35% of women met the criteria for ASD, often those with more severe mental health conditions.
What Might Autism and Eating Disorders Be Linked?
Scientists still aren’t sure how to conceptualise the link between autism and eating disorders. Some experts think that both autistic people and people with eating disorders may share some common characteristics.
The term autistic traits describes characteristics that are similar to traits of autism spectrum disorder, such as difficulties in expressing emotions and having restricted interests.
All kinds of people can show autistic traits, although they are more likely in certain groups, such as family members of autistic people. The concept of autistic traits helps us to understand autism as a spectrum, where people may share some autistic traits even when they do not meet the criteria for a diagnosis.
Some autistic traits, such as perfectionism, difficulties coping with change, and restricted interests, are also common characteristics of young people with eating disorders. These traits may manifest with a focus on weight, body shape, and food. For example, young people with eating disorders may be perfectionists about having a certain body shape or follow strict eating routines.
The over-evaluation of shape and weight and preoccupation with eating may also be conceptualised as a restricted interest that may dominate other aspects of daily life.
People with eating disorders may also think and act in social situations in ways that are similar to autistic people.
People with anorexia nervosa are more likely to experience social anhedonia and alexithymia – an inability to enjoy social situations and difficulty expressing emotions – and process emotions in different ways. These are also traits that are found among autistic people.
It’s not clear if or how the common characteristics of eating disorders and autism explain the prevalence of eating disorders among autistic people.
It may be that having autistic traits makes a person more prone to developing an eating disorder and more likely to develop disordered eating behaviours.
On the other hand, it’s possible that a link between autism and eating disorders is not related to specific characteristics, but more general explanations. Autism is also linked to many other mental health disorders, including depression and anxiety. Things like rejection from peers, stigma, difficulties navigating situations of daily life, and challenges forming friendships may make the development of eating disorders – and other mental health conditions – more likely.
Finally, it’s important to note that research connecting autism and eating disorders is still limited. More studies are needed to better understand the relationship and the explanations that underpin it.
Treating Eating Disorders in Young Autistic People
Recovery from eating disorders can be challenging, but with the right support, young people can reclaim a healthy future.
Because young autistic people usually respond differently to treatment approaches than other young people, they should have access to specialist recovery programs that understand and reflect their needs.
Cognitive Remediation Therapy (CRT) and Cognitive Remediation and Social Skills Training (CREST) are two therapies that may support autistic people with eating disorders. These modules support young people with thinking skills like planning, problem-solving, and switching between tasks.
Improving cognitive flexibility (the ability to move between tasks and adapt to new circumstances or events) may be particularly important for recovery from eating disorders, which often involve rigid thinking and fixation with certain goals.
Therapists have also found that flexibility in the length and pace of sessions can help autistic people to benefit from treatment. This might mean offering longer sessions to someone with a slower processing speed or offering regular breaks if someone has difficulty concentrating.
Equally, explaining to autistic people what to expect from treatment before they begin the process can help reduce anxiety about the process.
It’s also important that treatment settings are comfortable for young people with autism. Autistic people often find standard treatment settings over-stimulating because of their heightened sensitivity to light, sound, and touch.
These sensitivities can also cause autistic people to avoid foods with certain textures or prefer food with simple flavours.
With consideration and care, treatment can support young autistic people to overcome disordered eating behaviours and address underlying issues, promoting full recovery and positive growth.
As research continues, so does our understanding of autism and eating disorders, and how treatment can best address their needs.
The Wave Clinic: Specialist Recovery Programs for Young People
The Wave Clinic offers specialist recovery programs for young people, supporting them to plan and build better futures.
Our whole-person approach combines clinical excellence with education, community work, and a gap year experience, helping young people to rediscover their dreams – and develop the skills to follow them.
Our philosophy is founded on inclusivity and fairness, supporting every young person regardless of their presenting needs. We’re specialists in neurodiverse disorders like autism spectrum disorder, ensuring young autistic people receive the dedicated, tailored, and expert care they deserve.
If you would like to find out more about our programs, contact us today. We’re here to help.