Although there is limited research on the topic, some experts theorize that autistic people are more likely to develop eating disorders. The unique needs of autistic individuals may also complicate treatment.
Several studies have found much higher rates of autism among people with eating disorders. For example, in one 2017 study of women with anorexia, around 23% met the diagnostic criteria for autism.
Research into the co-occurrence of these diagnoses is ongoing, but some recent research suggests the two have a bi-directional relationship. This means that being autistic increases a person’s risk of anorexia, and having anorexia increases their chance of being autistic.
Some autistic traits — such as the tendency to prefer consistency or have food aversions — may make someone more prone to developing disordered eating habits.
Read on to learn more about the connection between autism and anorexia.
Numerous studies suggest that autistic people are more likely to have anorexia and that those with anorexia are more likely to be autistic.
For example, a 2021 review emphasized that more autistic traits tend to precede anorexia. A 2017 review showed that individuals with more autistic traits also had more obsessive-compulsive tendencies, which are often present in people with eating disorders.
Individuals with anorexia tend to have these same tendencies and use food restrictions, which can present as a compulsion, to manage anxiety, which can present as an obsession.
Autistic individuals also tend to have repetitive and restrictive behaviors, such as a limited number of safe foods, a desire for sameness, or difficulty with change. In addition to increasing a person’s risk of anorexia, this can also make treatment particularly challenging.
Research consistently finds higher rates of anorexia in autistic individuals. However, most research involves examining the rates of autism among people undergoing anorexia treatment.
A 2023 study found that 27.5% of young women seeking eating disorder treatment had a high number of autistic traits. While 10% had a preexisting autism diagnosis, an additional 17.5% gained an autism diagnosis while in treatment.
Another small 2017 study of young women seeking anorexia treatment found a similar autism rate at 23.3% of 60 women.
It is important to note that both studies included female participants, so these statistics are not applicable to a larger population. Doctors also frequently undiagnose or misdiagnose eating disorders in males.
Autism is a type of neurodivergence that does not require treatment. However, a person may seek treatment or accommodations for symptoms that cause difficulty in daily life, such as anxiety.
Despite this, anorexia is a serious eating disorder that requires treatment and support.
It is important that loved ones help a person seek treatment, as anorexia can be particularly challenging to manage in autistic people. A 2020 systematic review emphasized this, noting that autistic individuals may have a longer course of anorexia.
While individual treatment plans vary from person to person, treatment for anorexia generally includes:
Nutritional support: A person will work with a dietitian to learn optimal eating habits and regain or maintain weight. They may also need to stay in the hospital until their weight and vital signs stabilize.Physiological support: If a person has anorexia-related complications, such as organ damage, they may need additional treatment. Psychological support: Therapy focuses on helping a person manage the anxiety that underlies anorexia. In therapy, they will talk about their emotions, cultivate new coping skills, and slowly work toward healthier eating and food behaviors.Medication: No specific medication can treat anorexia. However, a doctor may prescribe medication to manage symptoms such as depression and anxiety.
Some people with eating disorders seek inpatient treatment. These can be beneficial as they provide all the care a person needs in a single location.
However, treatment outcomes are generally more negative in autistic individuals, so treatments need to accommodate someone’s unique needs.
For example, group treatment may induce anxiety, and disruptions in a person’s daily routine may be especially distressing. Sensory sensitivities, needs, and other differences may affect treatment.
Those giving treatment must be mindful of the unique needs of autistic people. Family members and loved ones can also advocate for the individual’s wants and needs.
Autistic individuals may need additional support to manage eating disorder symptoms. This includes accommodations at work or school and fostering an autism-aware treatment environment.
Online and in-person support groups can provide additional support.
Some places to start the search for support include:
Some questions to ask a doctor include:
What are the safest and most effective treatments available? Can you recommend a treatment center that has experience with autistic individuals? How can I tell the difference between autistic sensory sensitivities and eating disorder symptoms? What are some signs that I might be relapsing? What do I need to do to mitigate the health effects of an eating disorder?
Being autistic is a risk factor for anorexia and means someone may have more difficulty responding to treatment and recovering.
A person may need to advocate for themselves or find treatment that centers around their needs.
They may need support to detect signs of a relapse and require education about both diagnoses. However, with the right support and treatment, people can recover from anorexia.
