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According to the Centers for Disease Control and Prevention, approximately one in 54 children in the United States has been diagnosed with autism spectrum disorder (ASD). Thirty million people in the U.S. suffer from an eating disorder and this number includes all ages and genders.

Is there a connection between the two?

Existing research shows that people who have eating disorders (and in particular anorexia nervosa) or symptoms of eating disorders have higher levels of autistic traits than the rest of the population. However, all studies so far have measured these conditions at the same time. This means that it is not clear whether autistic traits precede the onset of (and could therefore be a risk factor for) eating disorders or, rather, they are a consequence of these conditions.

“In our study we wanted to investigate whether children who have high levels of autistic traits, and in particular problems with social communication, are more likely to develop symptoms of eating disorders later on in adolescence,” lead author Dr. Francesca Solmi from University College of London Psychiatry told us. “Finding this longitudinal association would support the hypothesis that autistic traits increase a person’s risk of developing eating disorders.”

There are many types of eating disorders. Anorexia nervosa involves weight loss and an extreme fear of weight gain. People with anorexia nervosa have a distorted body image.  Bulimia nervosa involves binging and purging. Binge eating involves eating large amount of food in a short amount of time but not purging. Pica involves non food items such as talcum powder, soap, dirt, or cloth. Rumination disorder involves frequently regurgitating food and is not related to bulimia or a medical condition.

As a result of the fact that this current study was the first longitudinal study exploring the question of an association between autistic traits and eating disorders, the research team did not have a predefined hypothesis based on previous evidence. 

“In clinical studies, around a fifth of women presenting with anorexia nervosa have high levels of autistic traits – and there is some evidence that these women benefit the least from current eating disorder treatment models,” Dr. Solmi told us. “Understanding whether autistic traits precede the onset of, and increase the risk for, eating disorders allows us to being to explore whether preventative interventions can be put in place to mitigate some of this risk.”

Among ten year olds in the U.S., 81 per cent say they are afraid of being fat. Researchers used data from 5,400 children who were part of a large general population study that recruited children born in 1991-1992 in Bristol (UK) and has followed them up since then. They used repeated measures of autistic traits taken when the children were 7, 11, 14, and 16 years and looked at trajectories of autistic traits among those who had eating disorder symptoms at age 14 and those who did not.

“We found that children who had eating disorder symptoms at age 14 had consistently higher trajectories of autistic traits throughout childhood and adolescence, with differences already visible at age seven years,” Dr. Solmi told us. “This suggests that autistic traits likely preceded the onset of eating disorders as these are very rare at that age.”

These results are a first step towards beginning to understand why we see this co-occurrence of autism and eating disorders in a substantial proportion of clinical cases. 

“The next steps will be to understand which mechanisms explain this association,” Dr. Solmi told us, “so that we can identify children who could benefit from potential preventative interventions.”