A new study finds that autistic traits can set the stage for eating disorders.
Previous research has found that about 20 percent to 30 percent of adults with eating disorders have autism, while up to 10 percent of children with eating disorders have autism.
But until now, it hasn’t been clear whether the autistic traits result from the eating disorders or precede them, according to researchers at University College London in England.
In their new longitudinal study, the researchers discovered that autistic traits in childhood come before behaviors characteristic of eating disorders, and so could be a risk factor for developing eating disorders.
“We have found that young children with autistic traits at age 7 are more likely than their peers to end up developing eating disorder symptoms in adolescence,” said lead author Dr. Francesca Solmi of UCL Psychiatry. “Most other studies looked at snapshots in time, rather than tracking people over multiple years, so it wasn’t clear whether autism increases the risk of eating disorders, or if symptoms of eating disorders could sometimes resemble autistic traits.”
The study involved 5,381 adolescents who have been participating in longitudinal research from birth as part of the University of Bristol’s Children of the 90s cohort study.
The researchers considered whether they had autistic social traits at age 7, 11, 14, and 16, and disordered eating — fasting, purging, prolonged dieting, or binge-eating — at age 14.
The researchers investigated autistic traits reported by the mother, rather than a diagnosis of autism. That meant that the study findings included children who do not necessarily have autism, but also included children with autism who might not have been diagnosed.
In the study group, 11.2 percent of girls reported at least one disordered eating behavior within the previous year, with 7.3 percent experiencing them monthly and 3.9 percent weekly. That compares to 3.6 percent of boys (2.3 percent monthly and 1.3 percent weekly).
Adolescents with eating disorders showed higher levels of autistic traits by age 7, suggesting that the autistic traits predated the disordered eating, according to the researchers, who noted that eating disorders are very rare at age 7.
Children who displayed higher autistic traits at age 7 were 24 percent more likely to have weekly disordered eating behaviors at age 14.
While the study did not investigate the reasons behind the relationship, the researchers point out that children with autism may have difficulties with social communication and developing friendships, which could contribute to higher rates of depression and anxiety at young ages. Disordered eating might result from dysfunctional methods of coping with these emotional difficulties, they postulate.
Other autistic traits, while not included in the specific measure of autistic social traits used, may also be linked to eating disorders, such as rigidity of thinking, inflexible behaviors, unusual sensory processing, and tendencies towards repetitive behaviors, the researchers said.
“The next step is to learn more about why those with autistic traits have a higher risk of developing an eating disorder so we can then design interventions to prevent eating disorders,” said co-author Dr. William Mandy of UCL Psychology and Language Sciences. “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. People with autism and eating disorders may need a different approach towards treatment.”
“Parents and other carers of children with autism should be aware there is an increased risk of developing eating disorders,” added senior author Professor Glyn Lewis of UCL Psychiatry. said. “Being alert to eating disordered behaviors and seeking help early could be helpful.”
The study was published in the Journal of Child Psychology and Psychiatry.
Source: University College London
Source: PsychCentral Autistic Children Face Higher Risk of Developing Eating Disorders