The overlap between autism and eating disorders

In recent years, research has found an association between eating disorders and autism, which has led to a growing interest in this area and how to better support autistic people with eating disorders.

Research has shown that autistic women have an elevated risk of developing anorexia nervosa, with research highlighting an estimated 20-35% of women with anorexia nervosa (AN) meeting criteria for autism (Westwood and Tchanturia, 2017). A further study of children and adolescents with restrictive eating disorders found that 16.3% of those with AN were also autistic (Inoue, et al., 2021).

Scroll down to see a lived experience video on the interplay between autism and eating disorders.

Some areas of overlap between eating disorders and autism include:

(Brede, 2020)

Sensory sensitivities 

Sensory sensitivities can contribute to autistic people’s eating disorders. This may be through food-specific sensitivities, sensory overload, and internal bodily sensations causing discomfort and confusion. This may cause autistic individuals to struggle in a treatment environment or clinical setting due to noise, touch and certain lighting. For some autistic young people, the effects of starvation on the body may contribute to numbing overwhelming sensations.

Social interaction and relationships

Autistic people may struggle with social communication and interaction and some may have had experiences of bullying, loneliness, and abuse. Some autistic individuals may use eating to cope with social difficulties, distract themselves or numb any consequent emotions. Often, the onset of eating disorders in autistic people coincides with social difficulties occurring.

Self and identity

Autistic people may struggle with their identity, sense of self, feeling different or not fitting in. For some, they may immerse themselves in eating disorder behaviours to cope with the emotional upset. Autistic individuals may use dieting and focussing on their appearance as a way to fit in with peers or establish a sense of identity.

Emotional difficulties 

There are overlapping emotional difficulties that autistic people and people with eating disorders may struggle with. This may include identifying, regulating, and communicating their emotions. In turn, this may result in emotional confusion and feeling overwhelmed. Struggling to find an alternative way of coping with these extreme emotions may be a challenge in eating disorder recovery for autistic individuals.

Thinking styles

There are several thinking styles that autistic people often have that may contribute to or exacerbate eating disorder cognitions. This may include rigid or literal thinking, obsessive and intense interests and developing rules around food/eating then struggling to shift focus from these rules once they have been established.

Preference for predictability

Autistic individuals may struggle to cope with change and have rigid thinking styles. This in turn creates a need for predictability to help them manage these difficulties. Those with eating disorders may turn to food to meet this need and sometimes control their intake in a ritualised fashion. Being able to create predictability and rules, struggling with change and needing control are all factors that may make recovery from an eating disorder more of a challenge for autistic individuals.

There are many strengths connected with autism that can support people in eating disorder recovery. It is so important to recognise, respect and champion autistic individuals.