A recent study at University College London found that autistic traits in childhood come before behaviors characteristic of eating disorders, and so could be a risk factor for developing eating disorders.
The study is published in the Journal of Child Psychology and Psychiatry. The lead author is Dr. Francesca Solmi (UCL Psychiatry).
Previous research has found that autism and eating disorders can occur together, as 20-30% of adults with eating disorders have autism, and 3-10% of children and young people with eating disorders.
However, it has not been clear whether autistic traits result from eating disorders or precede them.
The current 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.
They examined autistic traits reported by the mother, rather than a diagnosis of autism, meaning that the study findings would involve children who do not necessarily have autism but also would include children with autism who might not have been diagnosed.
In the study group, 11.2% of girls reported at least one disordered eating behavior within the previous year (7.3% experience them monthly and 3.9% weekly), compared to 3.6% of boys (2.3% monthly and 1.3% weekly).
Adolescents with eating disorders showed higher levels of autistic traits by age seven, suggesting that the autistic traits predated the disordered eating (as eating disorders are very rare at age seven), and therefore might pose a risk factor for eating disorders.
Children who displayed higher autistic traits at age seven were 24% more likely to have weekly disordered eating behaviors at age 14.
Further analysis confirmed that eating disorders at age 14 did not appear to increase autistic traits by age 16.
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.
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 team says early intervention is so important in treating eating disorders and they hope this research will help parents and clinicians spot early signs of an eating disorder more rapidly and ensure those at risk of developing an eating disorder get the help they need.
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.
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