Anorexia & Autism: The Connection.

Anorexia Nervosa (henceforth referred to as ‘anorexia’) is an eating disorder, diagnosed by a refusal to maintain a minimum body weight and a preoccupation with food and weight. Anorexia largely affects females, has an adolescent onset and is associated with above-average Intelligence Quotient (IQ). In the present study, scientists at Molecular Autism investigated whether there is any link between anorexia and autistic traits, despite the fact that superficially these seem very different. Autism spectrum conditions (ASC) are diagnosed far more often in males than in females. They are neurodevelopmental conditions, diagnosed on the basis of social and communication difficulties alongside unusually narrow interests (pejoratively called ‘obsessions’), strongly repetitive behavior, and a resistance to change.

There are several reasons for considering that anorexia and autistic traits may be linked. First, anorexia involves rigid attitudes and behavior, which can be seen as resembling the unusually narrow interests and rigid and repetitive behavior in autism, but in anorexia happen to focus on food or weight. Second, patients with anorexia are often extremely self-preoccupied (about their own weight, or their right to do what they want), and the word ‘autism’ literally means an exclusive focus on the ‘self’. A preoccupation with the self can present as a failure to empathize, for example, with the stress their behavior causes their family, and this resembles the social difficulties in autism. Third, both autism and anorexia show social anhedonia, difficulties understanding theoretical problems, and alexithymia (difficulty in reflecting on one’s own emotion).

For these reasons, it is possible that autism and anorexia share common underlying cognitive and neural phenotypes. The fact that these two conditions can be related is at least in line with this view, although relation alone does not help us understand why they are associated. The fact that many children with autism are ‘picky eaters’ and resist eating new foods provides another impetus for investigating the link between anorexia and autism further, as does the finding that girls with AS score significantly higher than controls on the Eating Attitudes Test (EAT)-26, a screening instrument for eating disorders.

As predicted, the patients Clinicians should consider if a focus on autistic traits might be helpful in the assessment and treatment of anorexia. Future research needs to establish if these results reflect traits or states associated with anorexia.

The study can be found here.

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