Is There a Link Between Anorexia in Girls and Autism?


New research has highlighted a possible link between autistic behavior and anorexia in girls and young women.

The study, conducted by leading autism expert Simon Baron-Cohen and team at Cambridge University’s Autism Research Centre, found that young women presenting with the eating disorder anorexia nervosa were more likely to also display characteristics associated with autistic behavior.

The study, which is published this month in the BioMed Central journal Molecular Autism, took a group of 66 girls aged 12-18 who all had anorexia but had not been diagnosed with autism and scored them on classic tests used to measure autistic traits including the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ).

The researchers then compared these results to a control group of more than 1,600 average teenagers within that age range.

While almost every person will exhibit some behaviors that appear to place them on the autism spectrum, it is the sum total of these measures that would actually suggest autism. What the researchers found was that teenagers with anorexia exhibited five times more autism-linked behaviors than the control group of so-called average girls.

What does this mean? Well, to understand that we first have to have a view of the two conditions.

Anorexia nervosa is an eating disorder that clinicians diagnose using benchmarks like a refusal to maintain a minimum body weight and a preoccupation with food, weight and sometimes exercise. Anorexia is thought to result from a number of causes, including but not limited to environmental and social pressures, underlying body dysmorphia and genetic predisposition. It is more commonly found among women but increasingly, teenage boys are being diagnosed. It is most often first observed during a woman’s teenage years.

Autism spectrum disorder, by DSM-5 parlance but more here on why this term is controversial, is harder to define because it is not specifically one behavioral trait or set of traits.

That said, autism is more often diagnosed in males than in females and is characterized with social and communication problems, strongly repetitive behaviors, a fear and strong resistance to change and a heightened tendency to become preoccupied, some might say “obsessed,” with certain tasks, activities or phenomena.

With this in mind, the study doesn’t necessarily mean that girls with anorexia are more likely to be autistic but it does suggest, as the researchers put it, that they share “common underlying cognitive and neural phenotypes” and that this is something doctors and care providers should be aware of when interacting with girls suffering from anorexia.

“Traditionally, anorexia has been viewed purely as an eating disorder,” lead researcher Baron-Cohen is quoted as saying. “This is quite reasonable, since the girls’ dangerously low weight and their risk of malnutrition or even death has to be the highest priority. But this new research is suggesting that underlying the surface behavior, the mind of a person with anorexia may share a lot with the mind of a person with autism.”

He went on to explain that, “In both conditions, there is a strong interest in systems. In girls with anorexia, they have latched onto a system that concerns body weight, shape, and food intake.”

With regards to treating those who suffer from anorexia, this study may be particularly illuminating. Dr. Tony Jaffa, who co-led the study, is quoted as saying, “Recognizing that some patients with anorexia may also need help with social skills and communication, and with adapting to change, also gives us a new treatment angle.”

The study also raises a red-flag for the parents and caregivers of young girls who have been diagnosed as autistic, as it could suggest a greater potential for developing an eating disorder. ”Shifting their interest away from body weight and dieting on to a different but equally systematic topic may be helpful,” Dr. Jaffa concluded.

That said, it should be noted that, strictly speaking, autism’s heightening the risk of developing anorexia wasn’t tested for in this study and so is only speculation at this juncture until more research is carried out on this specific question.

Regardless of this, the study provides an opportunity for greater insight into the serious and even sometimes fatal condition of anorexia and as such is particularly valuable as a starting point for wider research into an anorexia-autism spectrum disorder link.

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