Autism and eating disorders: What’s the connection?

Eating disorders (EDs) are mental health conditions that impact a person’s relationship with food and create challenges with eating. Left untreated, they can seriously compromise a person’s mental and emotional well-being, as well as their physical health. Autism spectrum disorder falls into a different category of mental health conditions. Autism is a neurological and developmental disorder. As a form of neurodiversity, it can affect the way a person thinks, feels, and behaves in various ways. 

These two types of mental health conditions might seem very different. But research shows that many people who have eating disorders also live with autism. Exploring the link between autism and eating disorders can help ensure that people living with these conditions get access to timely intervention and the support they need to nourish their minds and bodies.

Where autism and eating disorders overlap

Autism can cause difficulties related to eating and diet. For example, one common symptom of autism is sensory sensitivity. This might create discomfort around certain food textures, smells, or tastes. 

Additionally, some people with autism have social or communication differences. This might make it harder for them to describe what they need in terms of diet and eating habits. 

People with autism can have challenges related to food and eating without meeting the diagnostic criteria for an eating disorder. But it’s important to pay attention to these symptoms because of their potential health impacts. 

Research shows that between 4% and 23% of people with autism also have an eating disorder. While we don’t fully understand the reasons for this overlap, it could be due to:

• Feeling socially outcast and thinking that weight loss might help them fit in with neurotypical people
• Using food as a way of soothing uncomfortable emotions, like anxiety
• Developing rigid routines related to exercise or food that negatively affect their health
• Hyperfocusing on counting calories or monitoring food in other ways
• Difficulty identifying the body’s natural hunger or fullness cues

Autism and anorexia

Anorexia is an eating disorder that causes people to significantly restrict their food intake and fear gaining weight. It can lead to dangerously low body weight, malnutrition, and many other serious health concerns. Anorexia is believed to be the most commonly diagnosed eating disorder among people with autism. 

Researchers have identified two main reasons for this link. First, unlike neurotypical people — who may develop an ED in response to their desire to achieve an idealized body type — people with autism may have a heightened need for control around routines, predictability, and sensory sensitivities. This can impact eating, cooking, and grocery shopping in ways that can lead to disordered eating. Additionally, many people with autism experience difficulty in identifying physical cues like hunger.

Autism and ARFID

Avoidant/restrictive food disorder (ARFID) is an eating disorder characterized by a refusal to eat certain foods. It can also cause disinterest in food or eating and a fear of choking or gagging when eating. 

The link between autism and ARFID may be due to both conditions causing heightened taste sensitivity. Recent findings also suggest that both conditions are highly heritable. So if you have a close relative who also has ARFID, autism, or both, you may be more likely to have these conditions. 

Autism and pica

Pica is an eating disorder that causes a person to consume inedible items. Eating non-food items like dirt, hair, or soap can cause nutritional deficiencies and digestive problems. It can also lead to safety concerns, like poisoning. 

The sensory sensitivities brought on by autism may increase a person’s risk of developing pica. This is because eating non-food items may provide the heightened sensory feedback that many people with autism crave.

Autism and binge eating disorder

Binge eating disorder (BED) makes it difficult to control one’s food intake. It involves consuming larger amounts of food than intended within a short timeframe. 

We don’t fully understand all the causes of BED. But research shows that people who binge eat may do so, in part, as a way to regulate or soothe uncomfortable emotions. Since people with autism may also struggle with emotional regulation, this may put them at greater risk for developing BED.

Autism and bulimia

People with bulimia cycle between binging large amounts of food and purging the food from their bodies through vomiting, laxatives, or exercise. There is limited research on the link between autism and bulimia. 

However, some experts believe that it could be due to attention-deficit hyperactivity disorder (ADHD), which often occurs with autism. Since many people with ADHD also live with bulimia, this may explain the overlap between bulimia and autism.

Can autism cause eating disorders?

As we’ve explored, eating disorders are more prevalent among people with autism. But this doesn’t mean that autism is a standalone cause for eating disorders. Instead, eating disorders are believed to be caused by a variety of factors, including:

• Genetics: Having a history of eating disorders in your family
• Biology: Differences in brain chemistry 
• Mental health: Living with a co-occurring mental health condition, like depression
• Environment: Experiencing trauma, like bullying related to weight
• Dieting: Frequent dieting, including periods of starvation 

Treatment for people with autism and eating disorders

People with autism may develop eating disorders for different reasons than people without autism. For example, they might not be concerned with maintaining a certain weight or body type. Rather, their disordered eating habits might be the result of sensory sensitivities, difficulty changing routines, or emotional dysregulation. 

So instead of traditional eating disorder therapies, people with co-occurring autism and an eating disorder may benefit from:

• Social skills interventions
• Occupational therapy
• Visual learning tools
• Evaluation of sensorimotor concerns, specifically those related to eating
• Gradually introducing new foods and new routines related to foods

Find care with Rula

Autism and eating disorders often go hand in hand. And while living with co-occurring conditions can be a challenge, you can heal your relationship with food and form healthy eating habits with the right support. 

At Rula, we make it easy to connect with therapists who understand the unique link between autism and eating disorders. When you need care for your mental health, we invite you to explore our therapist-matching program. In just a few clicks, you can select a provider who takes your insurance and schedule your first appointment for as soon as tomorrow.

Find a therapist with Rula