New Study Identifies Which Issue Comes First
Research has proven that eating disorders and autism spectrum disorder (ASD) can occur comorbidly. Over the years, study after study after study has connected these two conditions. However, determining which disorder precedes the other had never been examined until now. New research from University College London (UCL) provides an answer to this question.
UCL’s longitudinal study published in the Journal of Child Psychology and Psychiatry discovered that autism traits appear first in children followed by eating disorder behaviors later in adolescence. The research team determined the order of these conditions by using data from the Avon Longitudinal Study of Parents and Children. More than 5,300 children born in the United Kingdom during the 90s were enrolled in the study. The research team used the Avon data to look for autistic social traits in these children at ages 7, 11, 14 and 16. It should be noted that autism traits were mother-reported instead of using a formal autism diagnosis. After receiving data about autism traits, the team surveyed the same cohort at age 14 and enquired about disordered eating habits (fasting, purging, prolonged dieting, or binge eating) they may have had or currently have.
Results showed that 11.2% of girls reported at least one eating disorder 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.) Due to the longitudinal nature of the study, researchers were able to go back in time to track behaviors associated with autism from an earlier age. The 14 year olds which exhibited eating disorders showed higher traits of autism at age 7. In fact, children displaying higher autistic traits at age 7 were 24% more likely to have weekly disordered eating habits at age 14. Additional investigation indicated that eating disorders at 14 did not appear to increase traits of autism at age 16.
Dr. Francesca Solmi, leader author, states, “We have found that young children with autistic traits at age 7 are more likely than their peers to end up developing eating disorder symptoms in adolescence. Most other studies looked at snapshots in time, rather than tracking people over multiple years, so it wasn’t clear whether autism increases the risk of eating disorders, or if symptoms of eating disorder could sometimes resemble autistic traits.”
Co-author Dr. William Mandy added, “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. Around a fifth of women presenting with anorexia nervosa have high levels of autistic traits—and there is some evidence that these women benefit the least from current eating disorder treatment models. People with autism and eating disorders may need a different approach towards treatment.”
Senior author Professor Glyn Lewis agreed and stated, “Parents and other caregivers of children with autism should be aware there is an increased risk of developing eating disorders. Being alert to eating disordered behaviors and seeking help early could be helpful.”
At the study’s conclusion, the research team theorizes that changes in neurodevelopment added to the challenges that come with peer relationships around adolescence could result in difficult emotions, anxiety and low moods. Eating disorders may be a result of dealing with the challenging teen years for individuals on the spectrum.
References
Heather Westwood, Kate Tchanturia. Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Current Psychiatry Reports. May 24, 2017
Kathrin Nickel, Simon Maier, Dominique Endres, Andreas Joos, Viktoria Meier, Ludger Tebartz van Elst, and Almut Zeeck. Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Frontiers in Psychiatry. October 10, 2019.
Wentz E, Lacey JH, Waller G, Rastam M, Turk J, Gillberg C. Childhood Onset Neuropsychiatric Disorders in Adult Eating Disorder Patients. A Pilot Study. European Child Adolescent Psychiatry. December 14, 2005.
Francesca Solmi, Francesca Bentivegna, Helen Bould, William Mandy, Radha Kothari, Dheeraj Rai, David Skuse, Glyn Lewis. Trajectories of Autistic Social Traits in Childhood and Adolescence and Disordered Eating Behaviors at Age 14 Years: A UK General Population Cohort Study. The Journal of Child Psychology and Psychiatry. May 2020.
