The Relationship Between Autism Diagnostic Criteria and Problematic Eating Behaviors

Why is this research important?
Recent research demonstrates higher rates of autistic symptoms among people with anorexia nervosa and higher rates of problematic eating among people with autism. The exact nature of this relationship continues to be investigated. This study replicated previous research findings that people on the autism spectrum report more problematic eating behaviours than their non-autistic peers. In addition, contrary to the authors’ prediction, autistic participants had higher levels of weight and shape concern than non-autistic participants. These results suggest that people on the autism spectrum may experience problematic eating behaviours associated with autism (such as food selectivity, food aversion or refusal, problematic mealtime behaviour, aversion to social mealtime situations) in conjunction with, rather than instead of, typical eating disorder cognitions (such as distorted views, and relative importance of, weight and shape). Further research is needed to ascertain any differences in the types of weight or shape concerns and their respective driving and maintaining factors, and this can assist in designing and setting up the most effective interventions for autistic people experiences disordered eating and eating disorders.

Authors: Robyn L. Young, Paris Smith, Alliyza Lim and Michelle Short


Objectives: We examined problematic eating behaviors among a sample of young autistic adults to better understand the purported relationship between autism and eating disorders. We hypothesized that autistic participants would score higher on measures of problematic eating behavior compared to a non-autistic comparison group, but that autistic participants would not report elevated levels of weight and shape concern. We also conducted an exploratory analysis to examine the extent to which each autism diagnostic criterion was associated with problematic eating behavior.

Methods: Seventy-four autistic and 40 non-autistic young adults aged between 18 and 25 years completed an online survey consisting of the Eating Disorder Examination Questionnaire (EDE-Q), Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS), autism spectrum quotient (AQ), and Autism Eating Behavior Questionnaire.

Results: Autistic individuals self-reported higher levels of problematic eating behavior than non-autistic individuals as measured using the EDE-Q, NIAS, and Autism Eating Behavior Questionnaire; however, contrary to expectations, weight and shape concern were also elevated. Autism diagnostic criteria explained a combined 19.2% of the variance in EDE-Q global score and 19.0% of the variance in NIAS total score; however, individually, only diagnostic criterion B4 (sensory sensitivities) was significantly associated with EDE-Q global score, and only diagnostic criterion B3 (restricted interests) was significantly associated with NIAS total score.

Conclusions: These results suggest that autistic individuals may experience autism-focused eating behaviors in conjunction with, rather than instead of, typical eating disorder cognitions.

Access: Closed


Citation: Young, R. L., Smith, P., Lim, A., & Short, M. (2022). The Relationship Between Autism Diagnostic Criteria and Problematic Eating Behaviors. Advances in Neurodevelopmental Disorders, 1-12.



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