Eating Problems in Autistic Females and Males: A Co-twin Control Study.

The sample was not randomly selected from the general population; it was enriched for twin pairs with autism or ADHD, which may affect generalizability. Eating problems were assessed via self-report (SWEAA), which requires participants to have the insight and ability to report their behaviors accurately. The SWEAA questionnaire does not fully cover central eating disorder symptoms like fear of gaining weight or binge eating, so the study cannot draw conclusions about clinical eating disorders. The sample included six participants with mild intellectual disability, for whom the SWEAA has not been validated, although excluding them did not substantially change the main results. The study was underpowered to detect small effect sizes, particularly in the within-pair analyses.

The study was funded by Vetenskapsrådet, Svenska Forskningsrådet Formas, Hjärnfonden, Region Stockholm, the Innovative Medical Initiatives (IMI), and Karolinska Institute. No conflicts of interest were reported.

Do not interpret the finding that the association between autistic traits and eating problems was lost in monozygotic pairs as proof that autism does not cause eating problems. The authors state this interpretation should be made with caution because the confidence intervals for monozygotic and dizygotic pairs overlapped, and the sample size for within-pair analyses was limited.