"For Me, the Anorexia is Just a Symptom, and the Cause is the Autism": Investigating Restrictive Eating Disorders in Autistic Women.
Janina Brede, Charli Babb, Catherine Jones and 6 others
PMID 32274604WHAT IT FOUND
Autistic women with anorexia described their eating disorder as a coping mechanism for autism-related distress, not primarily driven by weight concerns.
Restriction served to numb sensory overload, regulate confusion, and create predictability. This suggests standard anorexia treatments may fail if they ignore the underlying autism.
Key findings
01Participants identified six interconnected themes explaining how autism traits contribute to restrictive eating: sensory sensitivities, social interaction difficulties, self and identity issues, emotional difficulties, thinking styles, and need for control.
02Most autistic women reported that weight loss was not the initial aim of their eating disorder but a secondary consequence of behaviours used to feel calm or manage sensory and emotional overwhelm.
03Healthcare professionals observed that autistic women's motivation for food restriction often related to sensory properties of food rather than calorie or fat content, distinguishing them from non-autistic women with anorexia.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on self-reported autism diagnoses and the AQ-10 screening tool, which the authors note has low internal consistency in this sample and may not reliably detect autism traits in eating disorder populations. The sample was exclusively female, so findings may not apply to autistic males or non-binary individuals. All participants received their autism diagnosis in adulthood, often years after their eating disorder onset, which may affect how they interpret their past experiences. As a qualitative study, it generates hypotheses and themes but cannot prove causality or test the effectiveness of treatments. The theoretical model is based on interpretation of interviews and requires further empirical testing.
Declared interests
The authors declare no conflicts of interest. The study was supported by Autistica and the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre.
The easy way to misread this
Do not assume that the absence of reported weight or shape concerns means the patient is not suffering from Anorexia Nervosa. The study found that for autistic women, restrictive eating often serves functions like sensory regulation or emotional numbing, which may look like ARFID or other presentations but are diagnosed as AN in this cohort.