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Autism & Eating Disorders: Understanding the Connection

Published: October 6, 2022 Updated: March 27, 2023
Published: 10/06/2022 Updated: 03/27/2023
Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is Autism?What Is Autism?
  • What Are Eating Disorders?What Are Eating Disorders?
  • Connections Between Autism & Eating Disorders5 Connections
  • Common Eating Disorders in AutismCommon Eating Disorders in Autism
  • Eating Disorders vs. Picky EatingIs It Picky Eating?
  • Are the Causes of Autism and Eating Disorders Connected?Possible Causes
  • How Are Co-Occurring Eating Disorders & Autism Treated?Treatment Options
  • How to Cope with Comorbid Autism & Eating DisordersTips for Coping
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Autism & Eating Disorders InfographicsInfographics
Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD

Autism and eating disorders often overlap. Autistic people commonly exhibit atypical eating behaviors, and this pattern is especially pronounced in childhood. Research shows that anywhere from 20-35% of women with anorexia meet the criteria for autism. Similarly, there is a high comorbidity between autism and avoidant/restrictive food intake disorder (ARFID).1

What Is Autism?

Autism is a complex neurological condition that affects how someone thinks, processes, and relates to the world. Behavioral symptoms often emerge when a child is around 1-2 years old. However, most children are not diagnosed until after age 3.2 Common autistic symptoms include language delays, avoidance of make-believe play, lack of social interactions, repetitive stimming behaviors, and difficulties with transitions. However, it’s important to note that symptoms exist on a wide spectrum.

Research shows that about 1 in 44 children has autism. It’s diagnosed four times more frequently in boys than girls.3 While once perceived as a disability, there is an ongoing conversation about destigmatizing autistic behaviors and acknowledging neurodiversity. From this framework, an autistic person simply operates differently from a neurotypical person.

What Are Eating Disorders?

Eating disorders are mental health conditions characterized by issues with food, weight gain, exercise, and control. While eating disorder symptoms vary in type and intensity, people with eating disorders generally fixate on how, when, and what they eat. They often struggle with poor body image and low self-esteem and have a marked fear of gaining weight.

Research shows that approximately 9% of the U.S population will have an eating disorder in their lifetime. And while many people assume people with eating disorders are underweight, fewer than 6% actually are. Next to opioid overdose, eating disorders are considered the most deadly mental illness, contributing to one death every 52 minutes.4

5 Connections Between Autism & Eating Disorders

Although research isn’t sure exactly why autism and eating disorders overlap, there appears to be a strong correlation between both conditions. It’s probable that they share certain risk factors and comorbidities. For instance, obsessiveness, rigidity, and themes of perfection coincide with both conditions.5

Here are five commonalities in those with autism or an eating disorder:

1. Emotional Regulation Difficulties

Struggles with emotional regulation are a common symptom in both eating disorders and autism. Problems with emotional dysregulation can exacerbate stress, and people may turn to restricting food or emotional eating to cope.

2. Obsessive Interests

Autism and eating disorders both entail a sense of rigidity. Repetitive tasks like counting calories, tracking steps, or avoiding certain types of food can become ritualistic. In a sense, a person with either condition may use these behaviors as a way to cope with stress, and maintain a sense of control.

3. Rigid Thinking

All-or-nothing thinking is a classic symptom of both autism and eating disorders. Those with either or both diagnoses perceive certain foods or situations as ‘safe’ or ‘unsafe.’ Something is ‘good’ or ‘bad.’ The body is either ‘perfect’ or a ‘failure.’ This rigid thinking is often a result of executive dysfunction.

4. Social Difficulties

Eating disorders and autism can both include relationship problems and poor connectivity to others. Autistic people often report difficulties with intimacy and forming friendships. Subsequently, people with eating disorders often struggle with fitting in or worrying about others judging them.

5. Repetitive Behaviors

Both autism and eating disorders entail ongoing, repetitive behaviors that cause significant distress when interfered. Someone with anorexia may count calories due to poor body image and a desire to lose weight. Similarly, an autistic person may ritualistically count calories or compulsively exercise, even if weight loss isn’t the intended goal.6

Common Eating Disorders in Autism

Autism can correlate with any eating disorder, but comorbidity appears to be highest with anorexia and ARFID. For instance, although only 1% of the population is autistic, and 0.3% have anorexia, 20-35% of people with anorexia are autistic.1 Some research suggests that those with autism are five times more likely to be diagnosed with anorexia than non-autistic people.6 Furthermore, statistics on co-occurring autism and ARFID are around 33%.7 Children and young adults appear to have the highest rates of comorbidities.

However, studies and statistics are likely misrepresented. Most eating disorder research focuses on girls and women, and most autism research focuses on boys and men. Therefore, there may be some inconsistencies and missing data.

Autism & Anorexia Nervosa

Anorexia nervosa is an eating disorder characterized by chronic and consistent food restriction and a preoccupation with body image. People with anorexia are hyper focused on avoiding weight gain. However, the eating disorder symptoms often represent themes of control, perfectionism, and fear. Anorexia may be a coping mechanism to avoid stress or interpersonal difficulties. These symptoms often overlap with autistic symptoms of rigidity, control, and a preference for having a strict routine.

Autism & ARFID

ARFID refers to having little to no interest in eating food. People with ARFID aren’t worried about their weight or body size, but they do experience disgust and apathy towards eating. This overlaps with autism, as autistic people often experience sensory issues and difficulties with certain food textures, smells, or tastes. This is particularly pervasive among children, and it can cause ongoing food battles.

Autism & Pica

Pica is an eating disorder characterized by compulsively consuming non-food items (such as clay, dirt, paint, or glue) that have no nutritional value. Research shows that one in four parents report their young autistic child ‘sometimes’ eats non-food items.8 This pattern likely stems from limited food preferences, sensory processing difficulties, and intellectual disabilities that make it challenging to distinguish edible food from non-food items.

Autism & Bulimia Nervosa

Bulimia refers to patterns of binge eating (eating large amounts of food rapidly) and purging (self-induced vomiting, excessive exercise, abusing diuretics or laxatives). A person with bulimia can be rigid in their thinking (i.e., having safe and unsafe foods), although they also experience the perception of “losing control.” These patterns may also be present in autism, as autistic people often experience significant distress when a situation feels out of their control.

Autism & Binge Eating Disorder

Binge eating disorder is an eating disorder characterized by routinely bingeing without taking compensatory measures. People with this condition often use food as a way to cope with stress or numb their feelings. Some research has shown that autistic people can sometimes exhibit overeating tendencies in childhood. This pattern may be due to hypersensitivity and pleasure to certain textures.9

Resources For Autism

Autism Newsletter – Free newsletter from Choosing Therapy for those impacted by autism or have a loved one on the autism spectrum. Get encouragement, tips, and latest info sent twice per week. Sign Up


Parent Training For Autism – Forta’s parent training program empowers you to help your child learn and develop through personalized therapy. Provide ABA therapy and help your child diagnosed with autism progress to their next milestone. Visit Forta


Virtual Reality Therapy – Imagine a virtual world that is safe for learners, equipping them with skills and tools they can apply in their everyday lives. Floreo teaches social, behavioral, communication, and life skills for individuals with Autism Spectrum Disorder (ASD). Visit Floreo

Choosing Therapy partners with leading mental health companies and may be compensated for marketing by Forta and Floreo.

Eating Disorders vs. Picky Eating

Autism and picky eating often go hand-in-hand. But, being picky is not inherently synonymous with disordered eating. Someone who is picky may have strong preferences about what they like (and don’t like to eat). However, their food choices aren’t directly related to body image or weight control.

A picky eater may unintentionally restrict because they feel uncomfortable eating specific foods. In serious cases, young children go through entire periods of food refusal. But the restriction isn’t about controlling intake. Picky eating is also a common symptom of sensory processing disorder (SPD), a condition associated with being very particular about certain textures, smells, or tastes.

Are the Causes of Autism and Eating Disorders Connected?

Mental illness is multifaceted, and there are no definite causations for either autism or eating disorders. Instead, a complex constellation of variables may increase someone’s chance of developing one (or both) of these conditions.

Possible causes for ASD and eating disorders include:

  • Genetics: Specific gene combinations may affect brain development and impact how cells communicate, determining the severity of specific symptoms. We are likely in the early infancy stages of this neuroscience, and researchers are still examining these relationships.
  • Family history: Families with one child with autism or an eating disorder have an increased risk of another child having those disorders. Similarly, there are links between parents having these conditions and their children having them.
  • Preterm birth: Some research shows that babies born prematurely (before 32 weeks gestation) have a greater risk of developing autism and anorexia.10,11
  • Advanced paternal age: Although there hasn’t been extensive research on this topic, some data suggests that older paternal age is associated with an increased risk for various mental health disorders, including autism and eating disorders.12
  • Environmental factors: Researchers are examining the relationship between autism, eating disorders, and different environmental risk factors, including low birth weights, prenatal exposure to pollution and pesticides, and early birth difficulties.

How Are Co-Occurring Eating Disorders & Autism Treated?

Comprehensive treatment needs to consider both the distinction and overlap of eating disorder and autistic symptoms. Effective treatment should be multifaceted, and a thorough mental health assessment is essential. For instance, many people with eating disorders may have undiagnosed autism, and vice versa.

Treatment options for comorbid eating disorders and autism include:

  • Play therapy: Play therapy provides interactive support, and it can be especially helpful for younger clients. It can help people understand their thoughts and feelings without direct talk therapy.
  • Cognitive-behavioral therapy (CBT): CBT offers guidance in modifying negative or unhelpful thinking patterns, and replacing them with healthier ones. It also introduces adaptive coping skills for coping with triggering situations.
  • Enhanced cognitive-behavioral therapy (CBT-E): CBT-E is specifically designed for eating disorders. It blends concepts of psychoeducation, cognitive restructuring, and changing problematic eating disorder symptoms.
  • Acceptance and commitment therapy (ACT): ACT blends mindfulness and behavioral interventions. This therapy ultimately helps people identify their values and live congruently with them.
  • Family therapy: Family therapy can empower people to provide support to their loved ones with an eating disorder and autism. This therapy also teaches healthy communication and reinforces boundaries and safety.

How to Cope with Comorbid Autism & Eating Disorders

At times, having comorbid autism and an eating disorder may feel challenging. Depending on the severity of your symptoms, it might also seem like things will never get better. Implementing healthy lifestyle habits and considering professional treatment can make a significant difference in improving how you feel.

Here are some ways to cope with a dual diagnosis of autism and an eating disorder:

  • Build a healthy peer support system: It’s important to have reliable friends and family who can validate you. If talking to people feels overwhelming, consider finding an online group or forum.
  • Keep your hands occupied: Sensory and fidget toys can help with the restlessness that coincides with both disorders. These objects can also encourage mindfulness.
  • Practice positive affirmations: Remind yourself that you can cope with challenging circumstances and learn from your hardships.
  • Stick to a routine: Autistic people tend to thrive with routine. Aim to build a healthy routine that balances self-care with your typical responsibilities.
  • Change your environment: If you feel stressed in a particular setting, consider leaving altogether. Before you attend an event that may feel triggering, consider brainstorming an exit strategy.
  • Hold onto grounding items: Designate a small rock, coin, or other tangible item that promotes a sense of calm. The next time you feel triggered or overwhelmed, hold onto that item as a reminder that you can get through this moment.
  • Take a few deep breaths: Close your eyes and inhale as deeply as you can. Then, exhale as deeply as you can. Repeat at least five times.
  • Find a creative outlet: Consider journaling, painting, drawing, or taking photos as part of your wellness plan.
  • Celebrate small successes: Recovery from an eating disorder is rarely linear. Make it a point to acknowledge all steps taken in the right direction, no matter how small they may seem.

Final Thoughts

Eating disorders can be deadly, and comorbid autism can complicate your symptoms and prognosis. If you are struggling, it may be time to consider seeking professional help. Choosing the right therapist is a great step in the right direction. Using an extensive online directory is a great way to get started on your search!

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Autism Newsletter – Free newsletter from Choosing Therapy for those impacted by autism or have a loved one on the autism spectrum. Get encouragement, tips, and latest info sent twice per week. Sign Up

Parent Training For Autism – Forta’s parent training program empowers you to help your child learn and develop through personalized therapy. Provide ABA therapy and help your child diagnosed with autism progress to their next milestone. Visit Forta

Virtual Reality Therapy – Imagine a virtual world that is safe for learners, equipping them with skills and tools they can apply in their everyday lives. Floreo teaches social, behavioral, communication, and life skills for individuals with Autism Spectrum Disorder (ASD). Visit Floreo

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Forta and Floreo.

For Further Reading

  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov
  • Eating Disorders Helpline
  • Eating Disorders Parent Toolkit
  • 10 Best Eating Disorders Movies
  • Best Eating Disorder Apps
  • 11 Best Books About Eating Disorders
  • 12 Best Eating Disorder Recovery Blogs
  • 15 Best Books on Autism
  • A Parent’s Guide to Autism

Autism & Eating Disorders Infographics

How Do Autism and Eating Disorders Overlap?   Common Eating Disorders in Autism   Ways to Cope with Comorbid Autism and Eating Disorders

12 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Eating disorders and autism (2022). Eating Disorders Victoria. Retrieved from: https://www.eatingdisorders.org.au/eating-disorders-a-z/eating-disorders-and-autism/

  • When do children usually show symptoms of autism? National Institutes of Health. Retrieved from: https://www.nichd.nih.gov/health/topics/autism/conditioninfo/symptoms-appear

  • Data & Statistics on Autism Spectrum Disorder (2022, March). Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/ncbddd/autism/data.html

  • Eating Disorder Statistics. (2021). National Association of Anorexia Nervosa and Associated Disorders. Retrieved from: https://anad.org/eating-disorders-statistics/

  • Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disord Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796791/

  • Anorexia’s link to autism, explained (2020, December). Spectrum News. Retrieved from: https://www.spectrumnews.org/news/anorexias-link-to-autism-explained/

  • The central role of disgust in disorders of food avoidance (2019, February). International Journal of Eating Disorders. Retrieved from: https://onlinelibrary.wiley.com/doi/10.1002/eat.23047

  • ASD, Digestive Issues, and Pica (2022, April). Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/ncbddd/autism/features/ASD-digestive-issues-and-pica.html

  • Are Autism and Overeating Linked? (2017, October). Colombian College of Arts & Sciences. Retrieved from: https://columbian.gwu.edu/are-autism-and-overeating-linked

  • Autism spectrum disorder (2022). Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928

  • Very Preterm Birth, Birth Trauma, and the Risk of Anorexia Nervosa Among Girls (1999, July). JAMA Network. Retrieved from: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/205100

  • Paternal age at childbirth and eating disorders in offspring (2017, February). KI Open Archive Home. Retrieved from: https://openarchive.ki.se/xmlui/handle/10616/45938

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Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is Autism?What Is Autism?
  • What Are Eating Disorders?What Are Eating Disorders?
  • Connections Between Autism & Eating Disorders5 Connections
  • Common Eating Disorders in AutismCommon Eating Disorders in Autism
  • Eating Disorders vs. Picky EatingIs It Picky Eating?
  • Are the Causes of Autism and Eating Disorders Connected?Possible Causes
  • How Are Co-Occurring Eating Disorders & Autism Treated?Treatment Options
  • How to Cope with Comorbid Autism & Eating DisordersTips for Coping
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Autism & Eating Disorders InfographicsInfographics
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