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The link between autism and eating disorders

Autism spectrum disorder (ASD) can affect many aspects of a person’s life, including their eating behaviors or how they respond to certain foods.

In some cases, food-related behaviors common with ASD are also commonly seen in people with eating disorders, and researchers have discovered a number of links between the conditions.1

Still, ASD and eating disorders are very complex. It can be difficult to determine which condition certain behaviors stem from or how the conditions—or any co-occurring disorders—influence each other, making diagnosis and treatment challenging.1

Learning more about the connections between eating disorders and ASD can help you recognize signs of disordered eating in a loved one and help them find the appropriate type of care.

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people communicate, interact with other people, learn, and behave.
 minutes read
Last updated on 
April 4, 2024
Autism and eating disorders
In this article

What is autism spectrum disorder?

Autism spectrum disorder is a neurological and developmental disorder that affects how people communicate, interact with others and their environment, learn, and behave. 

As it’s medically defined today, the condition incorporates symptoms previously prescribed to four separate disorders:2

  • Autistic disorder
  • Asperger’s disorder
  • Childhood disintegrative disorder
  • Pervasive developmental disorder not otherwise specified

It was changed to a “spectrum disorder” in the latest edition of the Diagnostic Statistical Manual of Mental Disorders (DSM) to help explain not just the wide variety of characteristics that can present as part of the condition but the different levels of severity with which these characteristics can manifest.2

The new definition also stipulates that someone diagnosed with ASD be showing symptoms since early childhood, even if the symptoms weren’t recognized as part of ASD until later on in life.2

Social characteristics of autism

Social communication differences may include:2,19

  • Failure to initiate or respond to social interactions
  • Responding inappropriately in conversation
  • Misreading or missing nonverbal interactions
  • Having difficulty building or maintaining friendships
  • Poor eye contact or abnormal body language
  • Difficulty in sharing interests or emotions

Behavioral characteristics of autism

Behavioral characteristics may include:2,19

  • High dependency on routines
  • High sensitivity to environmental changes
  • Extreme focus on niche subjects
  • Indifferent or adverse reactions to certain smells, sounds, textures, and other
  • sensations
  • Fixation on certain sensations (e.g., excessive touching of particular objects, staring at certain lights)

Autism, sensory sensitivity, and food

One ASD symptom that can lead to many food-related issues is sensory sensitivity. 

People with autism spectrum disorder can be either hypersensitive or hyposensitive to outside stimuli.19 If they’re hypersensitive, they’re more affected by specific sensory experiences, like sounds, tastes, and smells. If they’re hyposensitive, they’re less impacted by these things.

When someone is hypersensitive, they can experience psychological distress when they encounter something they’re sensitive to, resulting in avoidant tendencies.20 Certain foods may trigger these reactions, including foods considered too hot, cold, slimy, mushy, or spicy. 

When someone is hyposensitive, they have less of a response to certain stimuli. This can result in behaviors attempting to “make up” for this deficit, such as constantly exploring textures with their hands or seeking other sensory experiences.20 Food-wise, someone with hyposensitivity may like to chew gum or specifically seek out crunchy or spicy foods, among other preferences.

Autism, cognitive rigidity, and eating disorders

Another common symptom of both autism spectrum disorder and many eating disorders is cognitive rigidity

In ASD, this often manifests as a high dependency on routines or difficulty with environmental changes.19 In eating disorders it’s been connected to everything from perfectionist tendencies to attention to detail.21,22

In either group, it can also manifest as specific rules and rituals around food and eating. People with ASD, eating disorders, or both may display behaviors such as not letting the foods on their plate touch, eating foods in a specific order, or eating certain things at certain times. And they may become agitated if these routines are disrupted.

Cognitive rigidity may also be behind the highly selective food preferences exhibited by people with both ASD and certain eating disorders.23 This is sometimes what leads to dangerously restrictive or limited diets.

Autism, eating disorders, and trauma

Autism spectrum disorder and eating disorders may have more than biological traits in common. Unfortunately, it seems like trauma may be another factor shared by both conditions.

Eating disorders have long been tied to trauma—particularly childhood trauma—and have a high rate of comorbidity with post-traumatic stress disorder.24 Research shows that those with autism spectrum disorder tend to encounter higher rates of trauma and stress and have higher rates of PTSD than their neuronormative peers.25

Bullying, whether related to weight, someone’s ASD diagnosis, or both, can frequently play a role. The social difficulties encountered by many people with both ASD and eating disorders can also contribute to the situation, leading to the type of social isolation that often allows eating disorders to go undetected for so long.

Autism and commonly co-occurring eating disorders

The connection between autism and eating disorders is still a relatively new discovery, and scientific research is ongoing, but some studies have already found significant connections, with the comorbid rate predicted to range anywhere from 8% to 37%.4

Atypical eating behaviors are especially common among children and adolescents with autism.

One study found up to 70% of children with ASD had atypical eating patterns, compared to 13.1% of children with other disorders and 4.8% of neurotypical children.3

Common eating behaviors in autism

More specifically, connections have been found between autism spectrum disorder and certain common eating disorders, including:

Autism and anorexia nervosa

Autism is perhaps most frequently linked in academic research to anorexia nervosa. That may be due to the high rate of co-occurrence between the conditions. Although both disorders occur rarely within the general population—at rates of around 1% for ASD and 0.3% for AN—they co-occur at a rate estimated to be as high as 16.3%.4,5

Although autism and anorexia occur rarely individually–around 1% for autism and 0.3% for anorexia–they occur together at an estimated rate of 16.3%.4,5

Further research into the matter has uncovered a number of potential reasons why. People with these conditions have been found to share traits such as issues with emotion regulation, introspection, empathy, and difficulty making or maintaining close relationships.6

Rituals around food and eating and extreme food selectivity are also common in both groups.6 And cognitive rigidity and sensory sensitivities are other major aspects of both conditions.7

Common traits and behaviors in autism and anorexia:6,7

  • Cognitive inflexibility
  • Sensitivity to textures, tastes, or smells
  • Rituals around eating and extreme food selectivity
  • Difficulty making or maintaining relationships
  • Issues with emotion regulation, introspection, and empathy

Autism and ARFID

Avoidant restrictive food intake disorder, or ARFID, is also closely tied to autism. One seminal study on the subject found a comorbidity, or co-occurring, rate as high as 21%.8

Autism and ARFID commonly occur together, with an estimated comorbidity rate of up to 21%.

ARFID is characterized by a persistent pattern of food avoidance, which leads to nutritional deficiencies and dangerously low weight. But what may particularly tie ARFID to autism is the motivation behind these eating patterns.

Those struggling with ARFID exhibit a general disinterest in food or eating, extreme aversions to food based on sensory factors like smell or texture, and/or a fear of choking or vomiting after eating. These motivations mirror many experiences people on the autism spectrum may have if they’re hypersensitive or hyposensitive.

ARFID features:
  • Disinterest in food and eating, often getting full quickly
  • Sensory avoidance of tastes, textures, smells, and temperatures
  • Fear of negative consequences, such as choking, vomiting, or allergies

Sensory sensitivities in those with ASD have been found to be a leading risk factor for developing a restrictive diet.8

Autism and binge eating disorder

Binge eating disorder has also been associated with higher rates of ASD traits, though much more research is needed to flesh out the reasons why.9

People with BED may share some of the same social difficulties as people with ASD and use food as a maladaptive comforting mechanism.11 Autism can also cause states of hyper fixation or obsession, which could manifest in someone with BED as a fixation with food.10

What autistic traits can look like when they relate to food and how they can lead to binge eating disorder:
  • Cognitive rigidity: Being hyper-focused on what, how, and when to eat
  • Sensory-seeking behavior: Overeating foods with certain textures, tastes, and flavors
  • Social skills challenges: Preferring to eat alone
  • Anxiety: Overeating to soothe mood

Autism and pica

Pica is an eating disorder involving persistent consumption of substances other than food, including soap, paper, cloth, hair, pebbles, paint, wood, chalk, and other materials. 

This disorder has a high co-occurrence with autism spectrum disorder, with one study finding a comorbidity rate anywhere from 9.7% to 28.1%, and another report on the subject noting that 1 in 4 parents of autistic children said their child ate non-food items sometimes or often.12,13

Research into the exact connection between the two conditions is still emerging. However, hyposensitivity to certain textures, sensory processing difficulties, and the inability to cognitively understand the difference between food and non-food are potential theories.13

Autism and pica have a comorbidity rate between 9.7%–28.1%. More research is needed to help us understand the exact connection between the two.

Treatment for people with ASD and a co-occurring eating disorder

Autism spectrum disorder is not a condition that needs to be “cured.” It describes a different set of neurological wiring that impacts how someone perceives and interacts with the world. Treatments for the condition can help people with ASD find helpful tools to navigate the world with less stress or anxiety.

Eating disorders, however, are dangerous conditions and need to be treated appropriately.

In many cases, an ASD diagnosis can impact the way someone responds to certain types of therapy, so both conditions should be considered when determining someone’s treatment plan for eating disorder recovery.

Still, some therapeutic methods have proven beneficial for people struggling with eating disorders that may be particularly helpful for people with ASD. 

Cognitive behavioral therapy
Family-based therapy
Art and experiential therapy

Potential barriers to treatment

Comorbid conditions, particularly when one is ASD, can also, unfortunately, make finding or receiving proper treatment more difficult for several reasons.

Recognizing the need for treatment
Diagnosing difficulties
Medication complications
Lack of comprehensive clinical programs

Finding help for an eating disorder with ASD

If you or a loved one are struggling with an eating disorder, or you suspect someone you care about may be, it’s essential to seek help. These conditions are dangerous and can even be deadly if left untreated. And especially for people with ASD, they often affect people long before symptoms are noticed.

Reaching out to your primary care doctor, therapist, or another trusted medical professional is a great place to start. These experts are often at least informed about different eating disorders and autism spectrum disorder symptoms and may be able to help you gain an official diagnosis or find a doctor or program that is better suited to help.

Just remember that it’s important for therapeutic approaches to be informed by a thorough knowledge of both autism and eating disorders. And don’t give up hope.

Anyone can make a full recovery from an eating disorder, especially when the condition is addressed early. The road to recovery is rarely a straight line, but it leads to a happier and healthier future.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.


  1. Nickel, K., Maier, S., Endres, D., Joos, A., Maier, V., Tebartz van Elst, L., & Zeeck, A. (2019). Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Frontiers in Psychiatry, 10, 708. 
  2. Autism Spectrum Disorder. (n.d.) American Psychological Association. Accessed January 2024. 
  3. Mayes, S. D., and Zickgraf, H. (2019). Atypical eating behaviors in children and adolescents with autism, ADHD, other disorders, and typical development. Research in Autism Spectrum Disorders, 64, 76-83.
  4. Westwood, H., Tchanturia, K. (2017). Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Current Psychiatry Reports, 19, 41.
  5. Inoue, T., Otani, R., Iguchi, T., et al. (2021) Prevalence of autism spectrum disorder and autistic traits in children with anorexia nervosa and avoidant/restrictive food intake disorder. BioPsychoSocial Medicine, 15, 9.
  6. Miniati, M., Marazziti, D., & Palagini, L. (2022). Is Alexithymia the Link Between Anorexia and Autism Spectrum Disorders? Clinical Neuropsychiatry, 19(3), 137–149.
  7. Li, Z., Hutchings-Hay, C., Byford, S., & Tchanturia, K. (2022). How to support adults with anorexia nervosa and autism: Qualitative study of clinical pathway case series. Frontiers in psychiatry, 13, 1016287.
  8. Koomar, T., Thomas, T. R., Pottschmidt, N. R., Lutter, M., & Michaelson, J. J. (2021). Estimating the Prevalence and Genetic Risk Mechanisms of ARFID in a Large Autism Cohort. Frontiers in Psychiatry, 12, 668297.
  9. Numata, N., Nakagawa, A., Yoshioka, K., et. al. (2021). Associations between autism spectrum disorder and eating disorders with and without self-induced vomiting: an empirical study. Journal of Eating Disorders, 9, 5. 
  10. Jack, C. (2021, September 14). Why so many people with autism have eating disorders. Psychology Today. Accessed January 2024.
  11. Are Autism and Overeating Linked? (2017, October). Colombian College of Arts & Sciences. Accessed January 2024.
  12. Fields, V. L., Soke, G., Reynolds, A., et. al. (2021). Association between pica and gastrointestinal symptoms in preschoolers with and without autism spectrum disorder: Study to Explore Early Development. Disability and Health Journal, 14(3).
  13. ASD, Digestive Issues and Pica. (n.d.) Centers for Disease Control. Accessed January 2024. 
  14. Cognitive Behavior Therapy for Autism. (2017, January). National Institute of Child Health and Development. Accessed January 2024.
  15. Rienecke, R. D. (2017). Family-based treatment of eating disorders in adolescents: current insights. Adolescent Health, Medicine and Therapeutics, 8, 69–79.
  16. Hu, J., Zhang, J., Hu, L., Yu, H., & Xu, J. (2021). Art Therapy: A Complementary Treatment for Mental Disorders. Frontiers in Psychology, 12, 686005.
  17. Mukherjee, S., Skrede, S., Milbank, E., Andriantsitohaina, R., López, M., & Fernø, J. (2022). Understanding the Effects of Antipsychotics on Appetite Control. Frontiers in Nutrition, 8, 815456.
  18. Schneider, E., Martin, E., Rotshtein, P., Qureshi, K. L., Chamberlain, S. R., Spetter, M. S., Dourish, C. T., & Higgs, S. (2022). The effects of lisdexamfetamine dimesylate on eating behaviour and homeostatic, reward and cognitive processes in women with binge-eating symptoms: an experimental medicine study. Translational psychiatry, 12(1), 9.
  19. Autism Spectrum Disorder: Diagnostic Criteria. (n.d.) Centers for Disease Control. Accessed January 2024. 
  20. Felton, A. (2022, November 10). What Is Hyposensitivity? WebMD. Accessed January 2024. 
  21. Buzzichelli, S., Marzola, E., Amianto, F., et. al. (2018). Perfectionism and cognitive rigidity in anorexia nervosa: Is there an association? European Eating Disorders Review, 26(4), 360-366.
  22. Wang, S., Gray, E., Coniglio, K. (2021). Cognitive rigidity and heightened attention to detail occur transdiagnostically in adolescents with eating disorders. The Journal of Treatment and Prevention, 29(4), 408-420.
  23. Zickgraf, H., Richard, E., Zucker, N. (2022). Rigidity and Sensory Sensitivity: Independent Contributions to Selective Eating in Children, Adolescents, and Young Adults. Journal of Clinical Child & Adolescent Psychology, 51(5), 671-687.
  24. Brewerton, T. (2007). Eating Disorders, Trauma, and Comorbidity: Focus on PTSD. The Journal of Treatment and Prevention, 15(4), 285-304.
  25. Haruvi-Lamdan, N., Horesh, D., Golan, O. (2020). Autism Spectrum Disorder and Post-Traumatic Stress Disorder: An unexplored co-occurrence of conditions. Sage Journals, 24(4).


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