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ASPartOfMe
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05 May 2021, 6:21 am

Eating Issues Common in People With Autism

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While it's well established that autism and certain eating issues go hand in hand, does gender also play a role?

Apparently it does, according to Swedish researchers who set out to better understand whether being male or female influenced eating issues in people who have autism.

The study found that autistic traits predicted eating problems, but the link was more pronounced particularly among girls or women. These issues around eating might increase the risk of social isolation for females with autism, the researchers also found.

"We didn't study the potential genetic difference between males and females, but we did look at this association between autism and eating problems. And we wanted to know if that was different between females and males," said study author Karl Lundin Remnelius, a PhD student at Karolinska Institutet in Stockholm.

“The specific eating problems that were noted by females involved social settings, Remnelius said.

These items were, for example, 'I find it difficult to eat with friends' or 'I find it difficult to eat in school or in a workplace or in a restaurant,'" Remnelius said. "And we actually saw when we looked closer at this subscale that it was only these social items that autistic females report or had higher scores in."

The study also found that autistic traits predicted increased eating problems. This may not be that autism also causes eating problems but that certain genetic factors could be responsible for both, Remnelius said.

“We don't know if this is causal, is autism causing eating problems, or if there might be some other factor that might be influencing both autism and eating problems. One thing could be that some of the genes that increase the likelihood of a person having autism might also increase the likelihood of a person having eating problems," Remnelius said.

"Sometimes you describe that as genetic confounding, so it's not really autism causing eating problems," he said. "It's more that people who have autism also have a sort of higher likelihood of having eating problems."

The study included nearly 200 identical and fraternal twins between the ages of 15 and 33, including 28 individuals diagnosed with autism, who were all part of the Roots of Autism and ADHD Twin Study in Sweden. The study looked at associations across the whole sample and then within the twin pairs.

Participants reported their eating issues in a questionnaire that covered eating problems in a broad way, Remnelius said. Participants also had neurodevelopmental assessments, and researchers collected parent-reported autistic traits information.

Eating problems included selective eating, sensory sensitivity concerning food and symptoms of eating disordeRs.


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DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


Steve1963
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05 May 2021, 7:08 am

Thank you for this article. I never knew there was a connection to eating issues and autism. It really, REALLY explains a lot about my own eating issues.



IsabellaLinton
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05 May 2021, 10:17 am

Sensory issues play a large role in eating problems especially among autistic people. Many of us can only tolerate certain "same foods" repeatedly, we can't stomach certain smells or sounds (crunching food etc. - related to misophonia), and it's common to have gagging reactions to different food textures and the "mouth feel" they create. It's common for our digestive system which is related to the nervous / sensory system, to be hypersensitive to various flavours, spices, or ingredients and cause IBS or other digestive difficulties, which we don't like to chance by eating meals in public.

Lots of autistic people develop rituals and routines about what they will / will not eat, and it becomes a repetitive behaviour cycle that can't be broken. We're notorious for having difficulties with change and adaptation. If very specific food preferences begin in childhood it's common that the autistic person will be teased or ostracised for having "childish" food preferences by their peers, as they age. This compounds their social anxiety when going to restaurants or sharing meals with others who will see their food choices, judge them, or even pressure the person to eat things they simply cannot. The social experience of eating food with other people is very nuanced with layers of etiquette, manners, and verbal communication which is also difficult for people with autism.

On top of this, there's the fact that many autistic people can't tell when they are hungry or full because of poor interoception awareness, so they might eat too much or too little and draw attention to themselves as if they have an eating disorder (bingeing, anorexia, bulimia).

This goes way beyond the issue of body image. For the most part it relates to sensory sensitivities / social anxiety about the way we'll be treated for our relationship with food.



Steve1963
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05 May 2021, 10:44 am

I wish I had known this, as well as knowing that I was autistic, 45 years ago. Thanks Isabella!



Biscuitman
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05 May 2021, 2:49 pm

It's one of the things that suddenly jumped out at me when I started thinking I might be on the spectrum.

I had eating disorders in my teenage years (all my life up until then in reality) and 20 years later was diagnosed with aspergers