The Relationship Between Autism Diagnostic Criteria and Problematic Eating Behaviors

Objectives: We examined problematic eating behaviors among a sample of young autistic adults to better understand the purported relationship between autism and eating disorders. We hypothesized that autistic participants would score higher on measures of problematic eating behavior compared to a non-autistic comparison group, but that autistic participants would not report elevated levels of weight and shape concern. We also conducted an exploratory analysis to examine the extent to which each autism diagnostic criterion was associated with problematic eating behavior. Methods: Seventy-four autistic and 40 non-autistic young adults aged between 18 and 25 years completed an online survey consisting of the Eating Disorder Examination Questionnaire (EDE-Q), Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS), autism spectrum quotient (AQ), and Autism Eating Behavior Questionnaire. Results: Autistic individuals self-reported higher levels of problematic eating behavior than non-autistic individuals as measured using the EDE-Q, NIAS, and Autism Eating Behavior Questionnaire; however, contrary to expectations, weight and shape concern were also elevated. Autism diagnostic criteria explained a combined 19.2% of the variance in EDE-Q global score and 19.0% of the variance in NIAS total score; however, individually, only diagnostic criterion B4 (sensory sensitivities) was significantly associated with EDE-Q global score,and only diagnostic criterion B3 (restricted interests) was significantly associated with NIAS total score. Conclusions: These results suggest that autistic individuals may experience autism-focused eating behaviors in conjunction with, rather than instead of, typical eating disorder cognitions.