“A traditional eating disorder is usually linked to fixation with food and weight, but there are also a large number of other thoughts and behavior in individuals with anorexia nervosa that have previously been considered typical for autism,” says Louise Karjalainen, PhD and psychologist at the Gillberg Neuropsychiatry Centre in Gothenburg.
It has long been known that individuals with autism have disturbed eating behavior. However, it has been unclear whether typical autistic behavior surrounding food also exists in those with anorexia nervosa.
One of the groups studied by Louise Karjalainen included around 30 women with anorexia nervosa between the ages of 15-25. After a year when their health had generally begun to improve, they still had the negative thought patterns and behavior around food that characterizes individuals with autism.
“Their general eating patterns improved during the follow-up year, but it was specifically noteworthy that they were still at the same level in their autistic behavior in terms of meal times,” says Louise Karjalainen.
A food smell that is unbearable, a dining companion making loud mouth noises or an aversion to the whole idea of eating together with others. These were the types of things that could make women regress long after the acute stage of anorexia. The autistic traits remained even after the body had been nourished and repaired.
“Cognitively, a person functions better once they have regained normal weight from an eating disorder, but the social aspects of meal times were still uncomfortable. They actually also had problems with multi-tasking. Cutting food and chewing at the same time was a challenge, and this is something that is also prevalent in individuals with autism,” says Louise Karjalainen.
“The fact that this is hard for patients with anorexia is something that has not previously been noticed or understood. It may be suspected that this partly is to do with the food and weight anxiety, but it was so clear that it is also linked to social factors,” she continues.
Changes in care
MRI scans also showed that women in the group had the same changes as women with autism in the parts of the brain linked to social cognition. This is due to thinning of the gray matter just behind the temple area, which was not present in the healthy comparison groups or in men with autism.
“We need to know more in order to understand how this is all linked, but nevertheless it is a highly interesting discovery,” says Louise Karjalainen, who believes that, in future, care for anorexics should be changed.
“It’s obvious that anorexia care must be food-focused; this is primarily about saving lives, but there are also other key factors in reducing the risk of relapse and to get people healthy at all levels,” she says.