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The Relationship Between Autism Diagnostic Criteria and Problematic Eating Behaviors

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Abstract

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.

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Data Availability Statement

The data from this study are available at https://osf.io/5fk2a/

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Acknowledgements

We thank two anonymous reviewers for helpful comments on an earlier draft of this manuscript.

Funding

This research was supported by the Hamish Ramsay Fund.

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Authors and Affiliations

  1. College of Education, Psychology and Social Work, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia

    Robyn L. Young, Paris Smith, Alliyza Lim & Michelle Short

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  1. Robyn L. Young
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  2. Paris Smith
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Contributions

RLY: developed the study concept and design and provided critical manuscript revisions. PS: collected and analyzed the data and wrote the original manuscript draft. AL: collected and analyzed the data and provided critical manuscript revisions. MS: provided critical manuscript revisions.

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Correspondence to Robyn L. Young.

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Ethics Approval

This study was approved by the Flinders University Human Research Ethics Committee (Project No. 2161). All procedures used in this study adhere to the tenets of the Declaration of Helsinki (1964).

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Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare no competing interests.

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Young, R.L., Smith, P., Lim, A. et al. The Relationship Between Autism Diagnostic Criteria and Problematic Eating Behaviors. Adv Neurodev Disord 6, 53–64 (2022). https://doi.org/10.1007/s41252-021-00231-9

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