A prominent British autism researcher says that girls with anorexia nervosa have "elevated" autistic traits. Simon Baron-Cohen, of the University of Cambridge, found that adolescent girls with anorexia scored higher on tests that evaluate autistic traits than adolescent girls without anorexia.
The study was published in Molecular Autism, which it should be noted is also edited by Dr. Baron-Cohen.
The researchers theorized that "anorexia involves rigid attitudes and behavior, which can be seen as resembling the unusually narrow interests and rigid and repetitive behavior in autism, but in anorexia happen to focus on food or weight."
The study authors are quick to point out that more research is needed on this topic, but hope that clinicians will be able to use the information to treat eating disorders.
"An understanding that some patients may have a different cognitive style, one prone to an obsessive focus on systems and a self-focused turning away from other people," the authors write, "may open up new avenues for both treatment and etiological research for anorexia."
Although Dr. Baron-Cohen has published hundreds of articles and several books, not everyone always agrees with his theories. He pioneered the concept that autistic people have deficits in "theory of mind" - understanding that other people may have thoughts and beliefs that differ from one's own. He also originated the theory that autism is a form of "extreme male brain" and that the cause of autism, at a biological level, is hyper-masculinization.
I'm not a Cambridge researcher, but as the mom of two autistic kids, I don't really agree with those two theories. I've written on my blog and for Salon about the ways in which my kids are sometimes more aware of their own and others' minds than plenty of neurotypical adults I know.
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But Dr. Baron-Cohen's latest study does ring true. Both anorexia and autism can involve a very ordered way of thinking, and in fact a friend's daughter was very recently diagnosed with both autism and an eating disorder. I had an eating disorder as a teenager, and for me it wasn't a body image issue: it was a control issue. My eating disorder was an outgrowth of my anxiety issues, and a need to exert control over the one thing I could: my own body.
While my son, for example, doesn't have an eating disorder, he definitely has rules and rituals for eating. For a long time, my son could only eat sandwiches cut into four triangles. It took 18 months of me making methodical, minute changes before he would tolerate sandwiches cut in four squares.
There are a lot of overlapping disorders, which doctors refer to as "co-morbid." Autistic people may also have ADHD or anxiety, for example. A person with an eating disorder might also have anxiety or obsessive-compulsive disorder. Nothing about this study says that all anorexic girls are autistic, or that all autistic girls are anorexic. Just that there's some commonality between autism and anorexia that might be helpful for clinicians to consider.
What's interesting is that Dr. Baron-Cohen's theory of "extreme male brain" was the basis for a completely opposite theory about anorexia just last year. Jennifer Bremser, an assistant professor at Alfred State College, theorized in Evolutionary Psychology that anorexia represented "extreme female brain." Her idea was that since vegetarianism is frequently seen in anorexic girls, it's an innate female ability to empathize that leads to being hypersensitive to animal welfare. Or something like that.
Autistic writer and educator Landon Bryce noted astutely (and sarcastically) at the time, "Because autistic people with eating disorders? That never happens, right?"
I do see some major upsides to this study, and the publicity it's getting: first of all, people are talking about girls and autism. Girls are generally diagnosed with autism later than boys, in part because autism used to be thought of as a "male" thing, an idea perpetuated by Dr. Baron-Cohen's "extreme male brain" theory. It's possible that this will help clinicians and pediatricians be more aware that autism can be a girl thing, too.
It also seems like a good thing for clinicians who work with eating disorder patients to consider that some of their patients may have a different cognitive style. In fact, it would be good for clinicians and physicians working with anyone to consider that some of their patients may have a different cognitive style, but I guess you've got to start somewhere.
-By Joslyn Gray
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