Is anorexia nervosa the “female form of Asperger’s?”

Name two medical conditions that have increased in prevalence and media coverage over the last decade, pose many unanswered questions, and scare the hell out of parents. I’ll give you a hint: they both begin with the letter A.

Anorexia nervosa – an eating disorder characterized by self-starvation and distorted body image – and Asperger’s syndrome – an autism spectrum disorder characterized by difficulties in social interaction, restricted and repetitive patterns of behavior and interests, and preserved linguistic and cognitive development – are being observed under the same diagnostic microscopes. The findings have shocked both the medical and psychological fields.

Remember the whole Nature vs. Nurture debate you learned about in high school science textbooks? Well, recent studies are suggesting a new approach to the debacle: a compromise.

A Swedish study (2002), an Australian study (2004), and an Israeli study (2006) have concluded that the main risk factors for autism arise during the perinatal period, which spans five months before and one month after birth. Autism was more prevalent in children whose births were induced; who were born with a low Apgar score (numerical summary of infant’s condition at birth); and who had experienced fetal distress, c-section, and/or other birth complications. Pre-natal distinctions – such as head circumference maternal diabetes, being a twin, or season of birth – and post-natal characteristics –vaccinations or bottle vs. breast feeding – did not show the significant effects on risk of autism that the perinatal conditions did.

Numerous studies have also included that the development of anorexia nervosa, like autism, is most likely related to perinatal conditions and complications. A large Swedish study (1999), which assessed the birth records of all girls born in Sweden from 1973 to 1984 and of the 781 girls between the ages of 10 and 21 who were hospitalized due to anorexia nervosa, concluded that forceps (tong-like instruments used to grasp the baby’s head) and ventouse (vacuum device) deliveries were noteworthy risk factors for anorexia. A cephalohematoma (collection of blood under the scalp of a newborn) at birth was the most significant risk factor. These factors all take place in the perinatal period. An Italian retrospective study (2006) showed results that were consistent with those of the Swedish study: anorexia nervosa and obstetric complications in the perinatal period showed significant correlations.

Oxytocin – a hormone involved in social recognition, bonding, sexual arousal and reproductive behaviors, release of stress and anxiety, and formation of trust between people – is known to be low in sufferers of both anorexia and autism. Many researchers suggest that this similarity is not a coincidence and again point to the perinatal period, a time when the oxytocin system is challenged and matured.

The “perinatal complication” comparison is not the only similarity between the two conditions. In 2007, Asperger’s syndrome expert Tony Attwood reported that between 18% and 23% of teenage anorexics meet some or all of the diagnostic criteria for Asperger’s syndrome. Dr. Janet Treasure, a researcher who specializes in eating disorders, stated “People with eating disorders find it difficult to change self-set rules… They also see the world in close-up detail, but this can be at the cost of having an ability to see and think about self-identity and connections with others… We also discovered that this distorted pattern of processing information has a strong similarity to autistic spectrums.”

Similar symptoms of anorexia and autistic spectrum disorders include:

-Fixation on detail; becoming distracted; missing the big picture

-Obsessive or compulsive behavior

-A need for perfection

-Difficulty with multitasking or switching between tasks or ideas

-Lack of flexibility in thoughts and responses; difficulty in coping with change

-Atypical eating behaviors (food preparation routines; refusing to eat certain foods)

-In some cases, ritualized or extreme exercise regimens

Some researchers are skeptic, others are completely convinced, and some don’t know what to think at all. Is anorexia nervosa the “female form of Asperger’s?” Or are researchers and psychotherapists over-analyzing in a desperate attempt to answer the unanswerable? It seems that the Nature vs. Nurture debate has new company.

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43 thoughts on “Is anorexia nervosa the “female form of Asperger’s?”

  • February 19, 2017 at 6:42 pm
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    They’re totally different, it would be more accurate to say that OCD and anorexia are similar or autism and ADHD are similar or something like that, since autism and anorexia are not even in the same branch of mental disorders.

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  • July 20, 2010 at 7:06 pm
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    Assigning gender to a disease makes it more difficult for anorexic males and austistic females to cope with their condition because they’re not this sex or that sex.  Therefore, their particular case will be deemed not as important.  It’s just entirely careless to make such claims.  Idiots!

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  • July 20, 2010 at 9:00 am
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    Yeah anorexia definitely is not a female thing. Sorry… that just bothers me when people categorize it like that. I have been in treatment with boys for my eating disorder. I guess I can see the similarities but I don’t necessarily thing they are necessarily the same thing. It’s interesting they have so much in common though.

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  • July 20, 2010 at 1:34 am
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    ive had an eatting disorder for about 5 years now. im almost 18. i think eating disorders and depression are more linked. i think its more behavioral. my dad is health obsessed and my mom loves food. so im stuck in the middle. Plus its about enviornment, being picked on for years and developing early, i freaked out plus an event happening, you just want to have SOME form of control. But autisim is more gentic. So i would think. I mean yes i have ADD(attention deficit disorder) but thats totally different, but its a big cycle. Since i also have depression. But i dont know, i guess anorexia and autisim could be connected…i dont know im not a doctor. But i would think they wouldn’t be. :/

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  • July 20, 2010 at 12:56 am
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    I learned my anorexia. A lot of bad things happened to me. I wasn’t just born with it. A lot of times anorexia is triggered by an event or change. Also plenty of people with anorexia were originally high functioning.

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  • July 19, 2010 at 6:16 pm
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    Let’s ignore the fact that Aspergers and Anorexia are both experianced by women and men, girls and boys. There’s no exception. So the way that si phrased..is quite poor.

    That aside, I would say that’s a fair stretch. Just to say OCD symptoms may be present in certain forms of schizophrenia and vice versa……yes the DMV is a guidline and many disorderes are on the spectrum (and also has it’s fair share of critiques). But doctors need to be more stringent in filtering out similarities, with definitive causality. That’s easier said than done…but it’s easier to do then throw speculations and scattered data to the public.

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  • July 19, 2010 at 5:16 pm
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    …     … there are a lot of causes to ed’s, I can’t recall the exact details at this moment, but a study in some random small country saw something like a 3fold increase in eating disorders after introducing tv shows and movies from North America.  Anorexia and aspergers maybe comorbid but I wouldn’t call an ED as something in the autism spectrum.  I also think people do what they do because of a combination of nature and nurture.  

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  • July 19, 2010 at 1:29 pm
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    Not at all. I completely disagree.

    For one thing, both males and females can have Asperger’s or Anorexia.

    For another, I’m sure several different disorders stem from similar causes or have similar symptoms; that does not mean that they are at all the same thing.

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  • July 19, 2010 at 11:16 am
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    This article is terrible.  It clearly states views from other studies and doesn’t cite them.  There is absolutely no credibility to this.  One of the main characteristics of Asperger’s is the inability to be empathetic.  (http://www.asperger-institute.com/aspergers-syndrome-characteristics.htm) Maybe you meant to compare Anorexia with Alexithymia.  Alexithymia is defined by the webster dictionary as an “inability to express ones feeling’s”. (http://www.merriam-webster.com/medical/alexithymia)  As someone with first hand experience with and eating disorder I can firmly say that I don’t relate to Aspergers in the least.  I understand others emotions very well.  Many eating disordered people lie to the people they love to keep there disorder a secret because of there awareness of other peoples feelings.  Sure there are other reasons but I find that is the big one.

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  • July 19, 2010 at 2:26 am
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    A female with Asperger’s is the female form of Asperger’s.

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  • July 18, 2010 at 9:06 pm
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    Id really have to disagree on this one, they may have similar symptoms but that does not make it the same thing. Also, anorexia is not just prone to females.

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  • July 18, 2010 at 8:43 pm
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    seems like they may be over analyzing a little bit. HOWEVER, my brother has Asperger’s, and I have an eating disorder, so….

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  • July 18, 2010 at 3:49 pm
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    I can attest to the perinatal complications leading to AN… I am anorexic and was born using a ventouse. although I’m not at all autistic. still, pretty crazy for me to read. I can’t believe that could be part of the cause for my ED!

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  • July 18, 2010 at 3:29 pm
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    I understand the similarities, but it’s not a female vs. male thing since both conditions occur in both sexes.

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  • July 18, 2010 at 12:34 pm
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    oh ..and folks, She is not here saying that someone who has Asberger’s also has Anorerxia. The studies were comparing the two different diseases and the people who have  them. She is stating the similarities found in the brains of those who have these conditions, according to some studies done…and possible perinatal causes .

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  • July 18, 2010 at 12:30 pm
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    wow..This was very educational for me! and I read everything.. Did you find any of those studies to be in conclusion with your personal experience with AN? ..the perinatal part, etc.. I don’t believe the studies are extensive enought.. I consider too..that anorexia can come on to someone who is in their 30, 40, etc… and I see it as a mental illness that manifests into a vicious cycle.. depression…starving, obsessing, starving causing depression and depression causing the starving rituals, etc… it is complex indeed.. Anorexia has always been a huge interest of study for me.I have never had it.. but maintain a healthy weight though I have been extreme with exercise and diet etc.. to lose weight. And I surely have behaviours, patterns  of someone with an ED, but just never got underweight yet. no B/P’ing for me though.. thank god. I wish you well with your studies at Penn State. I live in PA too. nice to meet you.
    xoxoxoxo

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  • July 18, 2010 at 10:41 am
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    Um, definitely an interesting perspective. I’m fourth year recovery and this is a little hard to swallow.. Though it’s funny, I meet criteria for sure. Very interesting similarities. Thanks for sharing.

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  • July 18, 2010 at 5:00 am
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    @zretrareo27@xanga – I agree, you brought up a lot of good points.

    Schizophrenia may also be a result of perinatal conditions, although granted, the symptoms are different than Asperger’s and Autism. However, because the symptoms between anorexia and Asperger’s are similar does not mean they are similar disorders, and unless a molecular link can be proven to cause both, it should not be linked together.

    Also, I could be mistaken, but I was under the impression that there is a closer link between depression and anorexia nervosa since both may involve serotonin levels. Interestingly, some of the bulleted points could sound like symptoms of depression.

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  • July 18, 2010 at 12:48 am
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    As everyone else has stated, you can’t say it’s a “female form” of Asperger’s since women get Asperger’s and men can be anorexic. Stating it the way this post does will mean that only men get Asperger’s while women get anorexia. And it’s not that simple.

    I think the main difference between the two is the feeling that what they are doing is wrong. In other words, people with Asperger’s aren’t really aware that their rituals and habits are weird. They don’t realize that the normal person doesn’t do that stuff. They don’t understand what they may have done wrong if getting into a fight with someone. They honestly just don’t understand social rules and how to conduct themselves with other people.

    With anorexics, it’s different. They know that what they are doing is wrong. That’s why they try to hide it. If they didn’t feel that their rituals and whatnot were wrong, they wouldn’t come up with excuses and lies for it. If it were really Asperger’s, they wouldn’t realize that their habits were so different from everyone elses.

    This was an interesting post though. Makes one think.

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  • July 18, 2010 at 12:13 am
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    I don’t agree at all. I have anorexia nervosa, and i have also met people with aspbergers. I really don’t know where people are getting this. People with anorexia can understand emotions, and many, when have proper nutrition, are very personable. Also, anorexia is not a female disorder. Sure, there are more  females diagnosed with anorexia. 1 in 10 sufferes are men. I suspect that men are underdiagnosed when it comes to anorexia, because of the shame and lack of understanding by doctors.

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  • July 17, 2010 at 10:56 pm
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    sounds like there’s a good point here but from my own experience these causes do not corolate.

    I was born at home with nothing like foreups were used.

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  • July 17, 2010 at 8:47 pm
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    ……………what?

    Males and females both suffer from anorexia nervosa AND aspergers, some simultaneously, I’m sure. they’re not mutually exclusive.

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  • July 17, 2010 at 1:21 pm
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    Well, I’m an Aspergers Autistic woman who definitely, positively does not have anorexia nervosa.

    I’ve heard that there may be a link in some cases, to some people, but the evidence suggests that the incidence is only nominally higher than the general population.  Without being able to view the studies you’ve referenced, I’d chalk this up to “post hoc, ergo propter hoc” and “more research is needed”.

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  • July 16, 2010 at 9:11 am
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    …Female form?

    There are plenty of males who suffer from Anorexia.

    But you do make great points. It’s never been pointed out to me in this aspect.

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  • July 14, 2010 at 10:10 pm
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    I certainly see that there are many connections, but many medical conditions are dependent on the perinatal state. When you look for things that are similar, you see similarities. However, that doesn’t mean that they are the gender based equivalent of eachother. In fact, anorexia nervosa is more closely related to Obsessive Compulsive Disorder than Asperger’s syndrome.

    It is improper to state many of these bulleted items because many of them are symptoms of starvation on the human body and will occur in most people who are deprived of nutrients and food. 
    It is important to remember that the mindset of anorexia nervosa can be changed to remove the ‘fear’, where you cannot remove the disabilities of asperger’s with psychotherapy. 
    Thank you for this article though. I would wish it would be more… speculative, I fear that people will begin to shroud those with anorexia nervosa into the category of ‘stereotypical’ autism. 

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  • July 14, 2010 at 3:31 pm
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    Hey! Great blog. Can you please upload the links to these studies? I am working on my masters in neuroscience, and we just spent a semester talking about Asperger’s and other mental disabilities.  I am a Physical Education teacher, I would find it really helpful if I could read these articles especially for when I am working on my thesis.  Thanks!!

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  • July 14, 2010 at 3:23 pm
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    Thank you for sharing, I found this to be extremely interesting. After reading this I can see the similarities between Anorexia and Aspergers.  But I do not believe that being Anorexic means you are Aspergers. I would like to research more this concept of the Oxytocin and the perinatal complication theory. We may be onto something with it. I post blogs on http://www.MySpeechTherapyCenter.com about communication welleness and awareness. Feel free to visit our site! 

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  • July 14, 2010 at 9:15 am
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    moon_on_a_string@xanga said it best. If you want to be taken seriously then its important to quote research papers. Tony Attwood is an Asperger’s expert, other than at his clinic where he may see people who also have anorexia, he doesn’t appear to have any connection at all with people with this disease. 

    But if we are talking empirically, then of the five people I know well who have had or have now anorexia, all of them are very social and popular women, no Asperger’s there. 

    btw I think you should have said that your source for the title came from here.

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  • July 13, 2010 at 10:04 pm
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    I wouldn’t call it the female form, since there are some guys who have dealt with anorexia and I know at least a dozen women with Aspergers who have no sort of eating disorder at all… at least not connected to self-perception. Personally, I can forget to eat simply because I don’t recognize my own hunger cues until they are screaming at me. I am only moderately concerned by my looks, but any issues with weight are tied to health… I am actually about 15-20 lbs overweight… but that is not according to how I look, it is according to charts that give aproximate weight to height ratios and the scale. It’s also tied to the fact that it has become increasingly difficult to do some things that before I gained this weight, I had no trouble doing.

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  • July 13, 2010 at 8:47 pm
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    I’ve never thought about this before. I was borderline Anorexic for awhile and have battled Bulimia to a far greater extent, and I am pretty sure I am at least a little bit Asperger’s.

    It makes a lot of sense, the rigid behavior. Seems like anorexia could in part be a coping mechanism for dealing with social incompetence; might have been for me. Do you think you may have it as well?

    Reply

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