Autistic women are overrepresented among people in treatment for Anorexia Nervosa (AN). The current study aimed to: (1) better understand how AN develops and persists in autistic individuals from the perspective of autistic women, parents and healthcare professionals; (2) derive a theoretical model of restrictive eating difficulties in autism. We conducted 44 semistructured interviews and used Thematic Analysis to identify patterns of meaning across the data. Themes related to sensory sensitivities, social interaction and relationships, sense of self and identity, difficulties with emotions, thinking styles, and a need for control and predictability. We developed a model of potential autism-specific mechanisms underlying restrictive eating difficulties. This study generated novel insights, which have the potential to inform treatment adaptations following empirical testing.

Distance running in humans has been associated with both positive and negative effects on the balance of bone remodelling. There is evidence to suggest that the negative effects may be linked to a failure to balance energy expenditure with an adequate energy intake. Energy restriction is known to reduce the synthesis and serum concentration of insulin-like growth factor 1 (IGF-1), which plays an important role in bone formation. The purpose of the present study was to compare the effects of repeated periods of prolonged treadmill running, under conditions of either energy balance or energy restriction, on markers of bone turnover and serum IGF-1 concentration in trained distance runners. Eight male distance runners [mean age 25.1 (SD 5.9) years, maximal oxygen uptake 61.8 (SD 4.9) ml x kg(-1) x min(-1)] undertook an exercise and diet regime on two separate occasions, 2 weeks apart. On each occasion they performed an intensive, 60 min treadmill run on 3 consecutive days. On one occasion their energy intake was restricted to approximately 50% of their estimated energy requirement (RES), whereas on the other occasion they remained in energy balance (BAL). The N-terminal pro-peptide of type 1 collagen (P1NP), osteocalcin and IGF-1 were measured in serum collected between 0800 and 0900 hours, when fasted and rested, on the day before and the day after each regime. The cross-linked N-telopeptides of type 1 collagen and deoxypyridinoline were measured from 24 h urine collections made on the day before and the final day of each regime and adjusted for creatinine excretion. The results showed that the serum concentration of both P1NP and IGF-1 declined by 15% (P = 0.008) and 17% (P = 0.007) respectively in response to RES, but did not change in response to BAL (P > 0.05). A strong relationship was observed between the magnitude of the reduction in the serum concentration of P1NP and IGF-1 after RES (r = 0.97; P < 0.001). There were no changes in the other bone markers in response to either regime. The results suggested that in trained distance runners, repeated periods of prolonged running do not affect the balance of bone turnover unless energy balance is simultaneously altered. These findings support the link between a negative energy balance, a reduced synthesis or serum level of IGF-1 and reduced collagen synthesis. They may also help to explain the bone remodelling imbalance that has been observed in some male and female distance runners.

This study explores autistic women’s experiences of eating disorder services. Estimates suggest that 20%–30% of women in treatment for anorexia nervosa display diagnostic features characteristic of autism. Research suggests that autistic individuals’ needs are not being met by standard anorexia nervosa treatments. In the current study, in-depth interviews were conducted with 15 autistic women with experience of anorexia nervosa, 12 parents of autistic women with anorexia nervosa, and 11 eating disorder healthcare professionals. Using thematic analysis, three overarching themes were identified: misunderstanding autism and autistic traits, one treatment does not fit all, and improving accessibility and engagement within services. We found that there were diverse barriers facing autistic women when in treatment for anorexia nervosa, and these were accentuated by a lack of autism understanding within eating disorder services. Future research should focus on developing interventions that are tailored to the specific needs of autistic individuals with anorexia nervosa. Lay Abstract This study explores autistic women’s experiences of eating disorder services. About 20%–30% of people with anorexia nervosa are also autistic, and current treatments seem not to work as well for them. We interviewed 15 autistic women with experience of anorexia nervosa, 12 parents of autistic women with anorexia nervosa, and 11 healthcare professionals working in eating disorder services. We asked autistic women and parents about their experiences of eating disorder services, and we asked healthcare professionals about their experiences treating autistic women with anorexia nervosa. Participants’ views were represented by three overall themes: misunderstanding autism and autistic traits, one treatment does not fit all, and improving accessibility and engagement within services. We found that autistic women face many barriers when in treatment for anorexia nervosa, often because of a lack of autism understanding within eating disorder services. Future research should look at developing anorexia nervosa treatments that can specifically help autistic individuals.

Strategies that enhance the acquisition of bone mass may be protective against osteoporosis. BMD was compared in 20 artistic gymnasts (10 boys; 10 girls) and 20 untrained children ages 7-8 years. Higher regional values of BMD were observed in female gymnasts than untrained girls. If retained to adulthood, this higher BMD may protect skeletal integrity in later life.Strategies that enhance the acquisition of bone mass in children may assist with the prevention of osteoporosis. This study explored the effects of regular high-impact and weight-bearing activity before the age of 7 years on total and regional bone mineral density (BMD). Twenty artistic gymnasts (10 boys and 10 girls) and 20 untrained children, 7-8 years of age, were recruited. The untrained children were matched to gymnasts by sex, height, weight, and age. Female gymnasts trained 8 -10 h per week and had trained regularly for 3-4 years. Male gymnasts trained 4 -6 h per week and had trained for 1-2 years. Measurements of bone mineral density were made using DXA for total body BMD (TBBMD); lumbar spine, both areal (aSBMD) and volumetric (vSBMD); total spine; pelvis; arms; and legs. Significant mean differences (8 -10%) in aSBMD, vSBMD, arm BMD, and TBBMD were observed between female gymnasts and untrained girls (p < 0.05: aSBMD, vSBMD, and TBBMD body mass (BM); p < 0.01: arm BMD). A nonsignificant trend toward a higher TBBMD/BM and arm BMD was observed in male gymnasts compared with untrained boys. Trends toward a higher BMD within the pelvis, legs, and total spine were also observed in gymnasts. There were no differences in total and regional BMD between untrained boys and untrained girls. The results suggest that gymnastics training before the age of 7 years enhances the acquisition of bone mass at selected skeletal sites.

We use what we call collaborative autoethnography in this article to tell the story of “Lindsey,” a person for whom sport and physical activity have been both friend and enemy throughout her life. Our intention is to place stories about disordered eating and over-exercising alongside modern panics about obesity and to wonder how children are likely to process the different things they are told about body weight, sport, and physical activity. We do this not to pathologize Lindsey’s behavior but rather to pathologize the moral universe that makes the moral superiority of the fit, athletic body possible.