Associations between childhood autistic traits and adolescent eating disorder behaviours are partially mediated by fussy eating

Abstract

Objective: Previous literature shows an increased risk for eating disorders in autistic individuals. This study tested whether fussy eating contributes to the association between childhood autistic traits and adolescent eating disorder behaviours. Method: Using data from the Avon Longitudinal Study of Parents and Children, we estimated the intercept and slope of parent-rated autistic traits and fussy eating between 7 and 14 years (N = 8982) and their association with selfreported eating disorder behaviours at age 14 years, including the indirect path from autistic traits to eating disorder behaviours via fussy eating. Analyses were adjusted for child sex, maternal age at delivery, maternal body mass index and maternal education. Results: Analyses found a small indirect pathway from autistic traits intercept to eating disorder behaviours via fussy eating slope (b = 0.017, 95% CI = 0.002-0.032, p = 0.026), with higher levels of autistic traits at age 7 years being associated with a shallower decline in fussy eating, which in turn was associated with greater eating disorder behaviours. Conclusion: Findings point towards fussy eating as a potential link between childhood autistic traits and later disordered eating. Addressing fussy eating patterns before they become entrenched may decrease risk for eating disorders later in development.

Case series of family‐based treatment for restrictive‐type eating disorders and comorbid autism: What can we learn? A brief report

“…Predictability and consideration for sensory or routine preferences are not an explicit part of the FBT manual, but parents in FBT are supported to implement renourishment and support in a way that is congruent with their family style, and these parents may be experienced in attuning to their particular child's individual need for structure and predictability (while treatment staff are not). Some parents have prior experience with structuring their child's eating pattern in the face of difficulty; for instance, a recent epidemiological study demonstrated, that a subgroup of YPs with autism spectrum traits had fussy, selective eating prior to developing a R‐ED (Carter Leno et al., 2022). Possibly, there might be a dual pathway where one proportion of YPs with autism quickly change their focus, for example, from restriction to regularity in response to the well‐structured support from parents and treatment, whereas another proportion may enter a vicious cycle of frustration, power struggles or emotional dysregulation, rendering parents and outpatient FBT powerless.…”

Nature and nurture in fussy eating from toddlerhood to early adolescence: findings from the Gemini twin cohort

“…However, the average trajectory scores never dipped below the initial starting average score, indicating children continued to display more food fussiness at 13 years old than they had at 16 months. Previous work also suggested fussy eating increases and then decreases between 7 -13 years, though fussy eating scores reached baseline levels at early adolescence, suggesting the need to explore this developmental period further (Carter Leno et al, 2022) .…”

“…Severe FF causes considerable caregiver anxiety, can disrupt family mealtimes (Wolstenholme et al, 2019) and challenges family dynamics (Zucker et al, 2015). Some epidemiological research has also linked food fussiness in childhood with increased risk for disordered eating in adolescence and young adulthood (Carter Leno et al, 2022;McClelland et al, 2020). Excessive selective eating can be a key symptom of avoidant and restrictive food intake disorder (ARFID), a relatively recently recognised eating disorder included in the DSM-5 (Zimmerman & Fisher, 2017).…”

Clinical Reflections and Treatment Adaptations for Avoidant Restrictive Food Intake Disorder: A Case Study

“…Research consistently demonstrates that ARFID, along with other eating disorders, is highly comorbid with autism (Feillet et al, 2019; Carter Leno et al, 2022). Autism is a neurodevelopmental condition, present from birth, that is characterised by difficulties with social interaction and communication, differences in sensory processing and restricted and/or repetitive behaviours (American Psychiatric Association, 2013).…”