Elevating the Discourse on the Comorbidity and Treatment of Eating Disorders and Autism Spectrum Disorder: Commentary on Inal-Kaleli et al. and Nimbley et al.

Abstract

Two recent review papers published in the International Journal of Eating Disorders have considerably elevated the rigor of scholarship on the comorbidity between autism spectrum disorder (ASD) and eating disorders. One paper reported that more than one-quarter of individuals with acute anorexia nervosa also have ASD, and that autistic traits are positively correlated with eating disorder psychopathology. The other paper reported that, compared to individuals with low autistic traits, those with high autistic traits report poorer experiences of eating disorder treatment, despite similar treatment outcomes. While both papers make excellent points, in this commentary we highlight important challenges in the assessment of ASD that may artificially inflate its prevalence in the context of disordered eating. We then caution the field against completely discarding evidence-based eating disorder treatments in the setting of comorbid ASD. Finally, we offer recommendations for future research to determine when and how eating disorder treatments should be modified to accommodate neurodiversity.