Q. I’ve recently heard that some girls with anorexia nervosa may have autistic traits as well. Is there any truth to this? (GM, Boise)

A. Cambridge University researchers reported that a group of female adolescents with anorexia nervosa had elevated scores on two measures of autistic traits, the Autism Spectrum Quotient and the Systemizing Quotient (Molecular Autism 2013; 4:24). Dr. Simon Baron-Cohen and his colleagues studied two groups: 66 female adolescents 12 to 18 years of age with diagnoses of AN and 1,609 female adolescents 12 to 15 years of age who did not have diagnoses of AN.

According to the authors, there are several reasons for considering that anorexia and autistic traits may be linked. AN involves rigid attitudes and behavior, which resembles the unusually narrow interests and rigid and repetitive behavior noted in autism. AN patients are often extremely self-preoccupied about their own weight or their right to do what they want—the word “autism” literally means an exclusive focus on the “self.” The authors note that in terms of “cognitive types,” their results showed that patients with AN were significantly more likely to systematize rather than empathize (Type S on the Autism Spectrum Quotient). The Type S profile could also reflect below-average empathy; in the case of AN this may be shown by an above-average preoccupation with the self (body shape, weight, appearance) rather than consideration of the thoughts and feelings of others.   The authors note that in addition to weight recovery for anorexic patients, it might also be useful to shift the focus of intervention away from the battle over weight and toward helping these patients recognize they have a mind that is more attracted to systems and less to emotion. This may help them develop useful coping strategies targeting individual cognitive styles (as is used in cognitive remediation therapy).