The Relationship Between Interoception, Alexithymia, Autistic Traits and Eating Pathology in Autistic Adults

This study investigated the mechanisms underlying disordered eating of autistic adults, by investigating associations between eating disorder (ED) symptoms and autistic traits; autism-specific atypical eating; alexithymia; interoception; and body image in autistic and non-autistic participants. Autistic adults (n = 196) and non-autistic adults (n = 206) completed online self-report measures assessing ED pathology, atypical eating, body image dissatisfaction, interoception, alexithymia, and autistic traits. Structural Equation Modelling tested a theoretical model of the relationships between these variables, and whether these relationships were moderated by autism diagnosis. Autistic adults self-reported higher ED pathology than non-autistic adults. The proposed model and the strength of the relationship between body image and ED pathology did not differ between the autistic and non-autistic groups. Atypical eating (not related to over-evaluation of weight/shape), however, was only associated with ED pathology in the autistic group. Both traditional and additional factors, including eating disturbances not driven by weight/shape concern, appear to contribute to ED pathology in autism.