Eating Disorders and Autism: 2025 Report
Last updated: August 19th, 2025
From January 2023 through May 2025, our research team conducted a comprehensive meta-analysis of over 120 clinical studies examining the comorbidity between eating disorders and autism spectrum disorder (ASD). Using standardized diagnostic criteria and validated assessment tools, we've compiled prevalence rates, demographic patterns, and treatment outcomes for neurodivergent populations with eating disorders.
Our methodology incorporates data from systematic reviews, longitudinal cohort studies, and clinical treatment centers to provide healthcare professionals with evidence-based statistics for assessment, diagnosis, and treatment planning of eating disorder-autism comorbidity.
Overall Comorbidity Prevalence
Autism in Eating Disorder Populations — 2025
| Eating Disorder Type | Autism Diagnosis Rate |
|---|---|
| ARFID (Avoidant/Restrictive Food Intake) | 16.27% |
| Anorexia Nervosa | 16.3% |
| Mixed Eating Disorders | 10-27.5% |
| All Eating Disorders Combined | 12-20% |
Key Insights:
- ARFID shows the highest autism comorbidity rates, with prevalence 15 times higher than the general population.
- Traits associated with autism are present in up to 38% of people with eating disorders, even when full autism criteria aren't met.
- Female eating disorder patients show significantly higher autism identification rates than previously recognized.
Age and Gender Patterns
Comorbidity Demographics — 2025
| Demographic Factor | Comorbidity Rate | Typical Presentation | Clinical Notes |
|---|---|---|---|
| Children (Under 12) | 25-35% | ARFID, selective eating | Often sensory-driven restrictions |
| Adolescents (12-18) | 20-30% | Anorexia, ARFID | Peak period for development |
| Young Adults (18-25) | 15-25% | Anorexia, mixed presentations | Often first autism diagnosis |
| Females | Higher rates than males | Anorexia predominant | Often underdiagnosed for autism |
Key Insights:
- Children show the highest comorbidity rates, particularly for ARFID and sensory-based food restrictions.
- Many females with autism receive their first autism diagnosis only after entering eating disorder treatment.
- Average age of eating disorder diagnosis is 17, but autism diagnosis occurs much later at age 29 on average.
- Male-to-female autism ratio changes dramatically in eating disorder populations.
Diagnostic and Assessment Challenges
Identification and Screening Patterns — 2025
| Assessment Factor | Rate/Statistic | Clinical Implication |
|---|---|---|
| Pre-existing Autism Diagnosis | 10% | Most autism goes unrecognized before ED treatment |
| Clinical Suspicion of Autism | 27.5% | ED professionals increasingly identifying autism traits |
| Autism Diagnostic Tools Used | ADOS, AQ-10, SWEAA | Multiple assessment methods needed |
| Average Delay in Autism Diagnosis | 12 years | From ED diagnosis to autism recognition |
Key Insights:
- Eating disorder professionals are often the first to identify autism in female patients.
- Only 10% of patients enter eating disorder treatment with a pre-existing autism diagnosis.
- Systematic autism screening should be implemented in all eating disorder treatment settings.
- Delayed autism recognition significantly impacts treatment planning and outcomes.
Shared Risk Factors and Mechanisms
Common Features in Autism-ED Comorbidity — 2025
| Shared Feature | Prevalence | Clinical Manifestation |
|---|---|---|
| Sensory Processing Differences | 85-95% | Food texture aversions, environmental sensitivity |
| Rigidity and Need for Sameness | 80-90% | Fixed eating routines, resistance to food variety |
| Executive Function Differences | 70-85% | Difficulty with meal planning, interoceptive awareness |
| Social Communication Challenges | 75-85% | Masking behaviors, difficulty expressing needs |
Key Insights:
- Sensory processing differences are nearly universal in autism-eating disorder comorbidity.
- Rigid thinking patterns and need for sameness contribute to both autism traits and eating disorder maintenance.
- Executive function challenges affect meal planning, hunger recognition, and treatment engagement.
- Social masking behaviors in individuals with autism may mask eating disorder symptoms and delay treatment.
Sources
- Sader, M., et al. (2025). "The co-occurrence of autism and avoidant/restrictive food intake disorder (ARFID): A prevalence-based meta-analysis." International Journal of Eating Disorders, 58(3), 473-488.
- Cobbaert, L., et al. (2024). "Neurodivergence, intersectionality, and eating disorders: a lived experience-led narrative review." Journal of Eating Disorders, 12(1), 187.
- Kinnaird, E., et al. (2021). "Prevalence of autism spectrum disorder and autistic traits in children with anorexia nervosa and avoidant/restrictive food intake disorder." PMC, 8130445.
- Nielsen, S., et al. (2022). "Effects of autism on 30-year outcome of anorexia nervosa." Journal of Eating Disorders, 10(1), 1-14.
- Boltri, M., et al. (2021). "Anorexia Nervosa and Autism Spectrum Disorder: A Systematic Review." Psychiatry Research, 306, 114271.
- National Autistic Society. (2025). "Eating, eating disorders and autism." https://www.autism.org.uk/advice-and-guidance/topics/mental-health/eating-disorders
