Anorexia as the “Female Asperger’s”
“Is anorexia the female Asperger’s?” asks Janet Treasure, Professor of Psychiatry at King’s College, London, and head of the Eating Disorders Unit at the South London and Maudsley NHS Trust, in the August 17th Times Online. Noting that “we now realise is that we need to be looking at underlying neural networks in the brain – how patterns of information are processed, how this affects both behaviour and the way an individual reacts to her environment, and why this goes wrong,” she notes these similarities:
- A “distorted pattern of processing information”: Treasure notes that those with eating disorders find it difficult “to change self-set rules and learnt behaviour once fixed in the brain” and “see the world in close-up detail,” and perhaps ” at the cost of having an ability to see and think about self-identity and connections with others without getting lost in the details.”
- Obsessive-compulsive disorder or overperfectionism.
- “Cognitive inflexibility” or difficulties in “set shifting”—in the capacity to “shift back and forth between different tasks or mindsets”
- Weak central coherence, which Treasure defines as “as a bias towards the local processing of information rather than placing it into a broader context”
The similiarities between anorexia and Asperger’s that Treasure ntoes seem to emphasize obsessiveness on and even a preference for certain (small) things, and also a difficulty with “switching” one’s brain and focus from activity to activity—though, there is much more to autism than these, such as different sensory processing, and difficulties in using and understanding language.
At the basis of Treasure’s theory about anorexia as “the female Asperger’s” is a belief that anorexia is genetic: Not too long ago, the conventional view was that one “got” an eating disorder from strictly cultural factors, such as society’s pressure on women to be thin and the (misguided) equating of beauty with thinness. The view that anorexia and eating disorders are genetic—as discussed in a 2005 Newsweek article on the biology of anorexia—is regarded with controversy. Somewhat in contrast, the belief that autism is genetic has been regarded as more of a “conventional” view, while those who champion the view that autism is caused by an environmental or other external factor see themselves as promoting a novel theory of autism. (Of course, cultural factors—such as bad parenting—were wrongly considered a cause of autism in the past.)
Interestingly, a study Treasure cites found not only that (1) the same kind of “weak central coherence” in those with anorexia as in those with autism and Asperger’s, but also that (2) that “more than 20 per cent of the anorexic group could be described as having a disorder from within the autism spectrum.” I am curious as to what criteria to define “a disorder from within the autism spectrum” are being looked at. And, in her article, Treasure does not specifically cite any girls or women with Asperger’s, though it seems that they ought to be included in any discussion of the “female Asperger’s”—whether autism is different in girls being itself a topic that more and more research is turning to.
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POSTED IN: Anorexia, Asperger's Syndrome, Gender, Genetics, Health, Psychology
13 opinions for Anorexia as the “Female Asperger’s”
Marcie
Aug 17, 2007 at 9:04 am
I guess people have gotten tired of talking about gut issues from one and are going for the other end (i.e. end of body).
This is so ridiculous - and possibly harmful as it doesn’t realize that there are other reason why an autistic person might be starving, such as the inability to recognize when one is hungrey and problems getting coordinated enough to get something to eat.
Kristina Chew, PhD
Aug 17, 2007 at 9:12 am
I think those things happen to Charlie sometimes—also, he doens’t always think to ask for food when he is hungry but gets anxious etc. and is not able to explain why.
mcewen
Aug 17, 2007 at 9:45 am
I certainly think that for both of my boys, ‘eating’ is just not important when compared with other activities.
Best wishes
Leanne
Aug 17, 2007 at 10:09 am
We have an opposite but still simillar problem. Patrick doesn’t know when he’s full.
Do you often see women who are anorexic having family members with anorexia? I’ve never seen that myself. Or are they talking more about a genetic mutation?
Kristina Chew, PhD
Aug 17, 2007 at 10:14 am
Ah, the continuing “neophobia’ issue!
Laura Collins
Aug 17, 2007 at 12:02 pm
The environment/gene question is often misunderstood in eating disorders, as it used to be more often with autism. The reason it matters, and the reason people like me keep bringing up the genetic side of things is that parents are still being blamed for their actions and omissions as if they “caused” the eating disorder. Patients are still held responsible for their illness and told to “get control” of the symptoms through force of will.
The intersections between autism spectrum and EDs, as well as other brain-based conditions, are many. I really believe that better understanding of the mechanisms of one will lead to better understanding of the others.
But as of now, it is still hard to get people off the “blame the victim” and “blame mommy” and get on with really helping people. The NIMH and most modern researchers understand EDs are brain disorders, but too much of the rest of the world resists this.
Kev
Aug 17, 2007 at 2:23 pm
This is very interesting. I can see why its an attractive hypothesis. Lets hope the science makes things clearer.
laurentius-rex
Aug 17, 2007 at 2:34 pm
The problem is that people believe that academics observe a scientific paradigm, they do not.
Who is the royal we, that this “treasure” of pyschiatry speaks, without validating one jot her use of convention within the English language, unaware of the cultural and social precedents of her own language, never mind the neurological substrates that gave origin to her own utterance.
Tis all like Searles Chinese room, the academic being but a mechanism which understands not why it does what it does :)
TheASMan
Aug 17, 2007 at 3:06 pm
As for the observation about not seeing anorexia in other women in the family with it, doesnt really hold much water per se. It is easy to say. I hear this all the time with autism. Unsupported observation is neither science nor a fact.
I have seen many autistics overweight. Usually they are living in an environment that reminds them of the time to eat and I am sure given our culture of fatty food and over sized portions, to eat plenty.
Regan
Aug 17, 2007 at 3:55 pm
Well, not to upset the apple cart, I don’t think that this is conclusive, but I had anorexia and bulimia when in HS and college, and one of my children does now. The child officially diagnosed with an ASD does not have an ED, and neither eats too much nor too little–she self-regulates very well at this time. The child with anorexia has not been officially diagnosed with Asperger’s but it was strongly suggested earlier in her life; she herself rejected the possibility and I respected her wishes.
In ED as well as ASD I have no doubt that there are common AND highly individual experiences. I can say that compared to ASD in our family that anorexia is more difficult and similar–complicated by rigid distorted thinking, some compulsive behavior and sensory disturbances. One obvious contribution is lack of nutrition which we have to work very hard to overcome and is definitely correlated with cognitive function, esp. until a minimum BMI has been met. There is also a definite environmental contribution in our case (I have a bone to pick with teen magazines,TV and the current plethora of no-cal foods) as well as some unexpected contributions in re: particular types of counseling. I have some insight because of my experiences, but there are distinct differences because my daughter and I are in different circumstances.
In essence this sprung out of the blue for our former athlete daughter, who two summers ago got the ball rolling with the desire to take off a “couple pounds” and “a few extra laps”, leading to exercise-induced anorexia and increasing restriction of food. But prior to that she had tendencies to perfectionism, and rigidity…now exagerated in the ED.
If you haven’t gone through this personally or haven’t had a family member go through this, I would reserve judgement in the opposite direction. I have had bipolar, schizophrenic, autistic relatives. If there is an identifiable genetic trigger or underlying brain disorder, I would like to know more about it. Certainly better treatment options than the “talking therapies” blaming family members, prescribing anti-psychotics (a disaster), or “giving control of the menu to the person with the ED” (for us another disaster) would be welcome. We currently are using Maudsley and refeeding.
Kristina Chew, PhD
Aug 17, 2007 at 8:27 pm
Perhaps it would be helpful to think not so much about the eating behaviors and difficulties with them in anorexia and eating disorder, but why they occur. ANRED suggests genetics, a link between stress and over-eating, brain “maturation/impairment” as possible causes.
Hope your daughter is ok, Regan.
Another way in which I’ve noted connections of a sort between eating disorders and autism is precisely the issue of mother blame.
Aidoann
Aug 17, 2007 at 11:11 pm
Unfortunately, it seems like the society wants to blame the parents for everything now-a-days.
What about the autistic people who are overweight? It seems like the majority of autistic people are on the heavier side (anywhere from a couple pounds above average to obese), not under-weight.
Personally, don’t eat a lot except when my folks are around to remind me to eat. A lot of that has to do with sensory issues, I think, because I can eat when the room isn’t too loud or the food isn’t too sweet, but I can’t stand eating in a crowded room or using metal utensils (hooray for wooden chopsticks!). This makes eating at restuaraunts difficult sometimes.
Regan
Feb 23, 2008 at 8:36 pm
Kind of off-topic to autism, but possibly relevant to insurance, eating disorders, and the talking points of mental v. biological.
NJ lawsuit turning on information posted to the web.
MySpace, Facebook Pages Called Key to Dispute Over Insurance Coverage for Eating Disorders
http://www.law.com/jsp/article.jsp?id=1201779829458
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