Tuesday, 13 July 2010
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Is anorexia nervosa the “female form of Asperger’s?”
Name two medical conditions that have increased in prevalence and media coverage over the last decade, pose many unanswered questions, and scare the hell out of parents. I’ll give you a hint: they both begin with the letter A.
Anorexia nervosa – an eating disorder characterized by self starvation and distorted body image – and Asperger’s syndrome – an autism spectrum disorder characterized by difficulties in social interaction, restricted and repetitive patterns of behavior and interests, and preserved linguistic and cognitive development – are being observed under the same diagnostic microscopes. The findings have shocked both the medical and psychological fields.
Remember the whole Nature vs. Nurture debate you learned about in high school science textbooks? Well, recent studies are suggesting a new approach to the debacle: a compromise.
A Swedish study (2002), an Australian study (2004), and an Israeli study (2006) have concluded that the main risk factors for autism arise during the perinatal period, which spans five months before and one month after birth. Autism was more prevalent in children whose births were induced; who were born with a low Apgar score (numerical summary of infant’s condition at birth); and who had experienced fetal distress, c-section, and/or other birth complications. Pre-natal distinctions – such as head circumference maternal diabetes, being a twin, or season of birth – and post-natal characteristics –vaccinations or bottle vs. breast feeding – did not show the significant effects on risk of autism that the perinatal conditions did.
Numerous studies have also included that the development of anorexia nervosa, like autism, is most likely related to perinatal conditions and complications. A large Swedish study (1999), which assessed the birth records of all girls born in Sweden from 1973 to 1984 and of the 781 girls between the ages of 10 and 21 who were hospitalized due to anorexia nervosa, concluded that forceps (tong-like instruments used to grasp the baby’s head) and ventouse (vacuum device) deliveries were noteworthy risk factors for anorexia. A cephalohematoma (collection of blood under the scalp of a newborn) at birth was the most significant risk factor. These factors all take place in the perinatal period. An Italian retrospective study (2006) showed results that were consistent with those of the Swedish study: anorexia nervosa and obstetric complications in the perinatal period showed significant correlations.
Oxytocin – a hormone involved in social recognition, bonding, sexual arousal and reproductive behaviors, release of stress and anxiety, and formation of trust between people – is known to be low in sufferers of both anorexia and autism. Many researchers suggest that this similarity is not a coincidence and again point to the perinatal period, a time when the oxytocin system is challenged and matured.
The “perinatal complication” comparison is not the only similarity between the two conditions. In 2007, Asperger’s syndrome expert Tony Attwood reported that between 18% and 23% of teenage anorexics meet some or all of the diagnostic criteria for Asperger’s syndrome. Dr. Janet Treasure, a researcher who specializes in eating disorders, stated “People with eating disorders find it difficult to change self-set rules… They also see the world in close-up detail, but this can be at the cost of having an ability to see and think about self-identity and connections with others… We also discovered that this distorted pattern of processing information has a strong similarity to autistic spectrums.”
Similar symptoms of anorexia and autistic spectrum disorders include:
-Fixation on detail; becoming distracted; missing the big picture
-Obsessive or compulsive behavior
-A need for perfection
-Difficulty with multitasking or switching between tasks or ideas
-Lack of flexibility in thoughts and responses; difficulty in coping with change
-Atypical eating behaviors (food preparation routines; refusing to eat certain foods)
-In some cases, ritualized or extreme exercise regimens
Some researchers are skeptic, others are completely convinced, and some don’t know what to think at all. Is anorexia nervosa the “female form of Asperger’s?” Or are researchers and psychotherapists over-analyzing in a desperate attempt to answer the unanswerable? It seems that the Nature vs. Nurture debate has new company.
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About the Author
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- From: lisastef@healthkicker
- Name: lisa
- About Me: if presented with a bowl of fortune cookies, i will open them until i get the fortune that i feel is most appropriate to my life. if presented with a computer, i will blog the hell out of it. i love writing & consider. i'm usually pretty funny, but if not, i'm at least fun to make fun of. if presented with a yoga mat, i will transform into a modern-day, female buddha. just kidding, but i am an avid "yogi" and spend about as much time on a yoga mat as i do on regular flooring. things i will never understand: bridges, the economy, & people who don't say thank you when you hold the door for them. things i hate: both the grenade horn & the "you're hot" whistle. [i prefer the silence of physical mediocrity.] things i love: genuinely nice people, wine, dark chocolate, extra crunchy peanut butter, designing nike shox, strangers who smile, & really cool little kids who aren't obnoxious. things i know: people are weird. [i realize i'm included in this.]
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Comments (42)
I've never thought about this before. I was borderline Anorexic for awhile and have battled Bulimia to a far greater extent, and I am pretty sure I am at least a little bit Asperger's.
It makes a lot of sense, the rigid behavior. Seems like anorexia could in part be a coping mechanism for dealing with social incompetence; might have been for me. Do you think you may have it as well?
I wouldn't call it the female form, since there are some guys who have dealt with anorexia and I know at least a dozen women with Aspergers who have no sort of eating disorder at all... at least not connected to self-perception. Personally, I can forget to eat simply because I don't recognize my own hunger cues until they are screaming at me. I am only moderately concerned by my looks, but any issues with weight are tied to health... I am actually about 15-20 lbs overweight... but that is not according to how I look, it is according to charts that give aproximate weight to height ratios and the scale. It's also tied to the fact that it has become increasingly difficult to do some things that before I gained this weight, I had no trouble doing.
If you're looking for a conclusion, you're going to arrive at it...
moon_on_a_string@xanga said it best. If you want to be taken seriously then its important to quote research papers. Tony Attwood is an Asperger's expert, other than at his clinic where he may see people who also have anorexia, he doesn't appear to have any connection at all with people with this disease.
But if we are talking empirically, then of the five people I know well who have had or have now anorexia, all of them are very social and popular women, no Asperger's there.
btw I think you should have said that your source for the title came from here.
Thank you for sharing, I found this to be extremely interesting. After reading this I can see the similarities between Anorexia and Aspergers. But I do not believe that being Anorexic means you are Aspergers. I would like to research more this concept of the Oxytocin and the perinatal complication theory. We may be onto something with it. I post blogs on http://www.MySpeechTherapyCenter.com about communication welleness and awareness. Feel free to visit our site!
Hey! Great blog. Can you please upload the links to these studies? I am working on my masters in neuroscience, and we just spent a semester talking about Asperger's and other mental disabilities. I am a Physical Education teacher, I would find it really helpful if I could read these articles especially for when I am working on my thesis. Thanks!!
I never thought of it that way...
wow really interesting post. thanks for all the info
...Female form?
There are plenty of males who suffer from Anorexia.
But you do make great points. It's never been pointed out to me in this aspect.
@Nawnaa@xanga - But the female-to-male ratio for Anorexia Nervosa is very high, as is the male-to-female ratio for Asperger's Syndrome.
Please link us to the studies you referred to.
Well, I'm an Aspergers Autistic woman who definitely, positively does not have anorexia nervosa.
I've heard that there may be a link in some cases, to some people, but the evidence suggests that the incidence is only nominally higher than the general population. Without being able to view the studies you've referenced, I'd chalk this up to "post hoc, ergo propter hoc" and "more research is needed".
...............what?
Males and females both suffer from anorexia nervosa AND aspergers, some simultaneously, I'm sure. they're not mutually exclusive.
sounds like there's a good point here but from my own experience these causes do not corolate.
I was born at home with nothing like foreups were used.
@explosive@xanga - Exactly....I guess this rubbish is what passes for content nowadays.
@Uek@xanga - I usually like her blogs, I don't know what happened here.
I don't agree at all. I have anorexia nervosa, and i have also met people with aspbergers. I really don't know where people are getting this. People with anorexia can understand emotions, and many, when have proper nutrition, are very personable. Also, anorexia is not a female disorder. Sure, there are more females diagnosed with anorexia. 1 in 10 sufferes are men. I suspect that men are underdiagnosed when it comes to anorexia, because of the shame and lack of understanding by doctors.
As everyone else has stated, you can't say it's a "female form" of Asperger's since women get Asperger's and men can be anorexic. Stating it the way this post does will mean that only men get Asperger's while women get anorexia. And it's not that simple.
I think the main difference between the two is the feeling that what they are doing is wrong. In other words, people with Asperger's aren't really aware that their rituals and habits are weird. They don't realize that the normal person doesn't do that stuff. They don't understand what they may have done wrong if getting into a fight with someone. They honestly just don't understand social rules and how to conduct themselves with other people.
With anorexics, it's different. They know that what they are doing is wrong. That's why they try to hide it. If they didn't feel that their rituals and whatnot were wrong, they wouldn't come up with excuses and lies for it. If it were really Asperger's, they wouldn't realize that their habits were so different from everyone elses.
This was an interesting post though. Makes one think.
@zretrareo27@xanga - I agree, you brought up a lot of good points.
Schizophrenia may also be a result of perinatal conditions, although granted, the symptoms are different than Asperger's and Autism. However, because the symptoms between anorexia and Asperger's are similar does not mean they are similar disorders, and unless a molecular link can be proven to cause both, it should not be linked together.
Also, I could be mistaken, but I was under the impression that there is a closer link between depression and anorexia nervosa since both may involve serotonin levels. Interestingly, some of the bulleted points could sound like symptoms of depression.
Um, definitely an interesting perspective. I'm fourth year recovery and this is a little hard to swallow.. Though it's funny, I meet criteria for sure. Very interesting similarities. Thanks for sharing.
wow..This was very educational for me! and I read everything.. Did you find any of those studies to be in conclusion with your personal experience with AN? ..the perinatal part, etc.. I don't believe the studies are extensive enought.. I consider too..that anorexia can come on to someone who is in their 30, 40, etc... and I see it as a mental illness that manifests into a vicious cycle.. depression...starving, obsessing, starving causing depression and depression causing the starving rituals, etc... it is complex indeed.. Anorexia has always been a huge interest of study for me.I have never had it.. but maintain a healthy weight though I have been extreme with exercise and diet etc.. to lose weight. And I surely have behaviours, patterns of someone with an ED, but just never got underweight yet. no B/P'ing for me though.. thank god. I wish you well with your studies at Penn State. I live in PA too. nice to meet you.
xoxoxoxo
oh ..and folks, She is not here saying that someone who has Asberger's also has Anorerxia. The studies were comparing the two different diseases and the people who have them. She is stating the similarities found in the brains of those who have these conditions, according to some studies done...and possible perinatal causes .
I understand the similarities, but it's not a female vs. male thing since both conditions occur in both sexes.
I can attest to the perinatal complications leading to AN... I am anorexic and was born using a ventouse. although I'm not at all autistic. still, pretty crazy for me to read. I can't believe that could be part of the cause for my ED!