Camouflaging, not sensory processing or autistic identity, predicts eating disorder symptoms in autistic adults

• Published in: Autism : the international journal of research and practice 2024-11, Vol.28 (11), p.2858-2868
• Main Authors: Bradley, Siofra, Moore, Fhionna, Duffy, Fiona, Clark, Lili, Suratwala, Tasha, Knightsmith, Pooky, Gillespie-Smith, Karri
• Format: Article
• Language: English
• Subjects: Autism; Autistic adults; Community organizations; Eating behavior; Eating disorders; Health services; Masking; Multiple symptoms; Original; Questionnaires; Sensory perception; Sensory processes; Sensory stimulation; Social identity
• ISSN: 1362-3613; 1461-7005; 1461-7005
• DOI: 10.1177/13623613241245749

The objective of this study was to explore the role that Autistic identity, sensory processing and camouflaging behaviours have on eating disorder symptomology in Autistic adults. Previous research has focused on cognitive and sensory factors to explain the association between autism and eating disorders, but the roles of social identity and camouflaging are yet to be explored. Autistic participants (N = 180) were recruited from NHS settings and community groups. The participants completed online questionnaires measuring autistic identity, camouflaging behaviours, sensory processing, autistic traits and eating disorder symptoms. Multiple regression revealed that camouflaging significantly predicted eating disorder symptoms. Although sensory processing was related, it did not significantly predict eating disorder symptom severity. In addition, there was no significant relationship between autistic identity and eating disorder symptom severity. This study highlights the impact that camouflaging behaviours and sensory processing can have on eating disorder symptomatology in autism and may indicate important considerations for the treatment of eating disorders in Autistic people. Lay Abstract This study aimed to explore the impact of Autistic identity (i.e. feeling like you belong to the Autistic community), sensory profiles (e.g. being over or under responsive to sensations) and camouflaging behaviours (i.e. masking) on eating disorder symptoms in Autistic adults. 180 Autistic people were recruited from the community and NHS. The Autistic people completed online questionnaires measuring Autistic identity, sensory profiles, camouflaging behaviours, autistic traits and eating disorder symptoms. The analysis showed that higher levels of camouflaging behaviour predicted higher levels of eating disorder symptoms. Sensory profiles were related to but did not predict eating disorder symptoms and there was no relationship between level of Autistic identity and eating disorder symptoms. This shows that camouflaging is the most important predictor of eating disorder symptoms in Autistic people, and warrants further exploration.