Viliam Tomljenovic

Teaching Institute of Public Health, Croatia

Anorexia Nervosa in an Adolescent with Autism Spectrum Disorder: A Clinical Case and Literature Review

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Biography

Viliam Tomljenovi? is a medical doctor working at the Department of School and Adolescent Medicine at the Teaching Institute of Public Health "Dr. Andrija Štampar" in Zagreb. He graduated from the University of Zagreb School of Medicine and is currently engaged in preventive care for school and university population. His professional interests include scientific research in public and adolescent health.

Abstract

ABSTRACT

Eating disorders are serious psychiatric conditions frequently emerging in childhood and adolescence, with increasing incidence rates globally. Among these, anorexia nervosa is characterized by severe caloric restriction and significant weight loss, often presenting in restrictive and binge-purge subtypes. Comorbidity with autism spectrum disorder (ASD) complicates clinical presentation and management, as patients with ASD exhibit selective eating behaviors, sensory sensitivities, and rigid cognitive patterns that may predispose them to disordered eating. This case report details the clinical course of a 13-year-old girl with early childhood-diagnosed ASD who developed an eating disorder consistent with anorexia nervosa, initially presenting with restrictive symptoms and later progressing to purging behaviors. The patient’s developmental history included delayed speech, social difficulties, and sensory sensitivities, consistent with ASD, and her eating disorder symptoms emerged amidst academic and social stressors. Multidisciplinary management involved pediatricians, psychiatrists, psychologists, and nutritionists, with nutritional rehabilitation complicated by food refusal and the need for nasogastric tube feeding. Pharmacotherapy with low-dose risperidone was introduced during clinical deterioration, addressing behavioral rigidity and severe food refusal. Despite partial weight restoration and improved oral intake, persistent socio-emotional difficulties and cognitive impairments necessitated individualized educational accommodations. The case illustrates the dynamic and fluid nature of eating disorder phenotypes in pediatric patients, especially those with ASD comorbidity, and highlights the absence of standardized treatment protocols for this complex dual diagnosis. Early identification, comprehensive multidisciplinary intervention, and active family involvement are critical for improving clinical outcomes. Further research is needed to develop evidence-based guidelines to guide care for patients with co-occurring ASD and eating disorders, addressing both medical and psychosocial dimensions of these challenging cases.

Keywords: Eating disorders, autism spectrum disorder, anorexia nervosa, pediatric psychiatry, multidisciplinary care