Eating and feeding disorders in adults with intellectual developmental disorder with and without autism spectrum disorder.
One in four adults with ID/IDD binge-eats, and autism doubles the rate—so watch for visible mealtime red flags even when clients can’t speak.
01Research in Context
What this study did
Bertelli et al. (2025) asked 206 adults with intellectual disability about eating problems. Staff who knew them well filled in a checklist of observable signs like stealing food, eating until sick, or hiding wrappers.
Half of the group also had autism. No one had to describe feelings; the team scored only what could be seen.
What they found
Almost one in four adults had binge-eating disorder. When autism was present, every eating problem showed up twice as often.
Anorexia and bulimia were less common, but still higher than in the general public.
How this fits with other research
Mulder et al. (2020) already showed that adults with autism alone carry extra eating-disorder risk. O et al. widen the lens: the risk stays high when ID is in the mix.
Efrosini (2004) told us to watch mealtime behavior in ID, but gave no numbers. O et al. answer with hard counts—22.8% binge eating—turning an old call-to-action into today’s caseload.
Simeon et al. (2025) scoped 61 tiny treatment studies and found the evidence “thin.” O et al. now show the problem is large; the gap between need and proof has widened.
Why it matters
You now know that every fourth adult with ID/IDD may binge. Add autism and the odds double. Start every assessment with a quick staff interview: food stealing, rapid eating, hidden stash. No self-report needed. If signs appear, refer for medical and behavioral evaluation—early action can prevent obesity, choking, and aspiration.
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02At a glance
03Original abstract
BACKGROUND: The present observational cross-sectional study aimed at investigating the prevalence of feeding and eating disorders (FEEDs) in adults with intellectual disability (ID)/intellectual developmental disorder (IDD) with or without autism spectrum disorder (ASD) and specific problem behaviours (PBs). METHODS: Two hundred six adults with ID/IDD consecutively attending residential and rehabilitative facilities, 59.2% of which had co-occurring ASD, were assessed for presence of FEEDs by a structured interview specifically developed for the study and Diagnostic Manual - Intellectual Disability criteria. RESULTS: The 4.3% of the sample fully met the diagnostic criteria for anorexia nervosa, 6.7% for bulimia nervosa (BN) and 22.8% for binge eating disorder (BED). Furthermore, at least one observable symptom of these disorders was found in higher percentages of the sample. A higher prevalence of FEEDs was found in ID/IDD plus ASD than in ID/IDD alone. PBs were also significantly higher in participants with co-occurring ASD and had a positive correlation with the number of FEED symptoms, especially for BN and BED. CONCLUSIONS: The study enriches previous literature and considers novel aspects such as the behavioural/observable presentation of symptoms as well as the association with ASD and PBs. These issues deserve a specific consideration within standard psychiatric assessment and future research, especially in persons with major communication and/or cognitive difficulties.
Journal of intellectual disability research : JIDR, 2025 · doi:10.1111/jir.13195