Understanding the autistic experience of restrictive eating disorders – a systematic review and qualitative-synthesis

TY - JOUR

T1 - Understanding the autistic experience of restrictive eating disorders – a systematic review and qualitative-synthesis

AU - Loomes, Rachel

AU - Chivers, Katy

AU - Georgeaux-Healy, Chloé

AU - Mandy, Will

AU - Jewell, Tom

N1 - Publisher Copyright: © 2025 The Author(s). European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.

PY - 2025/7

Y1 - 2025/7

N2 - Objective: To synthesise qualitative findings on the autistic experience of restrictive eating disorders in order to identify common themes and use this to inform future research on the development of more effective care. Method: This systematic review was pre-registered on PROSPERO (CRD42023434116) and followed PRISMA guidelines. CINAHL, PsycINFO, Medline, Embase, Web of Science and Global Health databases were searched. Studies were included if they contained qualitative data detailing the autistic experience of restrictive eating disorders from autistic people, carers or healthcare professionals. The Critical Appraisal Skills Programme was used to assess quality of studies. Recurring themes were identified via thematic synthesis. Results: Nine studies met the inclusion criteria, all focused on anorexia nervosa. Four themes arose from the analysis: (1) the relationship between autism and restrictive eating; (2) the journey to self-understanding; (3) experience of eating disorder services; (4) suggested treatment adaptations. Conclusion: Findings suggest a broad range of mechanisms underlying the development and perpetuation of anorexia nervosa that are related to autism and are not consistently acknowledged and addressed in current care provision. This emphasises the need for more research into developing adapted or novel interventions for autistic people with eating disorders, as well as training programmes for clinicians.

AB - Objective: To synthesise qualitative findings on the autistic experience of restrictive eating disorders in order to identify common themes and use this to inform future research on the development of more effective care. Method: This systematic review was pre-registered on PROSPERO (CRD42023434116) and followed PRISMA guidelines. CINAHL, PsycINFO, Medline, Embase, Web of Science and Global Health databases were searched. Studies were included if they contained qualitative data detailing the autistic experience of restrictive eating disorders from autistic people, carers or healthcare professionals. The Critical Appraisal Skills Programme was used to assess quality of studies. Recurring themes were identified via thematic synthesis. Results: Nine studies met the inclusion criteria, all focused on anorexia nervosa. Four themes arose from the analysis: (1) the relationship between autism and restrictive eating; (2) the journey to self-understanding; (3) experience of eating disorder services; (4) suggested treatment adaptations. Conclusion: Findings suggest a broad range of mechanisms underlying the development and perpetuation of anorexia nervosa that are related to autism and are not consistently acknowledged and addressed in current care provision. This emphasises the need for more research into developing adapted or novel interventions for autistic people with eating disorders, as well as training programmes for clinicians.

UR - https://www.scopus.com/pages/publications/86000078895

U2 - 10.1002/erv.3181

DO - 10.1002/erv.3181

M3 - Review article

SN - 1072-4133

VL - 33

SP - 800

EP - 814

JO - European Eating Disorders Review

JF - European Eating Disorders Review

IS - 4

ER -